BackWhat are waiting periods in health insurance policies?
Normally, the waiting periods are different for each disease/ailment/treatment and also depend on the specific benefits of the policy. To know the exact waiting period applicable on your policy, you must go through the policy wordings provided by the health insurer from whom you have purchased it.
PremiumWaiting period in health insurance is essentially the period during which you may not use the benefits of your health policy. It is calculated from the date your health policy is issued for the first time.
“Waiting periods are kept as part of the policy to prevent misuse of insurance and discourage people from filing unethical/fraudulent claims where a person who needs immediate hospitalization is taking a policy under false pretences," said Biresh Giri, appointed actuary, ACKO General Insurance.
Normally, the waiting periods are different for each disease/ailment/treatment and also depend on the specific benefits of the policy. To know the exact ‘waiting period’ applicable on your policy, you must go through the policy wordings provided by the health insurer from whom you have purchased the cover.
Health insurance policies usually have an ‘initial waiting period’ of about a month. What it means is that you cannot use any of your policy benefits for a month starting from the date your policy was issued. This is valid only for the first time you are buying a policy and doesn’t apply on policy renewals.
“Any hospitalization claims arising due to accidents do not apply to this clause and customers can avail the policy benefits for them," said Parag Ved, head - consumer lines, Tata AIG General Insurance.
To completely understand what ‘waiting period for pre-existing diseases’ means, you need to understand what insurers mean when they mention ‘pre-existing diseases (PED)’ in the policy.
The Insurance Regulatory and Development Authority of India (Irdai) has standardized the definition of PED across health insurance policies. A pre-existing disease refers to any condition, ailment, injury or disease that has been diagnosed up to 48 months before buying your health policy.
Some examples of pre-existing diseases include diabetes, hypertension, thyroid, etc. If you are already suffering from a PED, it is usually not covered by your health insurance immediately. There is a waiting period from the date of policy issuance after which you can use the policy benefits.
To prevent misuse of health policy, usually there’s a list of diseases that aren’t covered for a specific time period (waiting period) from the issuance of the policy. The waiting period may be different depending on the particular disease and benefits of the policy. There is usually a waiting period of 2-4 years for these diseases.
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