Updated on: Monday, December 20, 2021, 11:39 AM IST

All about pre-existing conditions in health insurance policies


Insurance companies are very apprehensive about providing health insurance for people with pre-existing conditions. This is primarily because when someone has a pre-existing health condition, they have a higher probability of making a claim. This poses a relatively higher financial risk to the insurance company and hence they would load a higher premium for such people. In recent times, insurance companies have started being more considerate and applying more lenient norms while taking on customers with pre-existing health conditions, especially if details are fully declared and all information is provided with transparency. Read further to understand the role of pre-existing conditions health insurance policies:

What is a Pre-Existing Condition?

If an individual, looking for an insurance policy suffers from a medical condition before purchasing a health insurance policy, such a condition is termed as a pre-existing medical condition.

Points to Keep in Mind

The following are some points to keep in mind while purchasing health insurance policy with a pre-existing condition:

- Policies Differ from Insurer to Insurer

While some insurance providers investigate the applicant’s medical history, others do not consider medical history. While some insurance companies provide health insurance policies for pre-existing health conditions, others do not. The terms and conditions pertaining to the policy differ from insurer to insurer, so it is important to check with each insurer about what they have to offer.

- Every Doctor’s Visit is not Counted

Health insurance providers only take into consideration health ailments that have an impact on the insured in the long run. One should remember that every doctor’s visit will not be counted as a red flag, and one need not have to worry about the short-term ailments.

- Never Hide Pre-Existing Medical Conditions

While buying a health insurance policy, transparency is the key, and it is unwise to hide pre-existing medical conditions from the health insurance provider. If it is found later that such important information was kept away from the insurance provider, they could reject the claim.

- Pre-Existing Medical Conditions Are Covered

The reason most people hide their pre-existing conditions is that they are unaware that pre-existing ailments can be covered under health insurance policies after certain period of time. Health insurance policies for pre-existing illnesses by including a waiting period or excluding the pre-existing ailment for a certain duration. While other illnesses will be covered, during the waiting period, the insurance policy will not cover the cost of treatment, medicines, or doctor’s fees for the pre-existing health condition. These costs will be covered only when the waiting period is completed.

- Waiting Period is Flexible

Whether it is an individual health policy or a family floater health insurance policy, there is a specific waiting period that one must complete. The time duration of the waiting period may differ from insurer to insurer. While some insurance companies have a waiting period of 2 years, others have a waiting period that lasts up to 4 years. Now, one must remember that switching the insurance companies in between a waiting period is not wise since the completed years will not be counted. Some insurance companies cut down on the waiting period if the policyholder is willing to pay an extra premium

Buying a health insurance policy is no more an option. In today’s world, it has become a necessity to own health insurance to safeguard one from the financial crisis. It is important to disclose details about pre-existing conditions to avoid any issues or claim rejections in the future.

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Published on: Monday, December 20, 2021, 11:40 AM IST