Most of us try to maintain a fit lifestyle and take necessary precautions to prevent illnesses and injuries. Notwithstanding our utmost endeavours, certain medical conditions may remain beyond our control; such health conditions are pre-existing diseases (PED). These ailments could be hereditary or a result of us leading a hectic and sedentary way of living. While it is essential to have insurance coverage for PED, policyholders must be aware of the waiting period associated with them.
What is Waiting Period?
A waiting period is a specific time in an insurance policy that must pass before the policyholder can receive benefits, such as cashless treatment. Waiting periods are a risk management tool employed by insurance companies to prevent policyholders from making immediate claims after obtaining a policy.
The duration of waiting periods can differ depending on the policy type and the benefits you claim. However, the exception to this clause is hospitalisation due to accidental injury. For example, if the policyholder sustains an injury while riding a bike or gets hit by another vehicle, the insurer will reimburse the treatment expenses.
What are the Waiting Periods for Pre-existing Conditions?
- A pre-existing condition is a medical issue or illness that exists before the policy purchase date.
- Insurance policies come with waiting periods for pre-existing conditions; during this time, a policyholder does not get coverage for treatment expenses related to the condition.
- The waiting period for pre-existing conditions can vary from policy to policy, ranging from a few months to several years, and gets typically specified in the policy document.
For example, a person has a pre-existing condition such as diabetes and purchases a health insurance policy with a one-year PED waiting period. If the person requires medical treatment for diabetes during the waiting period, his/her insurance provider will not cover the expenses. The policyholder needs to carry the burden of the treatment cost during this period.
Things you should know about Pre-existing conditions or PED
Now that you know the PED waiting period meaning, let’s look at certain important factors that you should be aware of.
- Impact on policy renewal: PED can also impact policy renewal, as insurers may review claims history and medical records to assess risk and premiums. Maintaining accurate medical records and following treatment plans to minimise the impact on policy renewal is crucial.
- Premiums for PED: Insurance policies for individuals with PED may have higher premiums due to the increased risk of claims. It is essential to compare policies and premiums across different insurers to find the best coverage for the most reasonable price.
- Disclosure of PED: Policyholders are required to disclose any pre-existing conditions at the time of policy purchase. Failure to disclose a PED can result in the insurer rejecting claims related to the pre-existing condition.
- Permanent exclusion of PED: Some insurance policies may permanently exclude coverage for certain PED, even after the waiting period has passed. It is essential to carefully review policy documents to understand the exclusions and limitations related to PED.
Disclaimer: The information provided in this blog is for educational and informational purposes only. It may contain outdated data and information regarding the relevant industry. It is advised to verify the relevance of the data and information before taking any major steps. ICICI Lombard is not liable for any inaccuracies or consequences resulting from the use of this outdated information.