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Pre-Existing Diseases In Health Insurance

It can be said that the average person’s health is declining since the average medical expense for an Indian resident is increasing every year. This indicates that while our parents are more susceptible to diseases than the generation before, so are we to infections. We buy health insurance online to reduce the financial risk of such problems. A health insurance policy frequently contains several clauses that we need help comprehending. One such provision relates to diseases that are already present.  

Pre-Existing Disease Meaning  

The IRDAI defines a pre-existing disease as any condition, ailment, injury, or disease that a doctor diagnosed within 48 months of the policy’s effective date or its reinstatement or for which a doctor recommended medical advice or treatment within a period of 48 months of the policy’s effective date or upon its receipt from a doctor. Simply put, pre-existing conditions refer to any illness you are diagnosed with within two years after you buy health insurance online. It could develop into a severe illness long-term. #

What Conditions Are Covered And Not Covered By The Pre-Existing Conditions Clause In Health Insurance?  

Pre-existing conditions are typically included in individual health insurance policies for diseases like blood pressure, diabetes, thyroid, and cholesterol. It is crucial to realise that pre-existing diseases do not contain common illnesses like fever, viral flu, cough, colds, etc., which do not have the potential to worsen over time.  *

Are Pre-Existing Conditions Completely Excluded From Health Insurance Coverage?  

‘NO’ is the response to that. After the waiting period has expired, health insurance companies honour claims relating to these diseases. The insured is not permitted to file claims for pre-existing conditions during the waiting period. Depending on the provider, this time frame typically ranges from two to four years. If you foresee needing to file a claim for this condition soon, choosing a policy with a shorter waiting period is ideal.  *

Considerations For Pre-Existing Diseases

Pre-existing disease must first be demonstrated to the potential policyholder so that he can assess his health and determine whether such conditions exist in him or not. 

The insurance company might also inquire about any additional medical conditions you may have; however, some only want to know about the most recent two to five years of your medical history. The needs of the policy and the provider will determine this. The policyholder has a responsibility to fully and truthfully disclose all relevant information to enjoy all health insurance benefits.  

You might need to undergo a medical examination to identify any pre-existing diseases, which can help your doctor assess your health.    

What Occurs If I Don’t Disclose Any Existing Medical Conditions?

If the preexisting condition is kept a secret, the policy renewal may not be allowed, or claims for such conditions may be dishonoured.  

Do Pre-Existing Medical Conditions Have Any Impact On The Premium Cost?  

Pre-existing conditions can result in higher insurance premiums because there is a higher likelihood that a claim may be made. You can manage all aspects of your health insurance using an app for health insurance.

Get insured anytime, anywhere! Check out Bajaj Allianz General Insurance website to learn more and download the app now.

*Standard T&C Apply 

#Visit the official website of IRDAI for further details.

Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.

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