Waiting Period in Health Insurance Policy

When customers buy new health insurance plans, it doesn’t get activated with immediate effect. The insurance product is available with a ‘waiting period’ and this period depends on the insurance type and other factors like medical history, insurer and the age.

In simple words, insurance companies in India are liable to entertain any claim amount filed once this waiting period is over. In case a policyholder undergoes hospitalization during the waiting period, then the insured person may not be covered for a loss.

As described earlier, the waiting period concept exists across various insurance policies and the limit of waiting period may vary based on the insurance company in India and the insurance type. However, below are the main indicators of the waiting period:

There is an initial waiting period of 30 days, which increases up to around 90 days in certain situations, from the effective date of the insurance. Some policies may allow treatment for accidental external injuries with a minimum of 24-hour hospitalization.

Pre-existing diseases may not be included in the initial two to four years of the policy based on policyholder’s age and the insurance type. A pre-existing disease refers to the customer’s health condition prior to the commencement of the insurance.

Nowadays, the healthcare plan may be effective for any other ailments in the initial few years of the health insurance policy. Any claim filed for illnesses related to the pre-existing diseases will not be included in the initial 1-4 years of the policy as mentioned in the policy papers.

Generally, this clause is very common in mediclaim policies made for senior citizens. In fact, insurance companies in India may insist that policyholder stick with the same insurance company in case insured person want the cover to continue without further waiting periods in the future.

An ailment will not be covered during the ailment-specific waiting period. This period differs from insurer to insurer. Polycystic ovarian diseases, ENT disorders, osteoarthritis, diabetes, osteoporosis, hernia and hypertension are some of the common ailments which are available with waiting period.

Usually, these ailments are included in the health insurance policy only after two years from the commencement date of the plan.

Health Insurance