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Is There Any Waiting Period for Claims Under A Policy?

Mar 05, 2018 | 2 years ago | Read Time: 2 minutes | By iKnowledge Team

Yes, there is a waiting period, but it differs across various ailments.

You may have heard that health insurance plans don’t cover pre-existing conditions. But that’s not true. Some insurance companies do offer policies that cover existing illness after a certain span of time. This is called a waiting period. Also known as cooling period, waiting period is a set duration after which you can start claiming insurance benefits for pre-exisiting conditions. Once the waiting period is over, the entire policy coverage takes effect.

Do waiting periods differ for various ailments?

Yes, it differs from case to case. The waiting period is usually between one and four years. The tenure depends on the medical test result. For some ailments like hernia, osteoporosis, ENT (ear, nose and throat) disorders, hypertension, piles, ovarian diseases and diabetes, there is a waiting period of one or two years.

You also need to be mindful that a health policy isn’t activated from day one. Even if you are as fit as Usain Bolt!

Every health policy has a waiting period clause. In case of a general health insurance, the initial waiting period is between 30 and 90 days. This is applicable to all policies, excluding medical expenses after an accident.

For maternity benefits, there’s a waiting period of 9 to 36 months. Insurance benefits for infants kick in only after a 90-day waiting period.

Why do insurers keep a waiting period clause?

Waiting periods are clauses inserted by insurance companies to prevent misuse of claims.

Say there was no waiting period, a person with an undisclosed ailment would receive insurance claim benefits right after he got a health cover. If that was the case, health insurance companies wouldn’t survive very long.

Can I get health insurance without a waiting period clause?

If you are part of a group policy, there’s usually no waiting period.

You can also get a lower waiting period by paying more premium.

Also, if you opt out of a group policy and convert it into an individual policy, your waiting period as part of the group policy is considered. So, you won’t have a waiting period.

What are the other things to keep in mind?

  1. Some insurance companies don’t have waiting periods for senior citizens. Instead, they add a co-pay clause. Here, the policyholder must pay a part of the claim amount.
  1. If you are diagnosed with an illness for the first time during the waiting period, it will not be classified as a pre-existing illness. You will be covered for the treatment costs arising from the ailment.

Just to sum up for you, there are several insurance plans like Aegon Life that cover pre-existing conditions. All you need to do is to check the policy details carefully. After all, it is important to secure yourself if you have any existing health problem or are undergoing a medical treatment.

Advt. no.: IA/May 2018/4041

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