What is Importance to Disclose Pre-Existing Diseases to Your Insurer?

Health insurance policies come with a clause of Pre-Existing Disease waiting period. A policy seeker is expected to disclose all the pre-existing diseases at the time of buying a policy. Let us find out why it is necessary to disclose them, in this post. 

The likelihood of suffering from diseases becomes more with age. Diseases like hypertension, diabetes, etc. are common phenomena among most people these days.  A health insurance policy is a cover that protect policyholders from the expenses incurred on the treatment of such diseases. However, you may note that most health insurance policies are available with a Pre-Existing Disease (PED) clause. 

Under this clause, if an individual is suffering from any PED, he/she can avail the benefits of coverage for such diseases after completing the PED waiting period. Generally, a PED waiting period might range from 2 to 4 years depending on the particular health insurance plan and the insurer that you are buying the policy from.  

In this post, we are discussing pre-existing disease health insurance and the reason why it is important to disclose the already existing diseases to your insurer while buying a health insurance plan.

Pre-Existing Diseases Under Health Insurance Plans

Pre-Existing Diseases (PED) in health insurance means the ailments that an insured is already suffering from at the time of buying a health insurance policy. Though most healthcare policies offer coverage against PED, there is a waiting period applied by the insurer that the insured has to undergo before availing coverage on such diseases. Hence, individuals with health insurance policies can claim the  expenses incurred on PED treatment after undergoing the waiting period. In most cases, the duration of the PED waiting period is between 2 – 4 years. So, a policyholder cannot avail coverage against PED conditions from Day 1 of the policy initiation date. Rather, they have to wait for a particular time period before they could avail the coverage on PED.

Even if a policyholder makes a claim against PED ailments before the completion of the waiting period, the insurer rejects the claim and no compensation is paid unless the waiting period for such diseases is over.  However, there are certain health plans that allow coverage against pre-existing diseases from Day 1 of the policy commencement. 

Also, health insurance providers charge extra premium costs on health plans for people who have pre-existing diseases. Since policyholders with PED are likely to raise claims against diseases that they are already suffering from. Hence, they are regarded as liability for the insurer and so the insurer charges them extra.  

This is one reason why many people try to hide the PED that they are suffering from at the time of buying a plan from their insurer. However, this is a bad idea as the policyholder might get into trouble by not disclosing the ailments that they are suffering from while buying a policy. 

Why Disclosing Pre-Existing Diseases to Insurers is its Importance?

To avoid paying extra premium on health insurance, most policy seekers tend to hide pre-existing diseases from insurers. However, not disclosing the PED while availing a policy is a fault that should be avoided by policyholders.  

So, what is the importance to disclose pre-existing diseases list at the time of policy purchase?

Actually, health insurance providers levy premiums on particular health plans for different policyholders depending on various factors. Some of these factors include age of individuals, health condition, or any existing diseases that the individual is suffering from, etc.  All this information is required to be filled in the proposal form by the policyholder at the time of buying a policy.  

The information offered in the form is regarded as accurate and is accepted by the insurer. Based on the same, the premium of the policy and other things are also determined. Hence, if a policyholder is suffering from any pre-existing disease, he/she is expected to disclose the same sincerely so that the right premium and other things can be decided. Now, if a person offers false information, it is considered as violation of trust and he/she is likely to get penalized by the insurer. 

Further, if the existence of PED is disclosed later during the tenure of the policy, the insurer may make the health plan null and void, and might reject the claim for breaching trust.   

Also, some insurers might take legal action against the policyholder on charges of fraud for providing false information. To avoid such hassles, it is better to disclose PED that you may be suffering from at the  time of policy purchase.