Find your suitable insurance plan
365
5 min read
Updated on Apr 28, 2023
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 (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.
Let us now check why it is so important to disclose the pre-existing diseases to the insurer while buying a health insurance plan.
Also Know: Pre-Existing Disease in a Health Insurance Policy
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.
Read More: Top 5 Cashless Health Insurance Policies in India
To Sum Up
Though pre-existing disease cover health insurance makes a health policy expensive. However, these plans provide security against such diseases. Making the mistake of hiding pre-existing diseases is something that a policyholder should never do. This way, they can stay away from any trouble in the future in terms of claim rejection and penalty. Hence, ensure that you offer your accurate personal and medical details to your insurer while you apply for a health insurance policy.
Browse PayBima Blogs to read interesting posts related to Health Insurance, Car Insurance, Bike Insurance, Term Life Insurance, and Investment section. You can visit PayBima to Buy Insurance Online.
View this post on Instagram
If you hide your pre-existing health conditions while buying a health insurance policy, it will be regarded as breach of trust. Hence, if the insurer comes to know about it later, the insurer might make the policy null & void and reject your claims as well. There is a difference between a pre-existing disease and medical history. A PED may include any disease that an individual is having for 48 months before applying for a health insurance plan. On the other hand, medical history may include any ailment that a person might have been suffering from since childhood. Pre-existing disease is a medical condition or illness that a policy seeker is already suffering from while buying a health insurance plan. For example, diabetes, hypertension, cancer etc. Pre-existing diseases insurance refers to the medical conditions that a policy seeker is already suffering from while purchasing an insurance plan. These diseases may determine the premium of health insurance policies. Some of these conditions include asthma, thyroid, high blood pressure etc. You must declare pre-existing medical conditions while buying a health policy because these conditions serve as a factor to determine your health insurance premium.
FAQs: Why is Disclosing Pre-Existing Diseases important?
What can happen if I don't disclose my pre-existing health conditions at the time of buying a policy?
What is the difference between medical history and a pre-existing disease?
What is pre-existing disease meaning?
What are the pre-existing conditions for health insurance?
Why do I have to declare my pre-existing health conditions?
PayBima Team
PayBima is an Indian insurance aggregator on a mission to make insurance simple for people. PayBima is the Digital arm of the already established and trusted Mahindra Insurance Brokers Ltd., a reputed name in the insurance broking industry with 17 years of experience. PayBima promises you the easy-to-access online platform to buy insurance policies, and also extend their unrelented assistance with all your policy related queries and services.
Food not only helps provide nourishment and facilitate survival but can also essentially serve the purpose of medicine. So can be proven by its role.
Apr 24, 2023
5 min read 
A new and exclusive health insurance benefit to Govt. employees and pensioners in Kerala In its fervent attempt to ensure that every individual in every.
Apr 19, 2023 5 min read 
Buying a health insurance plan is essential, but several people refrain from investing in such plans, and prefer investing in fixed deposits, mutual funds, and.
Apr 14, 2023 5 min read 
Nature has bestowed us with many beneficial trees and plants that we may not be aware of. Moringa or Drumstick plant is one such tree,.
Apr 10, 2023 5 min read 
Be it a huge conglomerate or a small business, a health insurance plan is imperative for one and all. Securing your employees and their families.
Apr 07, 2023 5 min read 
Are you looking at easy and effortless reimbursement claims for your health insurance? Here are some important things you should know about medical claim Reimbursements..
Apr 06, 2023 5 min read 
April 17 marks the World Haemophilia Day which is commemorated annually and is dedicated to people who have haemophilia. Let us discuss the history and.
Apr 03, 2023 5 min read 
Malaria is a disease caused by infected mosquito bites. On the occasion of World Malaria Day on April 25, 2023 let us highlight the commitment.
Mar 31, 2023 5 min read 
April 10 marks the event of World Homeopathy Day every year emphasising the importance of Homeopathy and its influence on health. Let us read more.
Mar 30, 2023 5 min read 
World Health Day is observed every year on April 7 to draw attention to a particular topic related to global health. The day marks the.
Mar 30, 2023 5 min read 
Corporate Office : Mahindra Insurance Brokers Ltd ( A Mahindra Group Company ) Sadhana House, Ground Floor, 570 P. B. Marg, Behind Mahindra Towers, Worli, Mumbai 400018.
Licenced by IRDAI License No. 261; License Validity : 17-05-2025; Category : Composite Broker; CIN : U65990MH1987PLCO42609 Member of Insurance Brokers Association of India (IBAI).
Insurance is the subject matter of solicitation.
For a seamless experience, use the latest version of Chrome/Firefox/Internet Explorer.
Copyright © 2023 Mahindra Insurance Brokers. All Right Reserved.
Get A Call Back