Under health insurance policy, a waiting period is the duration of time that a policyholder has to wait before raising a claim for certain diseases. To understand the different waiting periods on a policy for different health conditions, it is important to go through the policy wordings thoroughly.
In this post, we will discuss the various types of waiting periods that an insurance policyholder has to go through after buying a health plan along with its different aspects. But before that lets understand what a waiting period is in health insurance?
As already discussed, the waiting period is a time span in a health insurance policy that starts with the commencement of the policy. A policyholder has to pass the waiting period for different diseases and conditions applied by the insurance company before availing benefits for that particular condition/disease. For instance, the waiting period for pre-existing diseases is 2 to 4 years under most health insurance companies and you have to pass this time before you could raise health claims for any of your pre-existing diseases. Moreover, you must also know that every health insurance policy has an initial waiting period of zero to 30 days that every policyholder has to go through before raising any claims.
Let us understand the types of health insurance waiting periods.
| Health Condition | Waiting Period |
| PED or Pre-Existing Disease waiting period | 2 to 4 years |
| Initial waiting period | 30 days |
| Accidental hospitalisation waiting period | 0 days |
| Maternity insurance coverage waiting period | 9 months to 36 months |
| Critical Illnesses waiting period | 90 days |
| Waiting Periods for Specific Ailments/Procedures | 1 to 2 years |
If the policyholder has any ailment while buying the health insurance policy such as diabetes, thyroid etc., these are called pre-existing diseases. Almost every health insurance policy applies a PED waiting period of 2 to 4 years before the insured could raise claims for such ailments.
Almost every health insurance policy applies a waiting period of 1 to 2 years for certain diseases and surgical procedures such as cataract, joint replacement surgery, ENT issues etc. And a policyholder can avail the benefits of such plans only after completion of the specific disease waiting period.
Every health insurance policy has an initial waiting period of 30 days from the time of buying the policy during which no claims are accepted by the insurer except for accidental claims.
Most regular health insurance plans allow coverage against critical diseases after a waiting period of 90 days.
There are some health insurance policies which allow coverage against maternity and newborn care after completion of a waiting period of 9 to 36 months.
Yes, there is an option of reducing waiting periods under health insurance policies. There are some insurance companies who offer an add-on rider of ‘waiting period waiver’ to reduce policy waiting period. However, a policyholder has to pay an extra premium to avail that waiver.
Below are certain important points related to waiting periods that one should keep in mind:
is a particular time period that is applied in critical illness insurance during which an insured has to survive after being diagnosed with a critical illness to get coverage against the disease.
time duration ranges from 14 to 180 days as per policy type and the diagnosed illness. The survival period is different from a waiting period. If diagnosed with a critical illness, the policyholder can raise a claim after completing the survival period and receive a pre-defined lump sum amount from the insurer. After this the plan terminates.
| Waiting period | Survival period |
| Applies in critical illness insurance | Applies in all health insurance |
| This is the particular time period during which the insured has to survive after being diagnosed with a critical disease to receive the claim | This is the time period during which insured cannot avail the benefits of the plan or raise a claim |
| Time duration is 14 to 180 days | 0-30 days initial waiting period, 2-4 years PED etc. |
| Policy terminates after the payment of lump sum amount | Policy continues after completion of waiting period with regular premium payment |
Health insurance policies are very important. But the waiting period might make it difficult to avail the benefits of the plan. So, in case you are planning to invest in a good health insurance policy, don’t forget to check the waiting period and to buy a plan with the shortest waiting period.
Yes, most of the claims filed during the initial waiting period are denied by health insurance companies except for accidental hospitalization. However, it depends from insurer to insurer.
No, you can’t raise a claim during the waiting period of regular health plans except in the case of accidental hospitalisation.
The best benefit of having a short waiting period in health insurance is that the insured can avail the plan coverage soon. So, it is better to make sure to go through the terms and conditions related to the waiting period before buying a health insurance policy.
The waiting period of health insurance policies are applied mainly to ensure that no malpractices are carried on by policyholders.
* Rs. 245/month is the starting price for a 5 lac health insurance for an 25-year-old male, with no pre-existing diseases.
*! Rs. 334/month is the starting price for a 10 lac health insurance for an 25-year-old male, with no pre-existing diseases.
*@ Rs. 12/day is the starting price for a 5 lac family health insurance for an 25-year-old male and 22-year-old female, with no pre-existing diseases.
*# Rs. 12/day is the starting price for a 5 lac health insurance for an 25-year-old male, with no pre-existing diseases.
*$ Rs. 600/month is the starting price for a 20 lac health insurance for an 25-year-old male, with no pre-existing diseases.
*^ Rs. 12/day is the starting price for a health insurance that covers coronavirus for an 25-year-old male, with no pre-existing diseases.
