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Life Insurance - Waiting Period in Health Insurance

13 Jul 2011

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When you sign up for a new health insurance policy, it doesn't get implemented with immediate effect. The policy comes into effect after a 'waiting period', which depends on the the kind of insurance and other factors, such as age, your medical history and the company. In other words, the insurer is liable to entertain any claim amount filed only after this waiting period. If an individual undergoes an accident or undergoes hospitalization during the waiting period, the customer may not be covered for a loss.

As mentioned before, the concept of waiting period exists across different kinds of insurancepolicies,andthequantumof waiting period may differ dependingupontheinsurerandthe nature of the insurance policy. However, following are the broad indicators of waiting period.

There is an initial waiting period of 30 days, which goes up to 90 days in some cases, from the effective date of the policy. Some insurance policies may permit treatment for accidental external injuries with a minimum of 24-hour hospitalization.

Pre-existing diseases may not be covered in the first 2-4 years of thepolicydependingonyourage and the nature of the policy. A pre-existing disease refers to any medical condition of an individual prior to the commencement of the policy. Now the policy may be effective for any other ailments in the first few years of thepolicy.Buyanyclaimfiledfor illnessrelatedtothepre-existing disease will not be covered in the first 1-4 years of the policy as stated in the policy document. This feature is most common in insurance policies designed for senior citizens. Also, the insurer may insist that you stick with the same insurer if you want the cover to continue without further waiting periods in future. The third is the ailment-specific waiting period, during which an ailment will not be covered. This again varies from company to company. But some common ailments that involve waiting periods include, ENT disorders, polycystic ovarian diseases, diabetes, osteosrthiritis, osteoporosis, hypertension and hernia. These ailmentsareusuallycoveredonlyafter two years from the date of commencement of the policy.

Source: ET BACK