Knowledge Centre

3 Effects of A Pre-Existing Disease On Your Health Insurance Premiums

Have you been procrastinating applying for health insurance for your parents because of their pre-existing medical conditions? Do you have a pre-existing medical condition because of which you feel you might not be eligible for insurance?

Well, the best you can do in this case is to apply for insurance as soon as possible. Yes, health insurance policy for pre-existing diseases is definitely possible; however it may lead to an increase in premium or denial in some cases. But that shouldn’t stop you from attempting to buy one for securing medical contingencies which might occur in future.

First let us be clear what a pre-existing disease is. Any serious medical condition, ailment or injury for which you had signs or symptoms or diagnosis or treatment within 48 months prior to the day you are applying for the medical insurance policy, is considered as a pre-existing disease.

A pre-existing disease must not deter you and your family from securing your financial future. Once you honestly disclose the pre-existing condition while applying for insurance, there are 3 ways how this condition will affect your policy and premiums. Here is all you need to know about health insurance policy for pre-existing diseases.

Waiting period

The insurance company may agree to cover your pre-existing disease at the usual premium but only after a waiting period. This waiting period differs for different providers and for different types of diseases but is usually 2-4 years. Any hospitalisation or medical bill related to your pre-existing disease that is incurred during this waiting period, will not be covered by the insurance company. Only after the waiting period is over, will the insurance policy cover your pre-existing disease.

Premium Loading

There can be a scenario wherein you get instant coverage for your pre-existing disease but for a higher premium. This amount is added to the premium to cover the risks involved for insuring a person already affected by a medical condition. Premium loading for ailments like diabetes and heart diseases is very common. Even with a higher premium, you are secure as the insurance will cover all expenses in case of lengthy hospitalisation or further aggravation of the condition. It is also important to note that only at the time of buying the policy can an insurance company load your premium based on your pre-existing disease. As per Insurance Regulatory and Development Authority (IRDA) mandate, no insurance company can load its customer for any disease that occurs after issuing the policy and renewing it without any break.

Premium loading & waiting period

In some critical cases, the insurance company might decide to load the premium as well as apply the waiting period.

Some diseases like HIV, cancer etc. are permanently excluded from your policy. Don’t let a pre-existing medical condition stop you from applying for health insurance in India for pre-existing diseases. With seamless claims, 24X7 assistance and the affordable premium plans, HDFC ERGO can be your favourable partner for hassle free health insurance.

To know more about our Health Insurance Plans and its benefits CLICK HERE

Awards & Recognition