Knowledge Centre

Waiting Period in Health Insurance

As the name suggests it’s a period of time, which has to pass for you to avail certain covers or benefits under a health insurance plan. It is that period when a certain ailment or illness is not covered and you have to wait for that time to pass by making consecutive renewals to waive off the waiting period and start availing the benefits of your plan. Insurance companies may deny claims if intimated within the waiting period, however once the waiting period is over you are free to register claims.

Under what circumstances waiting period is implied?

Maternity cover: Insurance companies do not pay for maternity expenses such as pre-post natal and new born expenses as soon as you buy the policy or when you are pregnant. Most of the health insurance companies imply a waiting period of 3-4 years, hence you can claim under maternity cover post completing this waiting period with your insurer. Some insurance companies offer this as an add on cover, while some make it a part of their basic health policy.

Pre-existing diseases:  At the time of buying a health insurance plan if you are suffering from health ailments or you’ve had any sort of medical history such as diabetes, high blood pressure,[R1] thyroid[R2], hypertension etc then you have to declare this to your health insurance company. Bases your medical reports, health insurer either accepts the case by implying an additional premium or rejects the case depending upon medical adversity. Once your waiting period is covered for the declared diseases you can make claim under it.

Survival period: For critical illness insurance there is a survival period of usually 30 days. With HDFC ERGO Critical Illness Insurance you have a survival phase of 30 days before receiving the lump sum payment.

New born babies: Usually, new born babies are covered post 90 days.

What more should you know about waiting periods?

  • If any new ailment is detected during the policy period it will get covered and is not a part of pre existing waiting period.
  • However, if an already existing ailment is not declared at the time of policy issuance and claim has been registered then claim will not get honored.
  • Some insurance companies offer an option to reduce waiting period by paying additional premium.
  • There is also a common cooling period of waiting period of 1 month for accidental hospitalization or overall any claim to be registered. Hence you may not be able to immediately register a claim post buying a policy.

With this the concept of waiting periods in health insurance reads clear and is easily understood. The best way to escape waiting period is to buy your health insurance early. At an early age you are less susceptible to diseases and hence if you buy the health insurance plan at an early age there are lesser chances of having any pre-existing diseases.


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