What are Pre-existing Conditions?
A pre-existing condition is any disease, illness, or injury that you have been diagnosed with or have symptoms of before purchasing a health insurance policy. These conditions significantly impact your health insurance premium and coverage.
Definition: Any medical condition diagnosed within 48 months (4 years) before buying the policy is considered pre-existing.
Common Pre-existing Conditions
ð Diabetes (Type 1 & 2)
Most common pre-existing condition in IndiaâĪïļ Hypertension (High BP)
Affects premium but usually coveredðŦ Heart Disease
Angina, bypass surgery, heart attack historyðŦ Asthma & COPD
Respiratory conditions with waiting periodðĶ Thyroid Disorders
Hypothyroidism, HyperthyroidismðĶī Arthritis
Osteoarthritis, Rheumatoid ArthritisWaiting Period for Pre-existing Conditions
â° Standard Waiting Periods:
| Condition Type | Typical Waiting Period | Coverage After |
|---|---|---|
| General Pre-existing Conditions | 2-4 years | Full coverage after waiting period |
| Specific Diseases (listed) | 2 years | Covers specific listed conditions |
| Critical Illness | 90 days to 1 year | Lump sum payment on diagnosis |
| Maternity Coverage | 2-4 years | Normal delivery, C-section covered |
How to Get Coverage for Pre-existing Conditions
Step 1
Full disclosure of medical historyStep 2
Medical check-up if requiredStep 3
Accept policy with waiting periodTop Tips for People with Pre-existing Conditions
Always Disclose Truthfully
Non-disclosure can lead to claim rejectionCompare Waiting Periods
Some insurers offer shorter waiting periodsConsider Loading/Extra Premium
Pay extra for immediate coverageLook for Portability Options
Port existing policy to reduce waiting period
Important: Never hide your medical history. Insurers can reject claims if they discover undisclosed pre-existing conditions during investigation.