Pre-existing Diseases Waiting Period
A pre-existing disease refers to any condition, ailment, injury, or disease diagnosed or treated by a doctor 48 months prior to the date of issue of your health insurance policy.
Note, a pre-existing disease included in the waiting period is very different from the declaration of existing diseases in the proposal form. Your answers to questions on the proposal form should be complete and accurate, as far as possible.
Example 1 - Gaurav was diagnosed with cancer last year, which is now cured. If he applies for a health insurance plan now, cancer will be considered as a pre-existing disease.
Example 2 - Gaurav’s friend Sana had cancer in childhood, 10-12 years back. She did not undergo any treatment related to cancer in the last 48 months. If Sana applies for a health insurance policy now, while she will have to inform the insurer of such a history, as per IRDAI guidelines, the insurer cannot consider this cancer as a pre-existing disease.
Depending on the policy conditions, for pre-existing disease, they will apply a waiting period of 2 to 4 years for pre-existing conditions.
So, in the above examples, the insurance company can apply a pre-existing disease waiting period for Cancer under Gaurav’s policy, but not under Sana’s policy.