All comprehensive health insurance plans come with different waiting periods for different coverages and it may vary for every insurer
Apart from this, many insurers apply a two-year waiting period on certain specified illnesses such as cataract, hernia and knee replacement.
By Amit Chhabra
One of the most important terms that one must understand while buying health insurance cover is the ‘waiting period’. Under a comprehensive health insurance policy, the waiting period refers to a fixed time duration in which the policyholder cannot avail certain benefits or coverage. All comprehensive health insurance plans come with different waiting periods for different coverages and the waiting period may differ from insurer to insurer. Only after the policyholder serves the waiting period, the coverage for that specific condition can be availed. Insurers generally apply a waiting period in order to avoid any kind of fraud and misuse of the health insurance for pre-existing ailments.
Types of waiting periods
When you buy a new comprehensive health insurance plan, it comes with a waiting period of 30 days that you need to serve before filing a claim for hospitalisation. This is known as the initial waiting period under a health insurance policy. However, there is no waiting period on hospitalisation due to an accident. Once the policy is issued to the customer, a claim for hospitalisation due to an accident can be filed from the very next day.
Apart from this, many insurers apply a two-year waiting period on certain specified illnesses such as cataract, hernia and knee replacement. As these are slow growing illnesses, these attract a waiting period across all insurance plans.
Additionally, most insurers apply a waiting period on the pre-existing diseases of the customer. While buying a comprehensive health plan, the insurer asks you if you have any pre-existing condition such as diabetes, hypertension, kidney-related ailments or any other disease for which you are on continued medication. For any such pre-existing condition, the insurer applies a waiting period ranging from 12 – 48 months from the date of policy issuance. This means the policyholder will be covered for hospitalisation due to any pre-existing ailment after serving a waiting period of 48 months.
Not all comprehensive health insurance plans offer you maternity benefits, and those that offer maternity benefits come along with a waiting period of 12-36 months. Then there are some illnesses that fall under the permanent exclusion category and an insurer will never provide you cover for those illnesses. Some of such illnesses include HIV, hepatitis B, cosmetic surgeries and malignant Neoplasms.
If you feel that the waiting period is too long for any particular ailment, you may choose to reduce the waiting period by paying a little extra from your pocket. For those who want to port their policy to a different insurer, if they have served the waiting period with the current insurer, no fresh waiting period will be applied. However, if the waiting period with the current insurer has not been completed, the remaining waiting period will be applied by the new insurer.
The writer is business head, Health Insurance, Policybazaar.com