What to do if you miss declaring your health condition while buying health insurance

What to do if you miss declaring your health condition while buying health insurance  17th October 2022

A health insurance plan is an effective investment instrument to protect your finances against severe illness or an unfortunate accident. But did you know that your health insurance covers pre-existing ailments such as hypertension or diabetes too? Yes, it does! However, this insurance plan has a higher premium and different waiting periods.

You need to ask your insurer about all the available insurance plans and tell them about your pre-existing conditions. However, if you fail to inform your insurance provider about your health condition at the policy purchase, you should learn what will happen at the time of claim.

What are the pre-existing diseases?
A pre-existing disease is a person's health condition or illness before the purchase of a health insurance policy. To simplify, a pre-existing disease is an illness that physicians diagnose within 48 months of buying the policy. Some of these diseases include cancer, asthma, diabetes, cardiac conditions, and hypertension.

Ask your insurance agent about all the pre-existing diseases they cover in their policy. Policies that cover pre-existing diseases have a waiting period depending on your age and plan. Remember that the policy will not cover your medical expenses if you fall sick due to your existing medical condition during the waiting period.

How can non-disclosure of pre-existing conditions lead to trouble?
Non-disclosure of pre-existing medical conditions can be one of the primary reasons for claim rejection. Suppose the insurance company finds out that the policyholder has been suffering from health conditions like sleep apnea over the past seven years. In that case, the company will reject the insurance policy even though they have never made any claim in the past 05 years of buying it.

If another family member is part of the insurance policy, they will also experience rejection or cancellation of it due to non-disclosure of your pre-existing medical condition. So, you need to be careful and transparent regarding sharing essential information with your insurance provider to avoid missing out on crucial benefits.

The insurer has a robust finding-out mechanism that helps them know about their customers' health conditions. A policy buyer may forget what they disclosed in the insurance plan, but understand that the insurer never forgets.

What to do if you fail to disclose your medical condition?
If you fail to provide information about your medical condition when buying the policy, you can rectify your error during the 15-day free-look period. However, suppose you miss this opportunity to correct your mistake. In that case, the company will treat your policy as void at the time of claim, and you will not get any compensation for medical expenses.

According to the moratorium rule of the Insurance Regulatory and Development Authority of India, the insurance company will not cancel your insurance policy if you have paid premiums for eight or more years.

Suppose you are unaware of your pre-existing medical condition when purchasing a health insurance plan. In that case, the plan will cover your illness and hospitalisation expenses by default. However, the insurance company will consider any illness contracted within 03 months of taking the policy as a pre-existing disease.

So now you understand why disclosing all the health conditions clearly when buying a health insurance policy is necessary. Opt for insurance that has a short waiting period. It helps cover your pre-existing illness at an early stage. And we advise you to purchase a health insurance plan at a younger age to avail of coverage in case a disease occurs.

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Disclaimer: The information provided above is for illustrative purposes only. To get more details, please refer to policy wordings and prospectus before purchasing a policy.