Waiting Period in Health Insurance
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What is the Waiting Period in Health Insurance?
The waiting period in health insurance is the period during which the insured person cannot apply for a claim even if the illnesses are covered by their insurance. We set this period, which will vary depending on the type of insurance and coverage required.
For example, if you choose a policy that covers pre-existing health conditions, the waiting period will be different from that for a standard health insurance policy.
The Insurance Regulatory and Development Authority (IRDAI) sets an initial initial waiting period at 30 days from the day of commencement. Thus, to successfully claim your insurance, you must be aware of the types of waiting periods in health insurance and the duration of each.
Types of Waiting Periods in Health Insurance
Initial Waiting Period
The initial waiting period in health insurance, also known as the cooling period, is applicable at the start of any type of health insurance policy. Until this period cools off, you cannot claim your health insurance benefits.
The maximum limit is set by the IRDAI and is the same among all insurance providers. We offer a short initial waiting period of 15 to 30 days so that you can reap the benefits of your IndusInd General Health Insurance plan sooner.
Pre-Existing Disease Waiting Period
Diseases diagnosed within 48 months before buying a health insurance policy are known as pre-existing diseases, and the waiting period for these is known as a pre-existing disease waiting period. This period usually ranges from 1 year to 4 years of continuous policy coverage and depends on your medical status. However, with our competitive health cover waiting periods for pre-existing diseases, you can be assured of receiving the required healthcare quicker.
Maternity Benefit Waiting Period
IndusInd General Health Insurance offers maternity cover as an add-on feature to support expenses related to childbirth and pre- and postnatal care. A maternity benefit waiting period applies before you can avail yourself of these benefits.
However, with us, you can opt for the maternity insurance waiting period ranging from 1 year to 2 years. With a lower waiting period, you can take care of your maternity expenses stress-free.
Specific Ailments Waiting Period
This is a specific waiting period between 1-2 years for particular conditions like ENT disorders, tumours, hernias and osteoporosis. The waiting period varies depending on the choice of health insurance plan and is mentioned explicitly in our policy documents.
For example, our IndusInd Health Infinity Insurance has a waiting period of 2 years. However, you can purchase an add-on cover to reduce the waiting time to 1 year.
Waiting Period for Health Checkups
Most of our health insurance policies also offer coverage for annual health check-ups under preventive care coverage. Under this, you can avail yourself of preventive health check-ups up to a predetermined amount at the end of every policy year and before the start of the next policy year.
Waiting Period for Critical Illnesses
Critical illness insurance has a separate waiting period during which coverage benefits cannot be claimed. The waiting period for IndusInd Critical Illness Insurance is only three months from the inception of the policy. This waiting period ensures that all genuine claims can benefit from our policy offerings as soon as possible.
Waiting Period for Accidental Hospitalisation
Unlike other types of claims, there is no health cover waiting period for accidental hospitalisations. We offer immediate coverage for accidents upon policy activation, as accidents are unforeseen events and require immediate medical attention.
Waiting Period for Covid-19
The COVID-19 outbreak took the world by storm. To fight the pandemic, all our health insurance plans, including our two specially designed plans, offer coverage for COVID-19 treatment. The waiting period before you can utilise the plans’ benefits is 15 days from the date of policy commencement.
Waiting Period for Senior Citizens’s Health Insurance Plans
Health insurance plans for senior citizens offer coverage specific to their coverage needs. We offer health insurance for senior citizens through multiple plans, such as IndusInd Health Infinity and IndusInd Health Gain.
Thus, the health cover waiting period for these plans will depend on your choice of health insurance plans and the add-on options that are offered.
Waiting Period for Group Mediclaim Insurance Policies
Group mediclaim insurance policies cover multiple individuals under one policy. There is a stipulated initial waiting period of 30 days and a waiting period of 48 months for pre-existing diseases.
To offer early coverage benefits to our group health insurance policyholders, we offer zero initial waiting periods and zero waiting periods for the treatment of pre-existing diseases (as an add-on cover).
How Does Waiting Period in Health Insurance Work?
The waiting period must be completed before you can claim coverage for specific benefits, such as pre-existing conditions or critical illnesses. During this period, if you seek treatment for conditions covered under the waiting period clause, the expenses for the same are not covered.
As explained in the earlier section, the medical insurance waiting period varies for different conditions and starts from the commencement date. To benefit from your policy coverage and make the most of your health insurance, it is crucial to read your policy terms carefully and know the exact waiting period for each condition.
Why is There a Waiting Period in Health Insurance?
The medical insurance waiting period was introduced to prevent malpractice and misuse of insurance benefits. Often, individuals buy a health insurance policy simply to cover a recently diagnosed condition and its immediate treatment expenses.
In such cases, they misinform the insurance providers or hide their diagnoses to get coverage for them. Thus, to prevent fraudulent claims and ensure policyholders maintain long-term coverage for genuine healthcare needs, insurance companies exercise a waiting period.
How to Reduce Waiting Period in Health Insurance?
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Understanding Survival Period in Health Insurance
The term “survival period” is often associated with IndusInd Critical Illness Policy. It refers to the duration that a policyholder must survive after being diagnosed with a critical illness to be eligible for the claim. With us, the survival period is between 30 to 60 days.
The survival period ensures that the insured person receives coverage benefits only if they survive the initial impact of the illness, thus aligning the policy with its purpose of providing financial support during prolonged treatments. The claim is not payable in case of the insured individual's death during the survival period.
Key Differences Between Waiting Period and Survival Period
| Waiting Period | |
|---|---|---|
Purpose | Applied to prevent immediate claims and ensure policy sustainability. | Ensures policyholders survive a specific duration post-diagnosis to claim benefits. |
Application | Applies to various policy benefits, including pre-existing conditions, maternity and specific diseases. | Exclusive to critical illness policies, such as the IndusInd Critical Illness Policy. |
Duration | | This period is fixed at 30-60 days. |
Impact on Claims | No claims for benefits during the waiting periods until they lapse. | Claims are processed only if the insured survives the illness for the specified survival period. |
Coverage Payout/Continuance | Once the waiting period is over, the policy coverage is available for the insurer to claim. It continues until the policy term. | The insurer receives a lump sum payout at the end of the survival period to fund their treatments. |
Essential Tips for Health Cover Waiting Period
Know Your Policy
Since we offer a variety of policies to cover specific illnesses and offer distinguished coverage, the waiting periods for each may vary. Thus, it is important to know the policy you have opted for and understand its waiting period.
Plan Ahead
If you have a family history of certain health conditions or are aware of pre-existing conditions, consider buying respective health insurance policies earlier to complete the waiting period.
Take Advantage of Low Waiting Period Health Insurance and Add-Ons
We offer health insurance plans with reduced waiting periods and access to add-ons for the same. If you require immediate or early treatment, utilise them and reduce the waiting time.
Disclose your Pre-Existing Illnesses
It is important to inform your insurer if you have been diagnosed with any illness before purchasing a health insurance policy. This ensures you are offered coverage in your time of need, as non-disclosure of illnesses can lead to a rejection of your claim despite completing the necessary waiting period.
Key Takeaways
The waiting period in your health insurance policy is influenced by various factors like the type of health insurance (individual health insurance, group health insurance, etc.), medical history and age.
Thus, it is important to understand what is a waiting period in medical insurance and to pick a plan with a shorter waiting period. This will allow you to claim the benefits of your insurance as soon as possible instead of bearing medical expenses from your pocket due to a long waiting period clause.
We understand that each type of illness has varied coverage requirements, and we cater to them by offering separate health insurance plans and add-ons. For example, we offer Critical Illness Insurance with low waiting and survival periods and availability of longer policy term and continuity benefits, ensuring adequate coverage to support your treatment.
With our wide variety of health insurance plans, add-ons, attractive discounts and easy buying and claiming process, you can be assured of making the most of your insurance when in need.
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Disclaimer:
*T&C Apply. For more details on risk factors, terms conditions, brochure, and exclusions, please read the policy wording and CIS carefully before concluding a sale.
The total no. of customers insured data is for FY24 and has been picked up from the number of lives insured for Health, Personal Accident, Overseas Travel, Domestic Travel, Workmen Compensation and Crop Insurance, Weather LOB & Fire LOB provided by IRDAI count that is master policy count. Other than these LOBs, we have also provided data for the number of certificates issued.
This is the overall claim settlement ratio for FY 2023-24 without claim outstanding at the start of the financial year as per public disclosure of IndusInd General Insurance Co. Ltd.
The premium mentioned is excluding taxes for single person aged between 5 years to 20 years with individual health policy for Sum Insured of ₹3 lakhs considering no adverse health conditions/pre-existing disease/medical conditions with waiting period of 3 years. For more details, please refer to the policy wordings. Premium used is 2,919/year converted into a month which gives us Rs.243/month (2,919/12).
The details mentioned above are for IndusInd Health Infinity Insurance UIN: RELHLIP23120V042223
Maximum discount applicable for IndusInd Health Infinity Insurance policy is up to 35%.
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