Bought health insurance with a pre-existing disease? Check waiting period for claims and if you can reduce or waive it
When you buy a health insurance policy, you cannot request a claim immediately. All policyholders, irrespective of their age, must serve an initial waiting period, which is generally 30 days from the date of policy issuance.
During this waiting period, insurance companies would not cover hospitalisation expenses arising from illnesses, though accidental hospitalisation is covered from day one, subject to the policy terms and conditions.
The waiting period becomes longer for pre-existing diseases. Any medical condition such as high blood pressure, diabetes or asthma, that was diagnosed purchasing a health insurance plan is considered pre-existing disease.
As per guidelines by the Insurance Regulatory and Development Authority of India (IRDAI), the waiting period for pre-existing diseases cannot exceed 36 months of continuous coverage under a health insurance policy.
“This provision applies to both regular policyholders and senior citizens. However, insurers may offer different waiting periods depending on the product, age, underwriting assessment and policy terms,” Rohan Goel, Business Head of Health Insurance at Policybazaar, told Livemint.
He further advised that senior citizens (60 years and above) should pay more attention to the waiting-period clauses, as they may be more likely to have existing health conditions when purchasing a policy.
It is therefore important for consumers to compare not just the premium and sum insured, but also the waiting periods, exclusions and other coverage conditions before purchasing a health insurance policy.
A pre-existing disease refers to any condition, ailment, injury or disease that has been diagnosed by a physician within 36 months before the commencement of the health insurance policy, or for which medical advice or treatment was recommended or received during this period, Goel said.
“A condition does not necessarily have to require hospitalisation to qualify as a pre-existing disease. Even if an individual is managing a condition through regular medication or medical consultations, it may fall under this category,” he added.
He also advised consumers to disclose their complete medical history, including ongoing medication and previous diagnoses, at the time of purchasing a policy as non-disclosure or misrepresentation of medical information can lead to complications during the claim process.
Yes, health insurance products offer options to reduce the pre-existing disease waiting period, sometimes through riders. This means, a policyholder can reduce their waiting period for making claims by paying an extra amount, which depends on how much a particular insurance company charges.
Citing an example, the expert said, a policy that ordinarily has a three-year waiting period may offer an option to reduce it to a shorter duration through pre-existing disease reduction rider, subject to the insurer’s terms and underwriting conditions. Additionally, there’s also an option to opt for immediate coverage through day one covers, Goel added.
Eshita Gain is a digital journalist at Mint, where she joined in May 2025. She writes on corporate developments, personal finance, markets, and business trends, with a focus on delivering timely and relevant stories to a broad audience. <br><br> While her core beat lies in business and finance, she is not confined to a single niche and frequently explores stories across domains, including international relations and policy developments. <br><br> She holds a postgraduate diploma in business and financial journalism by Bloomberg from the Asian College of Journalism (ACJ), Chennai. During her time there, she received rigorous training in tracking financial data, interpreting corporate filings, and reporting on business developments. She has pursued her graduation from St. Joseph’s University, Bengaluru in a multi-disciplinary course. Her majors included Journalism, International Relations, peace and conflict studies. <br><br> Eshita has previously worked in digital marketing, which enables her to write SEO friendly copies that are clear and engaging. <br><br> Her primary interest lies in breaking down complex subjects and writing clear, accessible copies that inform readers. She aims to bridge the gap between technical financial language and everyday understanding. Outside the newsroom, Eshita enjoys reading non-fiction, and exploring new places, constantly seeking fresh perspectives and stories beyond headlines.
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