Mr Somanth, on his friend’s recommendation, buys a health insurance plan for his family. He selects a suitable policy accounting for the medical needs of his family too. Within two months of purchase of the plan, he is diagnosed with a heart condition and requires immediate treatment.
Little did he know about waiting periods under a health insurance policy, and he had to take care of the entire medical bills. Had he researched more on waiting periods while buying, he would not find himself paying the hospital bill even after availing a health insurance policy.
Are you familiar with the concept of waiting period? If not, don’t worry, read more to know the different types of waiting periods that are a part of health insurance plans.
A waiting period is a duration after purchasing a health insurance policy for which the policyholder cannot raise a claim. This duration of waiting period is different for each policy and varies across insurance companies too. Thus, as essential it is to select a suitable policy, it is equally important to know the waiting period under your policy.
Let us look at the different types of waiting periods that you must be familiar with –
1 Initial waiting period
An initial waiting period is a duration for which the insurance company will not cover any ailments to the beneficiaries. It is also known as the cooling period of your insurance policy. Here, the policyholder will have to wait to make any claims from their health insurance cover. Be it an individual health cover or health insurance plans for family, insurance companies, generally, have an initial waiting period of 30 days.
2 Waiting period for pre-existing diseases (PED)
Health insurance plans are purchased as a precautionary measure. Not all plans are required to be bought because you are already suffering from that disease. But not always a person ends up buying a health insurance policy at the very beginning. Some individuals buy at a later stage in their lives. Thus, the insurance companies need to account for pre-existing diseases too. The definition provided by the regulatory body, the Insurance Regulatory and Development Authority of India (IRDAI), states PED as any condition, ailment, or injury suffered by the insured 48 months before buying the health insurance policy. Therefore, if you have any pre-existing medical conditions, you might have to wait for a specified duration before which your insurance company covers that particular disease or ailment. Generally, while buying health insurance for senior citizens, you must take note of the waiting period as an ageing body suffers from health problems.
3 Waiting period for specific diseases
Some treatments are covered only after a specified duration has elapsed since the purchase of your policy. This duration is termed as the waiting period for specified diseases. Such waiting period is not applicable for all ailments but a select few which are mentioned in the policy document. One must make a note of disease-specific waiting periods while purchasing their insurance policy.
4 Waiting period for maternity benefits
Health insurance plans for families that include coverage for maternity benefits have waiting periods too. This duration ranges from a few months to a few years. Thus, it is advisable you purchase a health insurance plan even before planning for a family.
5 Waiting period for coronavirus
With the latest inclusion to your health insurance plans, a coronavirus health insurance plan also has a waiting period. Some insurers may include the same in the initial waiting period of 30 days, whereas in some cases, there is a separate waiting period for 15 days to 30 days. The insurance company shall reject any claims filed during this period.
To conclude, it is essential to get familiar with the terms of your policy. Along with knowing the terms, you must also educate yourself with these terminologies and scope of coverage to plan effectively for your future.
