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Buying Health Insurance with A Pre-Existing Illness? Things You Should Know

Read this article to know all the important things you should consider while buying a health insurance with Pre-existing illness to avoid any unnecessary situation.

  • 1,605 Views | Updated on: Dec 26, 2023

To ensure your and your loved ones’ well-being, you take all the possible measures in your control. However, situations that are not predictable sometimes arise, such as unfortunate incidents and unexpected medical diagnoses and some of these can become lifelong diseases. As a result, they incur heavy expenses that take up months to years and can heavily impact your lifelong savings. Therefore, having health insurance is necessary as it financially protects you during such circumstances with the required coverage. The types of health insurance plans that cover long term medical conditions come in the form of critical illness riders (there are options to get standalone policies as well), health insurance for senior citizens, etc.

Critical health insurance or critical illness health insurance is a type of health insurance plan that provides you with a pre-decided lump sum amount if there is a diagnosis of any critical illness mentioned under your policy during the policy period. Usually, the illnesses covered include cardiac issues, cancer, transplants, surgeries, etc. But the main question is - what happens in the case of pre-existing illness?

Pre-existing illness

A pre-existing illness or injury is something you have before you get a health insurance plan for yourself. Very often, there is an apprehension to mention such a situation because people fear that there is a high chance of their health insurance not coming through.

Further, there have been several instances wherein claims have been rejected as the guidelines by the regulatory body stating that if there are signs or symptoms of the ailment within three months of buying the policy, then it can be categorized as a pre-existing ailment. Some examples of pre-existing health conditions include diabetes, epilepsy, heart conditions, etc. However, these days pre-existing illnesses are not the pain points they used to be, thanks to newer regulations.

Some Points to Keep in Mind

You must be thinking about how you can work around this problem. Well, here are a few points to keep in mind if you are applying for health insurance with a pre-existing condition.

Different Insurers = Different T&Cs

There are many companies that take your entire medical history of pre-existing conditions into proper consideration. They understand your situation and help you chart out your plan accordingly so that you can get the required benefits with your plan.

Do Not Hide Your Illness

It is highly advisable to be honest with your pre-existing condition and refraining from hiding details. This is important because if, during the treatment process, they find out you hid something, your claim will get rejected.

All Doctor Consultations Are Not Counted

You have to bear in mind that all doctor consultations will not be covered under your health insurance. For instance, if you are making visits for short term ailments like cold, cough, fever, etc., those will not be covered under your insurance plan.

Pre-existing Illnesses will be Covered

There is generally a waiting period for a pre-existing illness. During this period, you have to wait till the said time is complete, post which the cover benefits will be provided to you. If you make any hospital visits during the waiting period, your insurance will not cover the costs.

It is usually suggested that you are honest about your medical background with the insurance provider for a smoother claim filing process so that you get the benefits you deserve. Therefore, while buying health insurance, it is crucial that you provide complete information to your insurer so that you can choose the health insurance which is best for you!

- A Consumer Education Initiative series by Kotak Life

Amit Raje
Written By :
Amit Raje

Amit Raje is an experienced marketer who has worked in various Fintechs and leading Financial companies in India. With focused experience in Digital, Amit has pioneered multiple digital commerce in India. Now, close to two decades later, he is the vice president and head of the D2C business department. He masters the skill of strategic management, also being certified in it from IIMA. He has challenged his challenges and contributed his efforts in this journey of digital transformation.

Amit Raje
Reviewed By :
Prasad Pimple

Prasad Pimple has a decade-long experience in the Life insurance sector and as EVP, Kotak Life heads Digital Business. He is responsible for developing user friendly product journeys, creating consumer awareness and helping consumers in identifying need for life insurance solutions. He has 20+ years of experience in creating and building business verticals across Insurance, Telecom and Banking sectors

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