All You Need About Waiting Periods In Health Insurance

Updated On: 2023-03-30

Author : Team Policybachat

The awareness of having a health insurance policy has been increased drastically in the past 6 months. All thanks to COVID-19 which made people understand the advantages of having a health insurance policy. Taking a health insurance policy needs proper planning and research. The health insurance policy consists of waiting periods before availing certain benefits. It is the period when a certain illness, disease or surgery is not covered and you have to wait for a certain period of time for the coverage to kick start.

Insurance companies do not settle the claims which are reported during the waiting period, however once the waiting period is over you are free to register the claims. These waiting periods are mandatory as per the IRDA rule and prevent customers from availing undue advantage out of insurance.

There are many types of waiting periods in every health insurance plan which needs to be satisfied before claiming for any illness or disease. Let’s understand the types of health insurance and what these cover:

1. 30 Day Waiting Period:  

An initial waiting period of 30 days is applicable in every health insurance policy. This period is also called as “Cooling Period” in health insurance. This 30 day period specifies the amount of time you have to wait from the date of issuance of policy to actively start using your health insurance policy.

As an industry standard, all the health insurance policies have an initial waiting period of at least one month.

The initial waiting period doesn’t apply to any health insurance claims related to accidental hospitalization.

2. Specific Disease Waiting period:

As the title is self explanatory, this class of waiting period implies that you need to wait for a prescribed amount of time when it comes to claiming for treatment and hospitalization related to a list of specific diseases.

Normally the specific waiting period across the industry ranges from 1 year to 4 years depending on the insurance company and the product being offered.

Some common diseases under this section include Cataract, Fissure, Hernia, Cyst, Ulcers etc.,

3. Pre Existing waiting period:

While taking a health insurance plan you will be asked about pre-existing diseases or the insurance company will ask you to undergo few medical tests to determine if you are suffering from any illness or disease.

As per the IRDA, a pre-existing disease refers to a condition, ailment, injury or disease that has been diagnosed up to 48 months before taking the health insurance policy.

Few examples of pre-existing diseases include Diabetes, Hyper tension, Blood pressure, Heart Stroke, Thyroid etc., If you have any disease prior to the inception of the policy, it is classified as pre-existing disease and you will have to wait for the prescribed time before you can claim for hospitalization or treatment of that particular disease.

In general, the waiting period for pre existing diseases is 2 to 4 years, depending on your health insurer and the health insurance product offered.

4. Maternity Benefit & New Born waiting period:

Maternity expenses such as pre and post natal are covered under the health insurance policy. But there is a waiting period before claiming under this section. The waiting period will be applicable to all the health insurance policies covering the maternity benefit and new born baby hospitalization expenses.

The waiting period under this clause varies from 9 months to 4 years which varies among the insurance companies and the products offered.

Maternity benefit cover has a waiting period to prevent people from taking undue benefit of insurance. Any insured or their family member with pregnancy cannot claim immediately under this clause. In other terms insurance companies do not pay for your maternity related expenses as soon as you buy the insurance policy.

For best health insurance plans visit Our Portal and check for the best health insurance quotes online using the health insurance calculator.

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