What is Pre-Existing Diseases & its Clause | Everything You Need to Know About Pre-Existing Diseases

In this article, we will be discussing Pre-Existing Diseases- What is it, what are its clauses, and what are tips one should follow regarding Pre-Existing Diseases while selecting insurance plans. So, let’s get started!

What are Pre-Existing Diseases?

A Pre-Existing Disease (PED) refers to a medical condition that a person is already suffering from (at least for the last 4 years), before the policy purchase.
Unfortunately, the PED waiting period is an obstacle for people who want to claim their PED expenses.
The good news is that some plans cover pre-existing diseases from day one.

Pre-Existing Disease Clause:

When an individual buys an insurance policy, there is a waiting period for PED of around 24 months to 48 months varying as per insurance policies.
If an individual does not discloses his/her PED, it comes under the case of fraud, and there could be some complications.
If a company thinks about a disease that can cause a lot of expense in the future, then that PED can permanently be excluded by the insurance company.
Other than this, insurance companies can also impose restrictions for payment up to a certain limit, even after the completion of the waiting period.

Things to Remember:

When individuals opt for the portability of insurance policies, then the waiting period for PED is carried forward.
If the sum assured is increased say from Rs. 10 Lakh to Rs. 20 Lakh, then the waiting period for the increased assured amount will be calculated separately.
Even if a new member is added to the insurance policy in the family floater plan then the waiting period PED of the new member will have a different waiting period.

Some Diseases are not even PED, but if happen there is waiting periods for the same, they are:

All the above mentioned are some of the diseases that will have a different waiting period of around 24 months aside from the waiting period for PED.

Tips for PED:

Never hide pre-existing diseases
Taking medical insurance after 48 months from PED
Opt for lower waiting period plans
Should look for Co-Payment Plans
In Corporate Plans, PED does not have waiting periods
Many Insurance Plans do not have any waiting periods for PED

What Should Individuals Do:

Pre-Existing Diseases (PED) are an important factor when selecting insurance policies. Individuals should carefully assess all the insurance policies and should also filter the plans based on the waiting period for PED. One should also not hide any PED from insurance companies to avoid any complications ahead.

Disclaimer: The information here is provided for reference purposes only and should not be misconstrued as investment advice. Under no circumstances does this information represent are commendation to buy or sell stocks or MF.