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What Is Pre-Existing Condition Exclusion Period in Health Insurance?

By Finserv MARKETS - Feb 15,2019
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What is Pre-Existing Condition Exclusion Period in health insurance?

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If you are healthy and lead an active lifestyle, you can get Health Insurance coverage quickly. Although online insurance plans are widely available if you are already suffering from a particular illness or pre-existing, getting Health Insurance can be tricky and more expensive.

While most health policies do have provisions for pre-existing diseases, they only get covered with certain term and conditions. In order to help you gain more insights into pre-existing illnesses, here’s all you need to know about pre-existing conditions.

What Are Pre-Existing Illnesses or Conditions?

Pre-existing illness is a medical condition that the policyholder is already suffering from, at the time of buying a Health Insurance policy. The disease or medical condition could be anything ranging from asthma to diabetes.

From an insurer’s point of view, customers with pre-existing conditions are considered too risky to cover under a regular health plan. This is one of the main reasons why most insurance companies impose specific terms and conditions when it comes to providing coverage for pre-existing conditions.

Importance of Declaring Pre-Existing Illnesses

As per the Insurance Regulatory and Development Authority of India (IRDAI) guidelines, any pre-existing conditions treated within 48 months prior to the issuance of the policy must be declared to the insurance provider.

Even if you have been cured for a disease or condition experienced before, it is advisable to declare this to your insurer in order to avoid future complications. If an insurer finds out about these conditions at the time of a claim, it could lead to outright rejection of the claim or even cancellation of the policy.

What Should You Do?

When seeking health insurance, it is essential that you accurately mention all your medical conditions to the insurance provider. After the insurer knows your medical history, they will then decide whether or not to offer insurance to you. This decision is mainly dependent on the severity of the diseases mentioned.

Will You Get Health Insurance Even With Pre-Existing Illness?

The answer is yes! Several insurance providers offer health insurance benefits to people with pre-existing illness and other significant issues. However, these health plans come with hefty premiums and many conditions. The bottom line is that you can still seek pre-existing health cover in India.

Exclusions Period or Waiting Period

Most health policies impose a waiting period for pre-existing illnesses. In India, the waiting period for pre-existing diseases is around 2-4 years.

However, it may vary from one insurer to another. Hence if you are planning to take up a Health Insurance policy with pre-existing illness, make sure to check the waiting period for it. A medical plan with Finserv MARKETS has a waiting period of 36 months for pre-existing illnesses.

Impact on Premium

In some cases, the insurer may agree to cover your pre-existing illness but may impose higher premium charges. This is called premium loading. If you have a pre-existing illness, your insurance company may choose to load your premium at the time of policy issuance.

Other Health Insurance Exclusions

  • Medical expenses incurred due to criminal activities, suicide or self-injuries
  • Medical care or hospitalisation needed due to war or war-like situations
  • Medical attention required when under the influence of alcohol and other intoxicants
  • For sexually transmitted diseases like AIDS
  • For participating in naval, military or air force operations or dangerous sports like racing and driving.
  • Mental disorders

Buy Health Insurance at Finserv MARKETS online

Buying health insurance with us at Finserv MARKETS is no rocket science. Just follow these simple steps, and you are done.

  • Choose the kind of coverage you need
  • Fill the application form
  • The insurer will assess and verify the details
  • Complete the online payment process
  • Health policy will be issued to you in no time

In the End, Just Remember One Thing!

Whenever you are seeking medical insurance, make sure that you are not hiding any pre-existing conditions from your insurer, as it can have some serious consequences later in the future. As you can see, pre-existing diseases have a major impact on a health policy. Hence, it’s best to buy a health Insurance policy as soon as possible. The longer you wait, the higher are the chances of you ended up paying a higher premium amount.

With health insurance plans available on Finserv MARKETS, you can benefit from features like swift claim settlement, reinstatement benefits, bespoke insurance plans, extensive coverage, and so much more. So, don’t wait! Get protection for your health, right away.

Also read in detail about the health insurance tax benefits you can avail with a variety of medical plans available on Finserv MARKETS.

Read our top blogs to know more about health insurance in India:

Finserv MARKETS, a subsidiary of Bajaj Finserv, is a one-stop digital marketplace that has been created for consumers on the go. It offers 500+ financial and lifestyle products, all at one place. At Finserv MARKETS, we understand that every individual is different. And that’s why we have invested in creating a proposition – Offers You Value. A value proposition that ensures you get offers which are tailor made for you. We also offer an amazing product range and unique set of online offers across Loans, Insurance, Investment, Payments and an exclusive EMI store. Be it in helping you achieve your financial life goals or offering you the latest gadgets, we strive to offer what you are looking for. From simple and fast loan application processes to seamless and hassle-free claim-settlements, from no cost EMIs to 4 hours product delivery, we works towards fulfilling all your personal and financial needs . What’s more! Now enjoy the same benefits in just one click with our Finserv MARKETS App.


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Bajaj Finserv Direct Limited ("BFDL") is primarily engaged in distribution of financial products and services through its digital platform (“Bajaj Finserv MARKETS”) and inter alia renders services of customer acquisition, providing preliminary credit support activities, fulfilment services and post-acquisition customer services to Banks, NBFCs, HFCs. BFDL is also a registered Corporate Agent (Composite) under valid IRDAI registration number: CA0551 valid till 10-Apr-2024 for solicitation and servicing of Insurance Products. Registered Office: Bajaj Auto Limited Complex, Mumbai – Pune Road, Akurdi, Pune – 411 035 CIN: U65923PN2014PLC150522