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Providing group medical coverage to your staff members is a method to create a preventive measure for their finances. One of the important aspects that you should bear in mind is the coverage of pre-existing conditions. You need to ask, “Does group health insurance cover pre existing conditions?” To know more about pre-existing diseases and their coverage, read on.

Important Update (Dated May 30, 2024) – Good news for Health Insurance policyholders! According to the Master Circular on Health Insurance Business 29052024 rolled out on May 29, 2024 by IRDAI, insurers are to decide on the request for cashless claims within 1 hour of receiving the request. Also, the final claim is to be granted within 3 hours after the policyholder’s discharge from the hospital. Insurers have been directed by IRDAI to establish necessary systems and procedures for this process by July 31, 2024. The Master Circular on Health Insurance Business 29052024 circular is available here -

Are Pre-Existing Diseases Covered Under Group Health Insurance for Employees?

While it depends on the company policies, in most cases, pre-existing conditions are covered by group insurance schemes. Such coverage is generally a standard feature of a majority of organisation health insurance schemes. If not,  the pre-existing illness waiver or another add-on coverage can be purchased to obtain it.

Pre-existing Diseases in Group Health Insurance Policy

Often the question stays in customers' minds: does group insurance cover pre-existing conditions? The answer is yes, that too at an additional premium amount once your insurance provider allows it. Here is a list of the most prevalent pre-existing conditions; however, the diseases covered by a group health insurance scheme may differ from company to company.


  • Asthma

  • Cholesterol Issues

  • Thyroid

  • High-Blood Pressure

How Do Pre-existing Diseases Get Covered in Group Health Insurance?

Suppose you look for a health insurance plan individually for pre-existing disease coverage. In that case, you may be mandated to submit a few medical tests before the insurer provides you with a scheme and assesses the appropriate rate. A test is not necessary under a group health insurance scheme, though.


A comprehensive plan for employee insurance offers the opportunity for individual customisation by charging further for add-on or top-up plans coverage. A group health insurance scheme normally covers pre-existing diseases automatically according to the terms and conditions. Prior to being insured by the plan, employees might need to disclose any pre-existing conditions.


The insurance plan's paperwork or certificate will include pre-existing disease coverage information. The employees receive a policy card bearing their names after the plan is issued. Contacting the company's HR department or administration will allow the employee to learn more about the plan.

Group Health Insurance

There are numerous health insurance companies that provide a significant health policy that includes both group health insurance and pre-existing conditions coverage. The plans are as follows-

Health Insurance Plan


Godigit PED Health Insurance

  • Only 1 year waiting period for specific diseases (i.e. hernia, etc.) with Comfort Pro Plan of Godigit

  • Cashless Claim

HDFC ERGO Health Insurance Plan 

  • High claim settlement ratio, i.e. 1 claim per minute

  • Premium loading option available for lowering the waiting period duration of pre-existing conditions coverage 

Aditya Birla Activ Health Platinum-Enhanced Policy

  • Provide day 1 coverage for illnesses like high blood pressure and diabetes

  • In case acute diseases are detected, it provides a premium waiver.

Star Group Health Insurance 

  • The sum insured is up to INR 1 Crore

  • It provides AYUSH cover for a  maximum of INR 25000 or 25% of the insured sum, whichever is greater, per insurance period

ICICI Lombard Group Health Insurance

  • Provide coverage for maternity expenses

  • Provides coverage for the people between 91 days to 80 years of age.

Can Pre-existing Diseases be covered from day one in group health insurance?

Yes, now you can cover pre-existing conditions from day one. You can provide pre-existing conditions coverage to your employees under the group health insurance scheme from day one of the plan. 

Should one choose the Pre-Existing Disease waiver?

In case the chosen employee group health insurance scheme does not provide pre-existing conditions coverage as part of the standard plan, you must select the pre-existing conditions waiver to make sure that your employees are provided with a wide range of coverage.


Thus, we can conclude that giving your staff access to a group health insurance pre-existing conditions coverage demonstrates your concern for them and their dependents. The insurance professionals advise buying an insurance plan online because it is more affordable, and you can get detailed information about the policy there. You can use the online premium calculator to determine the insurance premium rate by eliminating the agent commission.


Can an employee include his/her spouse in the policy?

Yes, an employee can add his/her spouse or any other family member to the group health policy. However, you can confirm the same from your insurer.

Can PED coverage be provided from day 1 in a group health insurance scheme?

Yes, a few insurance companies like ACKO provide PED coverage from day 1 under the group health insurance policy.

Can I choose a pre-existing conditions waiver?

In case the group health insurance plan is not providing the PED cover in the standard plan, then you can choose a PED waiver so that wide-ranging coverage is provided to the employees.

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