What Is The Waiting Period In Health Insurance And Why Does It Matter?

Key Takeaways

• The waiting period stops you from claiming right after buying the policy. It protects the insurance company from sudden claims.
   
• The first 30 days cover only accidents, nothing else. Normal sicknesses are not paid in this time.
   
• Old sicknesses need up to 36 months to get covered. This includes conditions like diabetes or high blood pressure.
   
• Once waiting period ends, coverage stays if you renew without break. You don’t have to wait again if you keep the policy running.

Bonus Tip: After 5 years of continuous coverage without any break, the insurance company cannot reject your claim just because you forgot to mention some past illness (except in cases of proven fraud).

Health insurance is a good choice. But if you buy it after you already have a sickness, it will not pay you in the beginning. This happens because of the waiting period. 

In India, as per current IRDAI rules from April 2024, this waiting time, including for old sicknesses, can go up to 36 months. Also, the first 30 days usually do not cover most sicknesses except accidents, if they are included. This blog will help you understand what is waiting period in health insurance is.

What Is Waiting Period in Health Insurance?

A waiting period is the time after you buy a health insurance policy, during which some claims are not paid. The policy is active, but not everything is covered yet. For example, if you get sick during this time, the company may not pay for that treatment. After the waiting period ends, you can claim for those sicknesses.

Why a Waiting Period Exists

Waiting periods are there to stop misuse of insurance. Without this, people could buy a policy only when they need treatment and claim money right away. That would make costs higher for everyone.

It also helps insurance companies handle long-term risk instead of sudden claims. This way, the system stays fair for all who have the policy. Many plans, like waiting period in health insurance Niva Bupa follow the standard 36-month rule for pre-existing diseases.

Types of Waiting Period in Health Insurance

Here are the main types of Waiting Period in Health Insurance:
 

Each type of waiting period has its own rule, so it is important to check them carefully before buying.

What is Pre Existing Waiting Period in Health Insurance?

This is the waiting time for sicknesses you already had before buying the policy. For example, if you had diabetes before taking insurance, you cannot claim its treatment right away.

You have to wait for a fixed period. After that, the policy starts covering it. As per current rules, this can go up to 36 months. Once this waiting period is over, the condition stays covered as long as you keep renewing the policy without a break.

How the Waiting Period Affects Your Claims

The waiting period decides when you can start using your insurance fully. If you raise a claim during this time for a condition that is not yet covered, it will be rejected.

For example, if you fall sick in the first 30 days, most sickness claims may not be paid. But accident cases are usually covered from day 1 if included.

If you switch your policy without any break, you can get credit for the waiting period you already completed in your old policy. This means you may not have to start from zero again. This rule applies across all the policies, including popular brands like waiting period in health insurance niva Bupa.

What Is Covered During the Waiting Period

Even while the waiting period is running, a few things are still covered: