Pre-Existing Disease
A condition diagnosed or treated before a health policy started.
Disclose every diagnosis at proposal stage. Non-disclosure is the most common reason for claim rejection, while a declared condition simply serves out its waiting period and is then covered.
Why Pre-Existing Disease matters when comparing products
Understanding what constitutes a Pre-Existing Disease (PED) is crucial when evaluating health insurance products in India. Each insurer may have specific definitions and waiting periods for declared PEDs, influencing the eventual scope and timing of coverage. Disclosure directly impacts claim admissibility, making it a key factor for comparing policy benefits and ensuring the policy effectively serves its purpose for medical contingencies. Non-disclosure can lead to significant financial implications.
Illustrative example
Suppose an individual has a diagnosed thyroid condition before purchasing a health policy. They disclose this, and the policy has a 2-year waiting period for this specific PED. If a claim for thyroid-related treatment arises after 2 years and 3 months, it would typically be covered. However, if undisclosed and a claim for ₹50,000 for the same condition arose, it could face rejection due to non-disclosure.