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Asked by Anonymous - Mar 31, 2024Hindi

If I have a chronic ailment (diabetes, BP, thyroid, heart cond ition, etc.) can I still get coverage? Should I inform the insurer? What if I hide this information from the policy issuer?

Ans: Yes, you can still get health insurance coverage even with a pre-existing chronic ailment like diabetes, high blood pressure, or a heart condition. Here's a breakdown of what to consider:

Disclosing Pre-existing Conditions:

• It is crucial to disclose any pre-existing conditions to the insurer. This is because they assess the risk involved in covering you. Hiding this information can lead to claim rejection later.

Coverage for Pre-existing Conditions:

• Most health insurance plans cover pre-existing conditions, but with a waiting period. This waiting period can range from 2 to 4 years depending on the plan and the severity of the condition.
• There are plans that offer coverage for pre-existing conditions from day one, but they typically come with higher premiums.

Finding the Right Plan:

• Do your research and compare different health insurance plans to find one that offers coverage for your specific chronic ailment and has a reasonable waiting period.

Here are some additional tips:

• Be honest and upfront about your medical history in your application.
• Get a copy of the policy documents and carefully review the exclusions clause to understand what is not covered.
• Consider critical illness plans that provide a lump sum payment for specific critical illnesses, including some chronic conditions.
• Remember, transparency is the key. Disclosing pre-existing conditions ensures you get the right coverage and avoid claim rejections later.

DISCLAIMER: The content of this post by the expert is the personal view of the rediffGURU. Users are advised to pursue the information provided by the rediffGURU only as a source of information to be as a point of reference and to rely on their own judgement when making a decision.

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Question by FAQ - Jul 05, 2022Hindi

3. If I have a chronic ailment (diabetes, BP, thyroid, heart cond ition, etc.) can I still get coverage? Should I inform the insurer?

Ans:

Yes. If you have any major health ailments in India -- whether it's Thyroid, BP or Diabetes -- you can still avail of your hospital and medical expenses. There are policies available for patients with the common complications of prevalent conditions like diabetes and thyroid. There is health insurance coverage accessible for everyone, but make sure you notify your insurance provider of any illnesses and understand your policy's coverage.

Thus, when you fill up your proposal form for a health insurance plan, you need to disclose all material facts; else your claim might be rejected on the basis of non-disclosure or misrepresentation of material facts. So, if you have high blood pressure or diabetes, just remember to mention it along with the list of medications prescribed to you. Then, the underwriter will assess your risk and quote the premium accordingly. Also, there could be a waiting period, or, an exclusion attached.

Once the health insurance plan is accepted with the specified risks, all expenses associated with your pre-existing ailment would be covered by your insurer.

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