The waiting period for pre-existing condition insurance in health insurance contracts has been reduced from four years to a mandatory three years, and the grace period has been reduced from 96 months to 60 months.
Currently, health insurance companies cannot deny coverage for your pre-existing conditions after you have completed his three-year waiting period for your health insurance policy. The Insurance Regulatory and Development Authority (IRDAI) has updated the definition of pre-existing conditions and moratorium period (MP) in health insurance contracts with effect from April 1, 2024.
The waiting period for pre-existing condition insurance in health insurance contracts has been reduced from four years to a mandatory three years, and the grace period has been reduced from 96 months to 60 months. During this period, insurance companies will implement a "no look back" policy.
“The new rules are very positive for policyholders,” said Abhishek Pondia, his CEO and managing director of SecureNow.in. "Many insurance companies have already shortened the waiting period for pre-existing conditions, but the new guidelines set it at a maximum of three years. Not only will it take several years, but the waiting period for pre-existing conditions will also be shortened." Policyholders will be less burdened to declare a pre-existing condition that has not been treated in the past three years or has been diagnosed after three years. Keep past medical records in case of a dispute with your insurance company. ”
Rahul Mishra, CEO and co-founder of Policy Assurance, said: "The previous definition used the term 'looking back' which was not clearly defined, creating ambiguity. The policy uses more specific language to indicate what the policy can and cannot do unless fraud is proven. Do not disclose or distort information from. ”
The revised grace period now explicitly includes the period covered by the previous insurer through portability and migration, allowing policyholders to maintain the grace period when changing insurers. became. This clarification will be beneficial to policyholders.
“Reducing the deferral period shifts the entire burden of underwriting to the insurance company.The insurance company cannot contest non-disclosure after five years, giving policyholders a smoother claim process. You will have great confidence in the processing. After five years of continuous renewal, you will not have to worry about your application being rejected," Bondia said.
Further, Siddharth Singhal, Head of Health Insurance, Policybazaar.com, said, “With the waiting period for PED reduced from 48 months to 36 months, more people are likely to opt for health insurance. "As a result, the penetration of insurance in the country will be promoted." Therefore, by reducing the waiting period for deferral from 8 years to 5 years, doubts about the abandonment of claims are reduced and customer confidence is increased. Furthermore, the specific waiting period due to illness can now be extended to three years, as it was four years ago. Customers can receive faster compensation. From a customer perspective, shorter waiting times are always preferable as it reduces uncertainty and allows for faster coverage of illnesses and insurance claims.
If the insured person is found to have a pre-existing condition, the waiting period will continue for up to 36 months based on the health insurance contract. Insurance companies can seek reduction in waiting periods for pre-existing conditions and certain waiting periods for health insurance products under his IRDAI (Insurance Products) Regulations, 2024.
“This change means that for the first time, policyholders will benefit from reduced waiting periods. Existing policyholders will also see reduced waiting periods to comply with the new three-year policy renewal regulations. They will benefit from this,” Singhal added. Overall, this initiative will benefit customers by ensuring enhanced benefits and reducing wait times when accessing health insurance.
Regulators will implement these measures to ensure flexible policyholder management practices, effective supervision and appropriate due diligence with respect to insurance products, including innovative products, taking into account the interests of policyholders. Changes were made.