Pre-existing conditions and health insurance claims

Pre-existing conditions are those illnesses or diseases that exist before purchasing the health insurance policy.

Apr 30, 2017 04:04 IST India Infoline News Service

Pre-existing conditions are those illnesses or diseases that exist before purchasing the health insurance policy. Not just that, the term also includes the following conditions:
 
1. Medical history of the insured for illnesses such as high blood pressure, diabetes, and similar diseases,
 
2. History of hospitalisation of the insured for diseases such as angioplasty or bypass surgery, kidney stone, etc.,
 
3. Displaying symptoms such as brain fog or sweatiness or signs of obesity and high sugar level or skin disorders such as psoriasis, vitiligo, etc.
 
4. Being on medication for diseases such as hypertension, diabetes, etc.,
 
All these are considered as pre-existing medical conditions and have to be disclosed at the time of buying a medical insurance policy.
 
If the insured fails to disclose these pre-existing medical conditions and deliberately conceals information about these conditions, the insurance company is likely to reject any claim arising out of these pre-existing illnesses and medical conditions.
 
An insurance company may or may not sell an insurance policy to a person with pre-existing medical conditions. If the insurance company sells a policy to such a person, it may charge a premium that is higher (also known as ‘premium loading’) than the premium it charges to a person who does not have such pre-existing medical conditions. Also, the waiting period for a medical policy may be 2-4 years, which means that only after the expiry of the waiting period, the company will provide cover for the pre-existing medical conditions.

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