Health insurance waiting periods play a crucial role in preventing unethical behaviour by policyholders and reducing the risk for insurers. Without waiting periods, it would be easy for individuals to exploit full coverage benefits by purchasing policies just before expecting medical expenses.
Consider this scenario: You get diagnosed with a critical illness but lack insurance coverage. Meeting the associated treatment costs on your regular income seems challenging, so you decide to buy health insurance for coverage. However, if you fail to disclose the condition to the insurer before purchasing the policy, it would be considered malpractice. Waiting periods in health insurance plans serve to address and prevent such unethical practices.
If you want to reduce the waiting period for your health insurance, you can opt for it by paying an additional premium. For example, if you have a pre-existing condition and want a health insurance policy with a shorter waiting period, you can contact the insurer and make an extra payment. The specifics of the waiting period waiver can vary depending on the chosen insurance provider.
Another scenario where the waiting period may be waived is when converting a group health insurance policy to an individual health insurance plan. According to the Insurance Regulatory Development Authority of India (IRDAI), employees have the option to convert their employer-provided group health insurance policy into an individual plan, allowing them to obtain health insurance without a waiting period. This exemption is granted because they would have already fulfilled the waiting period terms during the policy's group health insurance phase.
Rakesh Goyal, director, of Probus Insurance Broker said, “To minimize the waiting period in insurance, it's advisable to thoroughly review and understand the policy terms before purchasing. Opt for policies with shorter waiting periods, and consider insurers that offer quick processing times. Additionally, ensure that all required documentation is promptly submitted to expedite the underwriting process. Regularly communicate with the insurance provider to stay informed about the status of your application, and inquire about any potential ways to reduce waiting periods based on your specific needs and circumstances.”
First Diagnosis Of An Ailment: If you receive a diagnosis for an illness after obtaining a health insurance policy, it is not considered a pre-existing ailment. Unless there are specific exclusions in your health insurance plan, the coverage will extend to such an ailment.
Co-Pay Clause: Many contemporary health insurance policies offer the option to eliminate waiting periods by incorporating a co-payment or co-pay clause. Under this clause, the insured agrees to cover a predetermined percentage of a health insurance claim. This allows you to access health insurance benefits without waiting. It's essential to review the terms of your health insurance policy to understand the specifics of the co-payment clause.