Health Insurance policies in India are structured to provide you with a financial safeguard against serious future health situations. This includes an illness that you may develop in the future, or an accident that you may meet.

To provide you with this cover, insurance companies require that you fully and accurately share relevant information. A pre-existing medical condition is one such piece of information. This gives the insurance company information that is necessary for it to more accurately assess what providing health coverage to you will cost.

If you declare this (and other) information as required, it does not mean that you will not be able to buy health insurance. The insurance provider could still offer you the policy. The premium they will charge you, however, could be higher. *

On the other hand, what happens if you do not declare your pre-existing condition - whether it be an oversight or a deliberate attempt to hide it? Read on to find out.

  1. You have time to fix the error
  2. What if I missed the free-look window too?
  3. Can I declare at the time of renewal?
  4. Change your insurance provider
  5. 8-year moratorium
  6. Takeaway

Every health insurance policy comes with a “free-look period”. This is the immediate 15-day period after you have purchased the policy during which you are completely free to cancel the policy without any financial implications. One other advantage of this free-look period is that you can update the information you missed giving to the insurance company. This allows the insurance company to update the terms of the policy based on the new information. *

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Things will now be out of your control for the duration of this policy. If the pre-existing condition is discovered at the time of a claim, the insurance company could choose to reject the claim. The insurer would also be within its rights to cancel the policy itself. *

Of course, the chances of such outcomes are higher the more severe the condition you did not declare is. If you have chronic kidney disease, for example, and fail to declare it, this will likely attract strict action from the insurer. On the other hand, if you did not declare a fracture in the leg from a few years ago, it will likely not turn out to be an issue.

However, if you have continued treatment for a condition, have a critical illness, lifestyle conditions etc., these must be disclosed. *

So, you are likely out of luck with this policy. But what if you declare the information you missed out on at the time of the renewal of your policy?

Accepting the new disclosure depends on the insurer’s policies. The insurer could choose to continue the same policy, change the premium or cancel the policy completely.

That said, it is still advisable to declare the missed information at the time of the Medical Insurance renewal. It is a safer option to risk cancellation of the policy at the time of renewal than at the time of a claim. *

Not all is lost

The picture is gloomy so far, but do not worry - there are two bright rays of hope

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You always have the option of changing your insurance provider at the end of the current policy. And when you sign on for a health policy with a new insurer, make sure you declare all the information this time. It is quite likely that you will easily find another insurer that will agree to cover you without any problems. *

The possible downside of this choice is that you might have to pay a higher premium and/or go through a waiting period with the new insurer. However, on balance, having a policy where you do not have the risk of cancellation will be worth this extra trouble. *

If you choose to not change your provider, you still have one way of getting past this error - the moratorium rules. IRDAI’s (Insurance Regulatory and Development Authority of India) moratorium rules kick in when you have been paying your premium for eight consecutive years. As per these rules, your policy cannot be cancelled after these eight years, even if the undeclared pre-existing condition is discovered. Visit the official website of IRDAI for further details.

* Standard T&C apply

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Not declaring all pertinent information truthfully at the time of purchasing your health insurance policy can have dire consequences. However, if you did not do that for some reason, you have options to fix the error. You can declare the information during the free-look period, change your provider or wait for the moratorium rules to kick in.

 

Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.

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