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Why the Waiting Period in Health Insurance plan was Introduced?

IamCheated.com Research Team | July 03, 2019  6:59:pm

Why the waiting period in Health Insurance plan was Introduced?

As hospitalized expenses rise each day, it is very important to avail health insurance for you and family members. The health insurance plan makes sure; you don’t spend a single rupee from your pocket. The health insurance plan consists of terms and conditions you must be aware of, and one of the important concepts is the waiting period. Health insurance plans have waiting periods.

The waiting period is the period during which you will not be allowed to claim some or all the benefits of your health insurance policy. Even if you are hospitalized, you will not be able to claim during the waiting period. The waiting period and terms and conditions differ across insurers. 

Why waiting period in health insurance plan?

You might have questions regarding why the waiting period was introduced. Now, let us discuss the reasons for introducing a waiting period in health insurance plan.

Many people avail a health insurance plan, just to enjoy claims. Actually, the concept of the waiting period was introduced, with the intention of curbing misuse of health insurance plan.

Let us take an example of a person not having a health insurance plan. He falls ill and is diagnosed with a major disease. A doctor has advised him to undergo the surgery, which is very expensive. To bear the operation charges, the patient has to pay out of this pocket.

In order to save money, the patient avails health insurance without informing on the disease. He even undergoes the operation after availing the health insurance plan and the insurer pays up the amount. So, with the intention of avoiding such practices, the waiting period in a health insurance plan was introduced.

See Also: Importance of full disclosure to your Health Insurance Company

Types of waiting period:

1. Initial waiting period

When you avail a health insurance plan, there will be an initial waiting period of 30 days. During this period, you cannot make a claim, even if you are hospitalized. If you have to claim benefits from your health insurance plan, you must complete the initial waiting period.

2. Waiting period for pre-existing disease

Insurance companies have a certain waiting period for specific pre-existing diseases. These diseases have to be declared by the policyholder, while availing the policy. Pre-existing diseases are mainly diabetes, heart ailments and so on.

Waiting period for the pre-existing diseases is known as pre-existing disease waiting period. Pre-existing disease waiting period differs across insurers and is normally is around 1 year to 4 years. Duration of waiting period depends on the medical condition of the policyholder and the insurance company.

3. Maternity benefit waiting period:

Some health insurance plans even offer maternity benefits. Most of the maternity expenses are borne by the insurance company. But, the maternity cover comes with a waiting period of 9 months to 36 months. Waiting period varies across insurers.

4. Disease-specific waiting periods

There is also a specific waiting period for particular diseases like tumour, ENT disorder, hernia, osteoporosis and so on. This waiting period varies across insurers. This is clearly mentioned in the policy documents.

See Also: How To Claim Health Insurance?

Note: Before availing a health insurance policy make sure to go through the waiting period.

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