Health insurance is one of the most important financial decisions, yet many policyholders face claim rejection because they misunderstand one key condition — the waiting period.
In this article, you’ll learn:
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What a health insurance waiting period is
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The different types of waiting periods in India
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Practical ways to reduce its impact on your claims
What Is a Waiting Period in Health Insurance?
A waiting period is a predefined time during which an insurance company does not cover certain medical conditions or treatments after the policy starts.
Once the waiting period is completed, the policyholder becomes eligible to make claims for those conditions as per policy terms.
Types of Waiting Periods in Health Insurance
1. Initial Waiting Period
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Usually 30 days from the policy start date
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Non-emergency treatments are not covered
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Accidental hospitalisation is generally covered
2. Pre-Existing Disease (PED) Waiting Period
A pre-existing disease refers to any illness or condition diagnosed before purchasing the policy, such as:
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Diabetes
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Hypertension
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Asthma
Waiting period: Typically 2 to 4 years, depending on the insurer.
Claims related to these conditions are accepted only after the waiting period is completed.
3. Specific Disease Waiting Period
Certain medical procedures have a separate waiting period, including:
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Cataract
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Hernia
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Gall bladder stones
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Knee replacement
Waiting period: Usually 1 to 2 years.
4. Maternity Waiting Period
Maternity benefits are not immediately available.
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Waiting period ranges from 9 months to 4 years
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Applies to delivery, prenatal, and postnatal expenses
Common Reasons for Claim Rejection
Most health insurance claims are rejected due to:
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Waiting period not completed
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Non-disclosure of medical history
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Misunderstanding policy terms
Understanding these rules early can help avoid future issues.
How to Reduce the Impact of Waiting Periods
While waiting periods cannot be completely eliminated, they can be managed effectively:
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Buy health insurance at a younger age
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Maintain continuous policy renewal
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Port your policy carefully (waiting period benefits carry forward)
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Avoid relying only on employer-provided health insurance
How Waiting Period Works in Family Health Insurance
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Waiting periods usually start from the policy inception date for all listed members
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New members added later may have a separate waiting period
What to Check Before Buying a Health Insurance Policy
Before purchasing a policy, review:
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Waiting period clauses
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Pre-existing disease coverage rules
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Room rent limits
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Claim settlement process
Careful evaluation ensures smoother claims in the future.
Frequently Asked Questions
Is emergency hospitalisation covered during the waiting period?
Yes, emergency and accident-related hospitalisation is usually covered.
Does switching insurers reset the waiting period?
No. If you port your policy, completed waiting periods are carried forward.
Is the waiting period the same for all insurers?
No, it varies by insurer and policy type.
Conclusion
Health insurance is not just about buying a policy — it’s about understanding its terms.
A clear understanding of waiting periods helps you avoid unexpected claim rejections and plan your healthcare expenses more effectively.
Before purchasing a policy, always read the policy document carefully and disclose your medical history honestly.