Irdai cuts maximum waiting period for pre-existing diseases
NEW DELHI: In a major relief to customers buying health insurance policies in 2024-25, the insurance regulator has reduced the maximum waiting period for pre-existing diseases like hypertension, diabetes, thyroid, knee surgeries, from 48 months to 36 months, effective from April 1.
The Insurance Regulatory and Development Authority of India (Irdai) has reduced the maximum waiting period for pre-existing diseases (PEDS), but there is no bar for insurance firms on the minimum waiting period, a government official who did not wish to be named.
The waiting period in a health insurance plan is the duration before that certain specific diseases would not be covered by the policy. PED is an ailment a policyholder has before the purchase of a health insurance policy. Due to the cut-throat competition in the sector, many companies offer health insurance policies with a two-year waiting period or even less for specific diseases. However, Irdai’s new notification may see a further reduction in the waiting time, experts said.
“Waiting period for pre-existing diseases disclosed by the persons to be insured, shall be maximum up to 36 months of continuous coverage under the Health Insurance policy. Insurers may endeavour to have lesser pre existing disease waiting period and specific waiting period in the health insurance products,” Irdai said in a notification.
According to the new definition, PED means “any condition, ailment, injury or disease: a) that is/are diagnosed by a physician not more than 36 months prior to the date of commencement of the policy issued by the insurer; or b) for which medical advice or treatment was recommended by, or received from, a physician, not more than 36 months prior to the date of commencement of the policy.”
The specific waiting period up to 36 months from the commencement of a health insurance policy during which specified diseases (except due to an accident) are not covered.