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Did you know that withholding information about even common medical conditions such as high blood pressure or diabetes could lead to claim rejection by your health insurer as per the law? A large number of claims rejected by the insurance companies are due to withholding crucial information about pre-existing diseases by the customers. A pre-existing disease can be defined as any condition, ailment, injury or related condition for which policyholder had signs or symptoms, and/or were diagnosed, and/or received medical advice/treatment, within 48 months before taking the policy.
In case, policy had any break in between, then it will not cover the pre-existing disease. As per prevailing norms, if a customer renews his policy within 15 days of the grace period, the continuity benefits including cover for pre-existing diseases are provided. If he fails to renew within grace period, the old policy is cancelled and new policy is issued. However, in group insurance policies, it is a common practice to cover pre-existing diseases on payment of extra premium. Since it is not viable to collect and analyse medical history of each and every member to be included in group insurance policy, insurers underwrite the extra risk by charging extra premium. These policies are generally bought by small and medium organisations, NGOs, government and semi-government organisations. In global context, insurers cover pre-existing disease in retail segment as well. The premium charged by them to cover pre-existing disease though, is significantly higher than what they charge a regular policyholder. |
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