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Information About Waiting Period and Survival Period in Health Insurance!

Published On Jan 24, 2020 5:30 AM By Gunjan Anand

Health insurance is a tool which provides a range of medical benefits to ensure protection from illnesses. However, various provisions lie that should be taken into account for purchasing a policy such as the waiting period and survival period. These terms are described clearly in health policy wordings and play crucial roles in claim settlement procedures as well. Unawareness about these terminologies can lead to claims rejections; therefore, people must have knowledge about these.  

Waiting Period
Whenever someone buys a health insurance , they are entitled to get covered for diseases only after the end of the waiting period of a specific duration. Basically, it is a duration in which one cannot request a claim for any benefit from the insurer. The lower the waiting period will be, the sooner the coverage will be. Therefore, policyholders should know about this point before buying the plan.

Three basic aspects which determine the duration of the waiting period are the illness, the insurance firm and the plan. This is a common feature available in all the health insurance plans irrespective of their insurers. It is utilised by insurance providing firms to safeguard themselves from several liability risks.

Types of waiting periods

Initial waiting period: Normally, if someone falls ill or gets hospitalised within 30 to 90 days and even 180 days in some cases, from the beginning of health policy, he or she doesn’t entitle to receive any help from the insurer. One can’t avail the insurance plan during this period. The claim is accepted only for the hospitalisation or other medical expenses occurring due to an accident.

Pre-existing disease waiting period: If someone is suffering from an illness or a bad medical condition, which existed before or at the time of buying the health insurance plan, he or she won’t get coverage for any hospitalisation costs, which may arise due to the pre-existing ailment. However, in such instances, the waiting period could be of any duration, which may range from months to years that vary from insurer to insurer.

Disease-specific waiting period: In this type of waiting period, hospitalisation expenses for a specific list of pre-specified illnesses will be covered after a certain period of time only. Here, insurance firm issues a list of illnesses for which claims will be entertained after a certain period only, which can even last for almost 2 years from the beginning of the plan.  

Waiting period for maternity or newborn cover: The maternity cover isn’t available in many health insurance plans and present as an add-on cover in some. Still, some insurers offer this benefit, but only after a waiting period. Generally, the maternity option is available with 2 to 4 years of the waiting period. Thus, one needs to plan in advance to seek proper coverage for maternity and newborn baby expenses.

In short, proper planning is required to avail the health coverage and benefits offered under a plan with a waiting period. To ensure your eligibility, do thoroughly read all the policy documents and comprehend and negotiate it with the insurer until you get satisfied.

Survival Period

The term Survival Period might sound gruesome, but the fun part is that it is literally an awful clause. It states that in order to gain a benefit from the insurer, one need to survive for a specific time after getting diagnosed for the first time with a critical illness. It majorly applies to health plans covering critical illness insurance. Generally, insurers hold a survival period of 30 days, but it may vary from insurer to insurer. Hence, it’s suggested to opt for a plan with a minimum survival period. Here are a few points to remember about critical illness covers and survival periods, especially while choosing a health plan:

  • Survival period is computed after the first critical illness diagnosis
  • This duration is applicable in addition to the initial waiting period
  • The insured individual is entitled to receive a specified lump sum amount on the completion of the survival period
  • One can utilise the lump sum received post survival period in any way either for medical treatment or for personal expenses

Survival period is a crucial element, which shouldn’t be ignored while opting for a health insurance plan. Considering it properly can land you in the most suitable critical illness plan.

Also Read

4 Health Insurance Plans for Pre-existing Disease Coverage in India

How a Health Insurance Policy Benefits Women at Different Stages of Their Life?

Almost every insurer offers a waiting period and survival period with its health insurance plans for critical illness, in particular. The terms of these periods may vary from insurer to insurer. These policy terms can affect the utilisation of health coverage and gaining the benefits of the plan. Therefore, it is vital to hold the information about these terminologies as these can help you a lot in selecting a better health plan.

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