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Pre-Existing Diseases Coverage Under Health Insurance
Oct 28, 2023

Pre-Existing Conditions and Disclosure in Your Health Insurance Policy

With the growing cost of healthcare services, treating a major disease has become expensive. Relying on savings to take care of medical costs is not advisable as it could upset your financial stability and not allow you to focus on getting the best possible healthcare. Thus, it would benefit you to go for a health insurance policy that offers financial coverage for medical expenses. When buying a health plan, it's important to disclose any pre-existing conditions to the insurance company. A pre-existing condition is a health condition or illness that you had before the start of your health insurance policy. In this article, we will discuss pre-existing conditions and their impact on your health plan.

Definition of Pre-existing Diseases

When you are looking to purchase health insurance, there are certain pre-requisites laid down by the insurer. One of them is declaring any pre-existing conditions you might have. Pre-existing conditions refer to any health condition or illness that you have before you consider purchasing a health plan.* These conditions can include chronic illnesses, such as diabetes, heart disease, and cancer, as well as other conditions like allergies, asthma, and high blood pressure. Pre-existing conditions can be long-term or short-term and can vary in severity.

Why is Disclosure of Pre-existing Conditions Important?

Disclosing pre-existing conditions is crucial when applying for health insurance. Failure to disclose pre-existing conditions can result in a denied claim or policy cancellation. Insurance companies need to know about pre-existing conditions to accurately assess the risk involved in providing coverage. Pre-existing conditions can affect the cost of the policy, as well as the coverage limits and exclusions.*

When Should You Disclose Pre-existing Conditions?

You should disclose any pre-existing diseases when applying for health insurance. Insurance companies typically require applicants to provide information about any pre-existing conditions on the application form. Some insurance companies may also require a medical exam or review of medical records to determine pre-existing conditions.* It's important to note that you may also be required to disclose any changes in your health status during the policy term. This includes any new diagnoses, changes in medication, hospitalizations, or surgeries. Failure to disclose changes in your health status can also result in a denied claim or policy cancellation.*

What Happens if You Don't Disclose Pre-existing Conditions?

If you don't disclose pre-existing conditions, your insurance company may deny your claim or cancel your policy. Insurance companies can also investigate claims to determine if there was a pre-existing condition that was not disclosed on the application. If they find evidence of a pre-existing condition that was not disclosed, they may deny the claim or cancel the policy.* It's important to be honest and upfront when disclosing pre-existing conditions. Failure to disclose pre-existing conditions can result in significant financial consequences if you need medical treatment for a condition that was not covered under the policy.*

Can Insurance Companies Deny Coverage for Pre-existing Conditions?

Insurance companies can deny coverage for pre-existing conditions, but this will vary depending on the policy and the insurance company. Some policies may provide coverage for pre-existing conditions, while others may have exclusions or limitations for certain conditions. Insurance companies may also require a waiting period before coverage for pre-existing conditions begins.* It's important to carefully review the policy documents to understand the coverage for pre-existing conditions. If you have a pre-existing condition that is not covered under the policy, you may be able to purchase additional coverage or seek out alternative insurance options.*

Things to Keep in Mind When Buying a Health Plan

Having pre-existing conditions does not mean you require no health coverage. If you have pre existing diseases and are interested in buying a health plan, these are some of the things you should remember before you purchase the plan.
  1. Check the waiting period of the insurer for people with pre-existing conditions. Many insurers are willing to reduce the waiting period for a higher premium
  2. Check if the insurer offers voluntary deductible to reduce the premium amount
  3. Check for the exclusions of the policy as many insurers exclude some pre-existing conditions from the coverage
  4. Check if OPD charges are covered by the policy


Pre-existing conditions are an important factor to consider when applying for health insurance. It's crucial to disclose any pre-existing conditions to the insurance company and to be honest and upfront about any changes in your health status during the policy term to avoid having any complications while filing a claim for compensation. If you have any more doubts about the policy such as the cost, waiting period or the list of pre-existing conditions covered by the health insurance policy, you can get in touch with an insurance agent to get a better understanding about it.   *Standard T&C apply Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.

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