Why is It Important to Disclose Pre-existing Diseases to Your Insurer?

  • Author :
  • TATA AIG Team
  • Published on :
  • 05/10/2023

“Health is wealth!”

As we grow old, we start realising how true this axiom stands in our lives. As people are growing more aware of the benefits of good health, they are embracing healthy living. Despite this, medical emergencies or healthcare needs can occur at any time. And in that case, there is only so little we can do. The rising healthcare costs only make things worse.

It becomes even more challenging for someone who has an existing health condition like heart problem, diabetes, kidney ailment, and others. Treating some of these diseases can cost a lot of money.

Having medical insurance, in this case, can be a great help. It can financially protect you from the long hospital bills. The benefit of a health insurance policy is to safeguard you against the financial burdens you may incur in case of hospitalisation of your family members. Health insurance policies cover hospitalisation and treatment expenses up to a predetermined limit.

But there is one important factor that you must remember. If you have a pre-existing condition before buying health insurance, you must declare it. One should never lie about their health conditions at the time of purchasing medical insurance plans.

Keep reading to learn more about why it is important to disclose pre-existing diseases to your insurer.

What is a Pre-existing Disease?

The term pre-existing diseases refers to medical conditions that an individual already has when purchasing a health insurance policy. Per IRDAI, pre-existing diseases are conditions, ailments, injuries, or diseases that a physician diagnosed within 48 months of the policy's effective date.

During the 48 months before the effective date or reinstatement of the policy, the insured may also receive medical advice or treatment from a physician. This is essentially any existing medical condition or ongoing treatment the insured had before buying the health insurance policy.

Diabetes, high body mass index, high blood pressure, and cancer are some of the prevalent pre-existing diseases. But at the time of purchasing your health insurance, you should check the pre-existing disease lists in the health insurance policy document to get a clear idea.

Health Insurance Policy for Pre-existing Diseases

A pre-existing disease (PED) is an illness or condition an insured already has when purchasing the policy. The policy applies a waiting period for the insured before it covers the PED. After the waiting period, individuals with health insurance policies can claim their PED treatment expenses.

The waiting period for PED usually lasts between two and four years, and the insurer will reject any claims for PED ailments during the waiting period. However, some health insurance plans cover pre-existing conditions with no waiting period, covering from the very first day the policy begins. Also, there are some add-on covers that can reduce the waiting period or completely abolish it from the base policy.

But why disclosing pre-existing conditions is crucial while buying health insurance?

Let us know in the next section.

Disclosing Pre-existing Diseases To Insurers – Why is it Important?

Health insurance policy seekers tend to conceal pre-existing conditions to avoid paying higher premiums. It is a fault that policyholders should avoid when it comes to not disclosing their PED when applying for a policy.

Different health insurance plans charge different premiums based on other factors for different policyholders. Among these factors are the individual's age, health condition, or any existing diseases they suffer from. When buying a policy, the policyholder must fill in all this information on the proposal form.

Insurance companies accept the information provided in the form as accurate. This is also used to determine the policy's premium and other things. Therefore, a policyholder who suffers from a pre-existing disease should disclose it honestly to choose the right premium and other factors.

A person may be penalised by the insurer if they provide false information, and it is considered a violation of trust.

Moreover, suppose the existence of PED is discovered later during the policy term. In that case, the insurer may terminate the policy and reject the claim for breach of contract.

So, while purchasing a policy, go through the pre-existing disease list of a health insurance company and see if you, or the person you are buying the health insurance for, have any of those issues.


Buying health insurance with a PED can be expensive. However, it is essential to note that these plans protect against such diseases. Putting a mask over pre-existing conditions is something that policyholders should never do. On the other hand, it is advisable to buy a health insurance plan early in your life when you are fit and healthy.

But while buying health insurance, make sure you choose a reliable partner like Tata AIG. It offers the best medical insurance plans. In addition to providing insurance options, Tata AIG has an experienced number of professional and qualified experts who assist them in selecting the best one for their needs, such as maternity or health insurance for parents.

With Tata AIG, you can buy health insurance online and enjoy the benefits of health insurance.

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Disclaimer / TnC

Your policy is subjected to terms and conditions & inclusions and exclusions mentioned in your policy wording. Please go through the documents carefully.

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