What is Waiting Period in Insurance?
As the name suggests, waiting period is the time span during which you cannot claim some or all benefits of the health insurance from your insurance provider i.e., you must wait for a specified amount of time before you make a claim.
For example: One of the most common types of waiting period is the time you need to wait to be able to use special benefits such as a Maternity Cover; in this case most health insurers will include a waiting period of two to four years i.e., before you can actually benefit from the maternity cover, you should have your policy for at least two years (the amount of time is dependent on the health insurance policy you buy).
Why is there a need for waiting period in health insurance?
There are several cases where a customer buys a health insurance policy to enjoy the claims and reimbursement.
For example : A person doesn’t have a health insurance policy and is diagnosed with a disease. The doctor suggested him to go for a surgery which is quite expensive and could have put an enormous hole in his savings. Looking at the problematic situation, the person chose to buy a health insurance policy without disclosing the disease. He even got the surgery covered just after the purchase. Hence, to avoid such unethical practices, the waiting period clause was introduced in a health insurance plan.
Initial waiting period
If the person gets hospitalized in the first 30-90 days from the start of the policy, he/she won’t receive any claim benefit from their health insurance policy if they fall sick or get hospitalized. There is an initial waiting period that needs to get over if you want to receive the benefits under your health insurance plan.
Pre-existing disease waiting period
There is a particular waiting period for some specific diseases which are declared by the policyholder at the time of policy purchase. These diseases are known as pre-existing diseases, and the waiting period for such conditions is known as a pre-existing disease waiting period. The pre-existing waiting period usually ranges from one year to four years of continuous policy coverage. The time for such waiting period depends on your medical status and the insurance company you select.
Maternity benefits waiting period
Some health insurance companies provide maternity benefits, but that cover comes with a waiting period varying from 9 months to 36 months.
Disease-specific waiting period
There is a specific waiting period varying between one year and two years for particular ailments like a tumor, ENT disorder, hernia, osteoporosis which are mentioned explicitly in the policy documents. These diseases vary from company to company.
Critical Illnesses Waiting Period: Regular health insurance plans cover critical diseases after a waiting period of 90 days and reject any claims for such diseases received during this period.
Waiting Period for Accidental Hospitalization
Accidents can cause the most unexpected injuries and other medical concerns. Therefore, given the nature of accidents; all health insurers do not account for any waiting period when it comes to accidental hospitalizations. This means, one can claim for accidental hospitalizations even just days into their new health insurance policy. The initial waiting period doesn’t apply here either.
The waiting period in your health insurance policy is influenced by various factors. It is essential to read the fine print of the policy waiting periods of a health insurance policy It will allow you to avail the benefits of your health insurance policy as soon as possible instead of bearing medical expenses from your pocket due to a long waiting period clause.
