Ram took a health insurance policy for his father. While filling the proposal form, he witnessed a column asking about the pre-existing diseases. Since there was no sustained medical condition, he put a cross at that. After 2 years of continuous renewal, his father got hospitalised and insurance company denied the claim on the basis of non disclosure of the pre-existing condition.
After considering this, can we say that insurance companies are frauds? Well no. Neither the insurance company is at fault and nor Mr. Ram. The problem aroused because Ram did not know about what company mean by pre-existing diseases.
What is a pre- existing disease?
Well, pre- existing diseases doesn’t mean only the illness that a person has at the time of buying a policy. It also includes:
- Medical history of illness. History of diabetes, heart attack, etc.
- History of any prior hospitalization.
- Signs of increase in blood sugar level or obesity.
- Symptoms such as excessive sweating, loosing breath.
- Ongoing medication for any disease.
- Skin disorders.
- Major injuries.
- Illness which one have had before taking the policy but might revert like hypertension, diabetes.
Whether or not, the hospitalization occurs because of the pre-existing injury, insurance company has the right to repudiate the claim if the pre-existing conditions were not disclosed. These pre-existing diseases have a deep impact on the entire policy framework.
Terms and condition for pre-existing health condition:
- Premium loading might be applied to account for the greater risk.
- Waiting period is introduced and the cover of pre-existing ailment might be introduced after that.
- Both premium loading ad waiting period are implemented.
- Company might accept the proposal after a medical check-up.
- Exclusion of pre-existing conditions is sometimes deemed.
- If the conditions are really chronic and risky, a complete denial of proposal takes place.
Pre-existing conditions must not be confused with the disabilities from the birth. These don’t affect the insurance terms except from that they are not covered at all.
It is still advised to buy insurance policy with exclusions and waiting periods than committing a moral hazard and get claim denied. However, a proactive proposer might opt to get a voluntary medical check-up against the most common pre-existing diseases. This not only helps you to be clear about your health conditions but also saves the denial or loading on the basis of doubt.
Various common pre-existing conditions:
- Acid Reflux (Gerd)
- Alcohol Abuse And Recovery
- Anaemia
- Anxiety
- Arthritis
- Asthma
- Atrial Fibrillation
- Bipolr Disorder
- Blood Clot
- Blood Pressure
- Breast Cancer
- Blood Pressure
- Bronchitis
- Cancer
- Cardiovascular Diseases
- Cerebral Abnormalities
- Cholesterol
- Colon Cancer
- Polyps
- Congestive Heart Failure
- Coronary Bypass
- Depression
- Diabetes
- Digestive Track Disorder
- Drug Abuse
- Enlarged Prostrate
- Epilepsy
- Gastric Ulcer
- Glaucoma
- Heart Attack
- Heart Burn
- Hepatitis
- Insomnia
- Migraines
- Nasal Polyps
- Obsessive Compulsive Disorders
- Overweight
- Pacemaker
- Polycystic Kidney Disorder
- Seizures
- Stroke
- Thyroid