The following are some of the frequently asked questions on health insurance compiled from Insurance Regulatory Development Authority of India’s website:

Is there any waiting period for claims under a policy?

Yes. When you get a new policy, generally, there will be a 30-day waiting period starting from the policy inception date, during which period any hospitalisation charges will not be payable by the insurance companies. However, this is not applicable to any emergency hospitalisation occurring due to an accident. This waiting period will not be applicable for subsequent renewals.

What is the pre-existing condition in a health policy?

It is a medical condition/disease that existed before you obtained health insurance policy, and is significant because the insurance companies do not cover such pre-existing conditions, within 48 months prior to the first policy. It means pre-existing conditions can be considered for payment after completion of 48 months of continuous insurance cover.

Can I transfer my policy from one insurance company to another without losing the renewal benefits?

Yes. The Insurance Regulatory and Development Authority has issued a circular, dated October 1, 2011, which directs the insurance companies to allow portability from one company to another and from one plan to another, without making the insured lose the renewal credits for pre-existing conditions enjoyed in the previous policy. However, this credit will be limited to the sum insured (including bonus) under the previous policy.

What happens to the policy coverage after a claim is filed?

After a claim is filed and settled, the policy coverage is reduced by the amount that has been paid out on settlement. For Example: In January, you start a policy with coverage of ₹5 lakh for the year. In April, you make a claim of ₹2 lakh. The coverage available to you for May-December will be the balance ₹3 lakh.

Source: IRDAI

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