IRDAI reduces pre-existing health condition waiting period to 3 years

The IRDAI has amended the terms of coverage for people with pre-existing health conditions by reducing the maximum waiting period set out in health insurance policies to 36 months from 48 months previously. The change took effect from 1 April 2024 for new and renewed health insurance policies.

The regulator has also updated the definitions of pre-existing conditions and shortened the moratorium period (MP) from 96 months to 60 in the IRDAI (Insurance Products) Regulations, 2024.

The revised MP also explicitly includes time covered under previous insurers when policyholders switched their health insurance policies to another insurer through portability or migration.

Policy Ensure CEO and co-founder Rahul Mishra, said to Business Today, “The revised policy uses more specific language, stating that policies can’t be contested for non-disclosure or misrepresentation after the MP, except in cases of proven fraud.”

Policybazaar.com business head of health insurance Siddharth Singhal, said, “By reducing the pre-existing disease waiting period from 48 months to 36 months, more individuals are likely to opt for health insurance, thereby enhancing insurance penetration in the country. Additionally, the moratorium period, which has been reduced from 8 years to 5 years, would enhance customer confidence by minimising doubts about claim denials.” Asia Insurance Review