Understanding Waiting Period & Survival Period In Health Insurance

Health insurance is arguably the most important investment you can make for yourself and your family. Health emergencies can severely dent your finances and, in extreme cases, may even land you in a pool of debt. Unhealthy lifestyles, terminal diseases, age-related issues, etc., can become overbearing if you do not have the support of insurance. Also, as medical inflation rises through the roof, health insurance may no longer be a choice, but a necessity.

If you have been researching health insurance, you must have come across terms like ‘survival period,’ and ‘waiting period’ in health insurance. So, what do these terms mean? Can they hamper your claim? Read further to find out!

In this article, we decode the relevance of waiting and survival periods when concerning a health insurance.

What is the ‘Waiting Period’?

You cannot immediately make a claim when you purchase a health insurance plan. You will need to ‘wait’ for a certain period before making a claim. This tenure is called the waiting period. 

A waiting period is included in the insurance policy’s terms and conditions to avoid fraudulent claims, safeguard the insurance company’s interests and promote the right employment of coverage and medical resources. However, did you know there are different types of ‘waiting periods’ depending on the individual and insurance type? Let’s explore a few types below – 

  • Initial waiting period 

As the name suggests, most health insurance plans have a 30-90 day general window period, during which claims cannot be made; called the initial waiting period. Only after the lapse of this period can any claims be made, and this is regardless of any hospitalisation or emergency that may arise in that period. 

This period can vary depending on the insurer and type of plan. 

  • Pre-existing diseases waiting period

Most insurers have waiting period in health insurance for pre-existing diseases

Now, since the disease is already diagnosed, the time frame is prolonged, nearly 1-4 years, which again depends on the condition, plan, and insurer. 

Suppose you are an individual already diagnosed with diabetes and buy health insurance in 2022. If your ‘waiting period for pre-existing diseases’ is mentioned as 3 years, then regardless of your health condition, you will not be able to make any claims before 2025. 

  • Specific diseases waiting period 

For terminal and certain illnesses like cancer, insurance companies have a provision called – waiting period for specific diseases. The time period can range from 1-2 years, depending on many factors. You cannot make claims for specified diseases during this period. 

  • Maternity waiting period

If your insurance covers maternity, you could claim a considerable amount to cover the doctor’s fee, checkups, and more. However, there is something called ‘waiting period for maternity,’ according to which no claim can be made for a specific period. This can range from 1-2 years to even longer. 

So, if you are planning to expand your family, do not forget to read on the maternity waiting period.

What is the ‘Survival Period’?

Now that you have understood what the waiting period in health insurance is, let’s look at what a survival period implies. 

The survival period, in layman’s terms, is the duration a person needs to survive for (after diagnosis of critical diseases like cancer, etc.) to make a claim. 

If you have a critical illness health insurance policy and are diagnosed with a major terminal disease, the insurer is bound to pay you a lump sum amount, but only if you survive for a specified period (which can range from 15-30 days). In other words, an insurance claim can only be made if you survive the prescribed period. In case you do not survive this period, the insurer is not bound to pay you any amount. 

Most companies included this clause because it is practically impossible to process every individual’s claim as soon as they get diagnosed.

Difference between the waiting period and survival period

Both waiting and survival periods are often confused due to their nature. But it is important to differentiate between the two. 

A waiting period in health insurance is a common clause in most plans. In contrast, a survival period is confined to only critical illness plans. Also, waiting periods are often longer and can go beyond 12-18 months. On the contrary, the claim period is smaller when concerning certain critical illness plans. 

Additionally, the claim is processed only when a person survives the specified period, whereas normal insurance plans have no such conditions. 

Naturally, as an individual, you must look for plans with low waiting and survival periods. Also, it may help to speak to your agent and read the fine print before signing up. 

The takeaway

In today’s world, the importance of a health insurance plan need not be exemplified. It is imperative that you insure your family for the best possible protection, physically and financially. But, before you sign up for any insurance, it is important to read the fine print and paperwork meticulously. Understanding terms like waiting and survival periods is paramount to knowing your insurance’s true value. It can also help avoid unpleasant surprises later on. 

Share this:

Be the first to comment

Leave a Reply

Your email address will not be published.