Yashish Dahiya
I was recently diagnosed with a mild heart attack and was advised by my doctor to get admitted to perform certain routine tests and medication. I decided it was time that I utilise my newly bought Health insurance Policy. So I got admitted into the hospital and submitted all my insurance documents at the admission counter and looked for the best room my health insurer would cover. On the day of my discharge I was handed over a bill of Rs. 60,000 by the hospital to which I looked cynically and asked them, doesn’t my health insurance cover this?The Spiel:‘All you need to do is go and get admitted in the hospital. Your health insurance covers everything.’The Catch:Bought a Health Insurance plan recently, read the terms and conditions as soon as you receive the policy document. All major Health Insurers today have added a Waiting Period clause in their health insurance policies. By the word waiting period they mean, that until your health insurance policy has completed an XX number of years a few particular illnesses will not be covered under that policy. All critical illnesses are covered under a health insurance policy but only after the policy has completed a stipulated amount of time, taking an example of a Cardiac Arrest, all major insurers have a waiting period of between 2 – 3 years before they start covering you for all financial losses caused due to hospitalisation in case of a cardiac arrest. What you should do:All customers should mandatorily read the policy document booklet at the time the policy is issued to them. The policy document is the final word against which the insurer will settle all claims as made by the policyholder. Hence, it is mandatory for a policyholder to read the policy document as soon as he receives the same. All insurers also offer a Freelook period to a customer, which states if the customer finds anything wrong in the policy sold to him or any difference between what was communicated to him by the agent and what the policy document says, the customer can opt to discontinue the policy immediately and the insurer will bound to return the policyholder his money less of any medical check up charges, if incurred any. The freelook period is available to the customer for 15 days beginning from the time he receives his policy document. If the policy holder fails to respond in stipulated 15 days, he would not be able to discontinue the policy A short list of illness and their corresponding waiting period| Illness | Waiting Period |
| Any Illnesses or Ailments or Surgery Procedure | 30 Days |
| Hepatitis of any kind, Tuberculosis of any kind | Six Month |
| Tonsillitis, Arthritis; any Back, Spine or Spinal Chord Disorder | One Year |
| Cancer of any kind , Kidney Stone, Cataract, Hernia | Two Years |
| *This is an indicative list and waiting period would depend from insurer to insurer. | |
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