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All about Waiting Period in Health Insurance

By Neha Goyal
  | Published: 02 April 2021 | Last Updated On: 05 April 2021

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Many people purchase a health insurance policy without knowing its exclusions. One such exclusion is the waiting period. Purchasing a medical insurance plan doesn’t mean that the insurance company will start covering the policyholder from the very first day. Rather, he/she needs to wait for some days before making such claims.

Waiting period in health insurance is the time period during which the policyholder can not raise a claim for some or all benefits of the policy from the insurer i.e. the policyholder must wait for a specified time period before a claim can be considered. The terms & conditions and duration of a waiting period differ from one insurer to another. Different coverage and conditions have different waiting periods & also have different rules for the same. In most cases, policyholders will not get any coverage or reimbursement from their insurance provider during the waiting period.

There are a lot of doubts around waiting period. For Eg:  What is it? Its types and duration. If you want to know more about waiting period waiting period in health insurance then keep reading.

Different Types of Waiting Periods in Health Insurance

There are different types of waiting period in health insurance policy and they are as follows:

Initial Waiting Period

If the policyholder gets hospitalized within first three months from the start of the medical insurance policy then he/she is not entitled to claim benefits. To make any claim, the policyholder needs to wait it out. The usual waiting period varies from one to three months. The only exception to this rule is an “accidental claim” . The insurer approves claims if the policyholder meets a serious accident and requires hospitalization immediately.

Maternity Benefits Waiting Period

There are some medical insurance providers in the UAE that offer maternity benefits under the policy but with a waiting period of 3-4 years. That is why it is advised that policy seekers must start planning early on. If waiting period doesn’t sound too appealing to you, then there are a few companies that have reduced waiting period to meet market needs but their premiums are a bit higher than the rest.

Waiting Period for Pre-existing Diseases

There is a waiting period in health insurance for certain ailments which are already declared by the insured at the time of buying the policy. Such health diseases are known as pre-existing diseases and waiting period for such health conditions is known as pre-existing diseases waiting period. Generally, the waiting period differs from 1 year to 4 years of continuous policy coverage. In such cases, waiting period is dependant on policy holder’s medical condition.

Disease-specific Waiting Period

There is a particular waiting period of 1 to 2 years for specific diseases such as hernia, ENT disorder, osteoporosis, tumour, etc. The waiting period for each of these diseases is mentioned in the policy documents of each insurance company. Please note that waiting period for these ailments may differ from provider to provider.  

Free Annual Health Check-up Waiting Period

Some health insurance companies in the UAE offer a complimentary annual health check-up as part of their medical insurance policy. But, there may be a small waiting period (one year approx) to be served for to avail this benefit as well. Meaning that policyholders can avail of this benefit from the second year onwards of their medical insurance plan.

What is the Need of Waiting Period in Medical Insurance Policy?

There are many cases where a customer purchases a medical insurance, specifically to get reimbursements. In order to avoid such malpractices and fake claims, insurance companies introduced the concept of waiting period.

Final Words

The waiting period in health insurance is influenced by several factors  such as the type of medical insurance plan (group medical insurance, individual medical insurance, family floater medical insurance, etc.), medical history, and age of the policyholder. It is important to go through the fine print and know all about the waiting period of a medical insurance policy and then, opt for a plan that has a lesser waiting period. With this, one can avail the benefits of a medical insurance policy as soon as possible rather than bearing medical expenses from his/her pocket due to a long waiting period.