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I am 31 years old and underwent laparoscopy for kidney stone removal in 2011. A health insurance company said I won’t be covered for any kidney-related procedure for the next two years and my premium will be higher than for a normal person (without medical history). What should I do?
—Roshni Das
The feedback you have received is in line with market practice. Insurers do not cover pre-existing ailments for specified periods. For a person of your age, pre-existing waiting period varies from two to four years. During this period, treatment for conditions that existed before the policy issuance is not covered. The two-year waiting period mentioned by you refers to this pre-existing disease waiting period.
Before policy issuance, insurers typically do a medical underwriting based on the person’s age, previous medical history and quantum of sum assured. After their assessment, they may adopt any of the following three approaches for a non-standard proposal: decline the proposal completely; offer to issue policy subject to some permanent exclusions; or issue the policy with a loading for adverse risk. You have described the third scenario above. The rationale for the above is that people with a medical history have a higher likelihood to claim due to a relapse or another ailment.
