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Posted by Royal Sundaram on 08 Apr 2010
Pre-Existing Condition means any known medical condition, ailment or injury or related condition(s) you had within 48 months prior to the commencement of your health insurance policy with the following characteristics:
You have signs or symptoms of the condition and/or were diagnosed for the same
You have received medical advice/ treatment
You have undiagnosed symptoms, whether recognised or not
Why don’t companies cover pre-existing diseases? Well, the answer is quite simple. The likelihood of taking treatment for an existing ailment is a known risk and insurance covers only unknown risk. If health insurance companies decide to cover pre-existing condition, then everyone will take insurance only after they have been affected. It goes against the very principle of Insurance, which is collecting premium from many to make payment of claims for a relatively few claimants.
Health Insurance Companies however do cover pre-existing diseases if the policy remains with the company for four years and it is renewed thereon. It is not always necessary that pre existing disease has to be serious diseases like heart attack or cancer. It can be as simple as asthma or a sports injury. In recent times, Insurance companies are coming with products with limited or no waiting period for PED. There could be some catch regarding the extent of Sum Insured which is available for such illness / disease. So go through your policy and choose wisely.
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