People do not disclose their pre-existing disease (PED) while purchasing insurance. For this it is necessary to fill the proposal form. If the insured defaults, his claim may be rejected by the insurance company.
People take health insurance for the treatment of serious diseases or to cover emergency expenses, but many times companies reject the insurance claim. This is because many people do not disclose their pre-existing disease (PED) while purchasing insurance. For this it is necessary to fill the proposal form. If the insured defaults, his claim may be rejected by the insurance company. Therefore, this form should be filled compulsorily while taking insurance.
IRDA reduced waiting period
The Insurance Regulatory and Development Authority of India (IRDAI) has recently made important changes in the rules related to health insurance. Under this, the time period for covering pre-existing disease i.e. PED has been reduced. This will directly benefit the consumers taking health insurance.
Till now, illness up to four years before applying for the policy was considered pre-existing illness. Now this period has been reduced to three years. This means that now the disease occurring before three years of purchasing the policy will come under the category of PED, but its benefit will be available only if the insured has filled the proposal form while taking the insurance.
What is proposal form?
Whenever a person buys health insurance, the insurance company fills a proposal form. In this, various types of questions related to the lifestyle of the applicant are asked. Also, complete details of any disease from which the applicant is suffering are sought. Under IRDAI rules, illnesses and injuries incurred up to 36 months before purchasing health insurance will fall under the category of PED. Diseases like high blood pressure, asthma, thyroid and diabetes are included in PED.
The company may reject the claim
Experts associated with the insurance sector say that pre-existing diseases are an important issue while buying health insurance. These should not be hidden. If these are detected later, the insured may suffer a huge loss. For example, if a person applies for a health insurance policy, then according to the new rules of IRDAI, if he has any chronic disease or has been undergoing treatment for three years before purchasing the policy, then it will have to be disclosed in the proposal form.
If at the time of filling the proposal form, the insurance company comes to know that the applicant or any member included in the policy has any disease, then it can increase the premium amount, add any condition or reject the application itself.
If the applicant takes insurance cover by hiding the disease and after a few months, while undergoing treatment, the company comes to know that the disease is chronic, then it can reject the claim. Not only this, the policy can also be discontinued.
Take these precautions
1. Fill the form yourself: Take special care that you fill the proposal form yourself. Do not get it filled by anyone else, nor allow anyone else to fill it.
2. Do not leave any column blank: Fill the form completely and with correct information. Do not leave any column blank.
3. Understand all the questions: Make sure you understand the questions asked in the form correctly. This will have to be declared in the form.
4. Do not hide any information: Do not hide any information or fact while buying insurance. Doing this may cause problems while making an insurance claim.
5. Keep a copy with you: A copy of the signed proposal form must be kept with you. This will be a solid record of mutual agreement with the company.
6. Must add phone number: Make sure that your phone number is registered with the insurance company. In case the claim is rejected, a message will reach you.
7. Coverage Must Check: Also ensure whether the policy covers your health needs and critical illnesses. Also see what is covered and what is not included in the policy.
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