Pre-existing conditions are one of the most misunderstood areas in health insurance. Many people believe that if they have diabetes, BP, thyroid, asthma, or any long-term illness, their claims will automatically get rejected. That’s not true — but pre-existing conditions do affect your premium, waiting period, and claims in specific ways.
What Are Pre-Existing Conditions?
Pre-existing conditions refer to any illness, injury, or medical condition that you already had before buying a health insurance policy. Examples include:
- Diabetes
- High blood pressure (Hypertension)
- Thyroid issues
- Heart problems
- Asthma or breathing disorders
- Chronic back pain
- Any surgery done in the past
If you were diagnosed with a medical condition before buying the policy, it counts as a pre-existing condition.
How Do Pre-Existing Conditions Affect Your Health Insurance?
1. Waiting Period Applies
Most insurance companies apply a waiting period of 2–4 years for pre-existing diseases. During this period, you cannot claim for treatments related to your existing illness.
2. Premium May Be Higher
If you have diabetes, BP, obesity, or heart issues, insurers may charge a slightly higher premium. This is because you fall under a higher-risk category.
3. Medical Tests May Be Required
Depending on age and medical history, the insurer may ask you to undergo medical tests such as:
- Blood sugar test
- ECG
- Blood pressure evaluation
- Liver and kidney function tests
These tests help the insurer assess your health condition accurately.
4. Loading Charges
Some insurers add “loading charges” — an extra amount added to the premium because of the increased health risk.
5. Claim Approval Depends on Full Disclosure
The biggest impact of pre-existing conditions happens during claims. If you did not disclose your medical history at the time of buying the policy, the insurer may:
- Reject the claim
- Cancel the policy
- Investigate your medical history
Full disclosure = safe and smooth claims.
Why Hiding Pre-Existing Conditions Is a Big Mistake
Many people hide their diabetes, BP, or thyroid issues because they fear premium increase. But this is dangerous. Insurance companies verify medical records at the time of claim.
If they find undisclosed medical history, the claim will be rejected immediately.
How to Avoid Issues With Pre-Existing Conditions
- Always disclose your complete medical history
- Choose a plan with a lower waiting period
- Check if the insurer covers your specific condition
- Consider disease-specific health plans (e.g., diabetes cover)
- Take preventive tests every year to avoid complications
Conclusion
Pre-existing conditions do affect your premium and waiting period, but they do not stop you from getting quality health insurance. The key is honesty, proper documentation, and choosing the right insurer. Declare everything clearly, and your claims will be processed smoothly.
