Forgot to declare your health condition while buying insurance? Here’s what you can do

Posted on: May 4, 2023 | | Written by: HDFC ERGO Team

Forgot to declare your health condition while buying insurance? Here’s what you can do

Published on May 03, 2023. EST READ TIME: 3 minutes

What to do if you miss disclosing your health condition while buying health insurance

Imagine that you have been dealing with some concerning symptoms for a few months but are afraid to go to the doctor because you don’t have health insurance. After some research, you decide to purchase a health insurance plan - individual health insurance or family floater that seems affordable and offers the coverage you need. However, when you fill out the application, you decide to omit some details about your symptoms because you’re worried that they’ll increase your premium or even cause your application to be denied. You get approved for the health insurance policy, but a few months later, you receive a shocking diagnosis that requires expensive treatments. Unfortunately, because you withheld information from your insurer, you may not be covered for the costs of your treatment. Let’s find out the consequences ofnot declaring pre-existing medical conditions and if anything can be done to avoid the outcomes.

Consequences of withholding information about health conditions

First, if you raise a claim and the health insurance provider discovers that the claim is due to an illness which was not declared, the insurer can deny the claim or even terminate health insurance plans. The insurer can find out details about the health conditions while verifying documents related to the pre-existing disease health insurance claim.

Second, even if the claim raised is unrelated to the health conditions that are not disclosed, the insurer can still cancel the policy.

Third, if the hidden information is about pre-existing ailments or critical illnesses needing regular treatment, you will not be covered under pre-existing disease health insurance. With rising healthcare costs, medical expenses can burn a hole in your pocket, particularly if your pre-existing disease health insurance claim is denied or rejected.

Remedies for non-disclosure of health condition while buying an insurance

Not declaring pre-existing medical conditions while buying individual health insurance or any other healthcare plan can have serious consequences, but there’s still a way out.

1. Rectify the error during the free-look period. After you buy a health insurance policy, there’s a free-look period during which you can cancel, modify or correct any details in the policy. So, if you have not declared some information about your health while purchasing the policy, you can do it during this period, which is generally 15 days from the date of purchase. The insurer will underwrite the policy as per the guidelines.

2. If the free-look period is over, you can still disclose your health condition at the time of policy renewal. However, it is the insurance provider’s discretion to accept the new disclosure, continue the coverage, charge a high premium, exclude the medical condition or even cancel the health insurance policy.

3. You can buy a new health insurance policy or switch to another health insurance provider and honestly declare your medical conditions while purchasing a new plan to get coverage under pre-existing disease health insurance.

However, if you have been paying premiums for 8 continuous years and any pre-existing disease in the list of pre-existing diseases in health insurance is discovered after this period, the insurance provider cannot cancel the policy.

Conclusion

Honestly declare your current health conditions, medical history, or any pre-existing diseases while purchasing individual health insurance or any other healthcare plan to get coverage under pre-existing disease health insurance. Not declaring pre-existing medical conditions will not only lead to claim rejection, but the policy will also be considered null and void. For financial security, it is best to be transparent and avail complete coverage for pre-existing disease health insurance. It’s better to check the list of pre-existing diseases in health insurance before purchasing a policy.

Disclaimer: The above information is for illustrative purpose only. For more details, please refer to policy wordings and prospectus before concluding the sales.

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