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Preexisting Disease clarification

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28 May, 2021 by  Dipak Jambusaria

This question was posted earlier also but reply not received

Preexisting disease is defined as one for which symptoms / treatment was there in the previous 4 years. Does it mean that if some had some disease prior to 4 years but if no symptom / treatment was taken in previous 4 yrs it need not be disclosed as per existing disease?

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Health Insurance

2 Answer

Regional Director, Amicus Insurance Broking

You are mixing two different things in your question:

  1. Pre-existing condition
  2. Disclosure

A condition or illness which was there four years prior to taking the policy and you have been fully cured and not continuing to take any treatment or having symptoms thereafter will not be a pre existing condition.

But you are obliged to disclose the condition to the insurer while filling the proposal form where there will a question for past illnesses or treatment undergone.

In other words the disclosure is not limited to something which can be a pre-existing condition, but extends to all conditions whether pre-existing or otherwise.

Non disclosure of the condition can lead to suppression of material fact and your claim may not be paid and policy cancelled ab-initio.

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28 May, 2021
Dipak Jambusaria

Thanks for clarity

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