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Question about health Insurance to young generation who has pre-existing diseases

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11 May, 2021 by  Jayashankar Maddipoti

Hi team,


I have one question related to the health insurance, generally some people who are in early stage say around 25-30 can fall in pre-existing diseases like diabetic, blood pressure ..etc due to their way of living or some other reasons. For them, to take health insurance, obviously insurers will deny telling that we will not cover those type of cases. How can any person who is at this stage can get health insurance?


One solution: They can change their life style in order to suppress the pre existing disease as they are in youth stage, they can easily get over it by taking certain precautions and take the report from practitioner/doctor that they are perfectly fit from all of the things.


But even though they get this certificate from doctor, insurers won't believe as it is comes as under life long disease, can be changed any time.


What would you recommend for this type of case? Could you elaborate every known point? Anyone can give their perspectives. Thanks in advance. Waiting for your responses.

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12 May, 2021

It's not that such members will not get cover. The insurance companies apply a waiting period (usually 4 years) for coverage. During this period, the insurers will not pay for hospitalizations arising out of these pre-existing conditions (directly or indirectly).

If these are lifestyle diseases, they can generally be reversed with lifestyle modifications like exercise, diet & other methods to reduce stress.

Health insurance is just the payment mechanism for hospitalizations. It's in individual's hand how to manage their own health proactively. Prevention of disease is the best insurance and with proper discipline & care, most lifestyle diseases can be eliminated.


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12 May, 2021
Jayashankar Maddipoti
Hi, thanks for the reply. This question was asked for the person who had a pre-existing disease like BP, diabetic ..etc and wanted to take the a health insurance plan. I just checked with the few insurers whether they will issue any plan to the person(who has pre-existing disease), they are simply denying to issue a policy. I think, every insurer will give the same reply to that person, then how he will get a new policy? I hope you got my question.
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16 May, 2021

Yes, you are right Mr. Maddipoti,

The person would not get insurance as most insurers would avoid having such risk on their books for a lifetime.

There should be an option to accept such risks at a higher premium or making such lifestyle ailments an exclusion for a certain period.

Hope IRDAI looks into it & builds some guidelines around this..

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19 May, 2021
Jayashankar Maddipoti
Thanks Sudhir for your clarification. So, what would your opinion about taking insurance for my friend? If he declares that he has this conditions, it would automatically registered with IRDAI and other insurers. Can he wait for few months and correct his lifestyle and then go for Insurance? What you would say?
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19 May, 2021

Hello Mr. Maddipoti,

He wouldn't get insurance now if few insurers have already rejected his proposal form.

The best way is to undertake lifestyle modification & get diabetes/hypertension under control and then try again for insurance after few months.

The IRDAI part is about expected changes in the guidelines from them to insurers. I wish if people have lifestyle conditions like diabetes/hypertension, they should not be denied insurance cover. Insurers should limit hospitalizations arising out of such conditions for a certain period (or maybe look at some tests after 4-5 years and check whether those earlier conditions still prevail), also, maybe make it lifetime exclusion BUT provide cover. Such a person would have a probability of hospitalisation which may not be related to these lifestyle conditions and at such times, the insurance cover would come in handy.

Your friend can write to IRDAI & provide this as feedback for guidelines for better insurance coverages which will improve insurance penetration in this country.

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