What Is Considered A Pre-Existing Condition On Health Insurance Policy?

Pre-existing disease as defined under ‘Guidelines on Standardization in Health Insurance, 2016’ is as below:-


Pre-existing any condition, ailment or injury or related condition(s) for which the Life Assured had signs or symptoms, and/or were diagnosed, and/or for which medical advice/treatment was received within 48 months prior to the first policy issued by the Company and renewed continuously thereafter. Any investigation or treatment for any Illness, disorder, complication or ailment arising out of or connected with the pre-existing Illness shall be considered part of that pre-existing illness.

Products which have ‘Pre-existing disease exclusion’ mention no benefit shall be payable for any condition(s) which is a direct or indirect result of any pre-existing conditions unless Life Insured has disclosed the same at the time of proposal or date of reinstatement whichever is later and the Company has accepted the same.

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