Can I Claim Health Insurance for an Existing Disease?

Yes — but usually only after the pre-existing disease waiting period, and only if you disclosed the condition honestly. Here's exactly how it works.

By Nikhil Mhaskar, COO, IndSure

Can I claim health insurance for an existing disease?

Usually yes — but not immediately. A pre-existing disease (a condition you already had when you bought the policy) is covered only after you serve the policy's pre-existing-disease (PED) waiting period. Claim before that window ends and it will be declined; claim after, and it is treated like any other illness.

How the waiting period works

Insurers apply a PED waiting period counted from when your continuous cover started. During that time, hospitalisation caused by the declared pre-existing condition is excluded. Once served, the condition is covered under your normal sum insured.

Two things decide whether the claim is paid: that you disclosed the condition honestly when buying, and that the waiting period is over. Non-disclosure is the most common reason a pre-existing-disease claim is contested.

What to do

  • Declare every existing condition at purchase, even if it lowers no premium — hiding it risks the whole claim.
  • Note your policy's PED waiting period and when it ends.
  • If you are switching insurers, port the policy so the time you have already served carries over instead of restarting.

See our plain-language explainer on the pre-existing disease waiting period and portability.

Frequently asked questions

How long is the pre-existing disease waiting period?

It varies by plan and has changed under IRDAI norms over time. Check your policy's PED clause for the exact duration, and count it from when your continuous cover began.

What if I didn't know I had the condition when I bought the policy?

Genuinely undiagnosed conditions are treated differently from concealed ones. Disclose everything you know; problems arise mainly when a known condition was hidden at purchase.

Does porting reset my pre-existing disease waiting period?

No. Portability credits the waiting time you have already served with your previous insurer, so you do not start the clock again if the new insurer accepts you.

Can the insurer still reject a claim after the waiting period ends?

If you disclosed the condition and the waiting period is over, that condition is covered. Rejection would need another valid reason, such as an exclusion or non-disclosure of something else.