Looking through health insurance can bring you across overwhelmingly technical terms. From deductibles to co-payments, it's quite an endless list. But one such term that you should know about is the moratorium period in health insurance. But what exactly does it mean? And how does it affect you as a policyholder? Let's find out.
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The moratorium period in health insurance refers to a fixed time period after which your insurer cannot reject any claims on the grounds of non-disclosure, misrepresentation, or pre-existing conditions (PEDs) unless proven fraudulent.
Revised IRDAI Guidelines (Effective April 1, 2024):
The IRDAI introduced the moratorium period in health insurance under its guidelines to increase transparency and fairness in processing claims. Earlier, even if policyholders had an active policy for years, their claims would get rejected due to some neglected or undisclosed pre-existing illness.
That left many policyholders feeling frustrated and in a dilemma during medical emergencies.
An important distinction between the moratorium period and the waiting period is their purpose and duration. Think of the waiting period as a short-term restriction on specific conditions. On the other hand, the moratorium period informs how long insurers can question or reject claims related to your pre-existing conditions or medical history. It is a long-term safety net for policyholders, which offers claim security.
| Moratorium Period | Waiting Period |
| Insurers can dispute prior non-disclosure or PED-related claims | Specific pre-existing conditions and treatments are not covered |
| Up to 5 years of continuous coverage | 30 days to 3 years, depending on condition or policy |
| Applies to all conditions or past health issues not disclosed, unless fraudulent | Applies to specific illnesses, surgeries, or pre-existing conditions |
| After 5 years, claims can't be denied for non-disclosure | Claims are not allowed for stated conditions during waiting period |
You buy a health insurance policy in June 2024 and disclose that you have hypertension at the time of purchase.
If you were to make a claim
The moratorium period is more than just a legal mandate; it actively works in your favour as a policyholder, offering claim security and flexibility.
If you’ve kept your policy active for 5 consecutive years, the insurer cannot reject your claims based on non-disclosure or past medical history, unless it’s proven to be fraud. This helps to create a further transparent and fair claims process for policyholders.
The fixed 5-year rule promotes better communication and clarity between policyholders and insurers. As a policyholder, you don’t get penalised over minor oversights, while the insurer gets to work within a clear, defined timeline.
You can switch insurers or plans without resetting your moratorium period, as long as you maintain continuity. This guarantees much more flexibility and choices for long-term policyholders.
The moratorium period is meant to benefit anyone who continues to maintain a health insurance coverage, but it’s especially useful for:
The moratorium period in health insurance being reduced to 5 years is definitely a big win for policyholders. Not only does it offer improved claim security, but also rewards long-term loyalty. Whether you're just getting started with health insurance or have been a long-term policyholder, knowing how the moratorium period works can help you make smarter, more confident policy choices.
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Reviewed by Dr. Harshita Dahiya 
Acko Technology & Services Private Limited
#36/5, Hustlehub One East, Somasandrapalya, 27th Main Rd, Sector 2, HSR Layout, Bengaluru, Karnataka 560102
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