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Understanding Waiting Period and Survival Period in Health Insurance

Team AckoJul 22, 2021

Health insurance can seem perplexing for those who are new to the concept. People are usually aware of vehicle insurance but not that educated when it comes to health insurance. One of the reasons for this can be that vehicle insurance is mandatory and comparatively simple. Health insurance might not be mandatory and has layers that make it multifaceted, but that doesn’t mean it should be confusing. Digital-first insurers are simplifying health insurance for you and this article is about decoding two seemingly complex terms: waiting period and survival period in health insurance.

Waiting Period and Survival Period in Health Insurance

You must know about the basic terminologies associated with a health insurance policy before buying one. Otherwise, there are chances that you might end up disappointed during the claim settlement process. Waiting period and survival period are two such terms that you must be acquainted with to truly understand the scope of a health insurance plan and its relevance to you. Read ahead to know more about these terms and understand their intricacies.

What is the Waiting Period?

A waiting period is a predefined span of time that needs to pass before one can raise a claim against an insurance policy. Simply put, you must wait for the stated period to pass before availing the benefits. For example, if you buy a policy on 1 January and it has a waiting period of 30 days, then you cannot raise a claim during those thirty days. You can raise a claim on 31st January.

What is the Relevance of Waiting Period in Health Insurance?

The waiting period in health insurance is defined by the insurer. The policyholder must wait till the expiry of this waiting period to raise a claim. Different types of conditions can have different waiting periods. Some policies have a 15-day waiting period and some policies have a two-year waiting period.

From an insurance company’s perspective, the waiting period can be viewed as a buffer zone. Consider this example; a person with a diagnosed disease might go ahead and buy a policy covering the disease and raise a claim against it immediately. This is in a way against the core concept of insurance, as insurance is related to an uncertain event. And in this case, the event was certain. Similarly, the waiting period for Maternity Plans usually ranges between two to four years because it is something that falls in the grey area as far as certainty and uncertainty are considered.

The Top Benefit of a Lower Waiting Period:

As a policyholder, the lower the waiting period, the better the situation. Sometimes, different insurance companies might have different waiting periods for a similar cover. This is where comparing policies can be helpful. Considering other things equal, you can choose a policy that offers a lower waiting period. This is because you are in a better position to raise a claim as you do not have to wait for a long time to be covered by the policy.

Also, read: COVID-19 Health Insurance in India

Types of Waiting Periods:

Waiting periods are not restricted to one type. They can vary depending upon the policy, its coverage, and the terms. The concept of the waiting period across different types remains the same—you cannot raise a claim during the stated duration. Here is a brief explanation of different types of waiting periods in health insurance.

1) Initial Waiting Period

This is the basic type of waiting period. You must wait out the specified initial days after buying a policy. In most cases, this period is around three months. However, if you are hospitalised due to an accident, then this period can be waived off.

2) Pre-existing Disease Waiting Period

A pre-existing disease is a disease that you already have before buying a health insurance policy. If you want to raise a claim against it, you will have to wait for the pre-existing disease waiting period to get over. This period can be in the range of a few months to a few years depending upon the intensity of the pre-existing disease and the insurer’s terms and conditions.

3) Disease-related Waiting Period

Sometimes, the waiting period can be specific to a disease. For example, diseases like hypertension, diabetes, etc. will have a longer waiting period. This type of waiting period can be for two years.

4) Maternity Cover Waiting Period

Such a waiting period can be in the range of two to four years. This kind of cover is offered by limited health insurance companies. Those who keep the waiting period less might charge a high premium.

What is the Survival Period?

Just as the waiting period states that the insured must wait for a specified time before raising a claim, the survival period states that the insured must survive (live) for specified days after contracting a disease. If the insured dies during the survival period, the insurance company will most likely not honour the claim.

What is the Survival Period in Health Insurance?

Survival period in health insurance is usually related to Critical Illness Plans. Such plans offer a lump-sum pay-out in case of contracting a disease. To benefit from the claim amount, the insured must live beyond the survival period. This survival period is in addition to the waiting period if any.

Also, read: Arogya Sanjeevani Health Insurance Policy

What Should You Do While Buying Health Insurance?

As you might have noticed from the above-mentioned explanation of the waiting period and the survival period—you must make an informed decision while purchasing the policy. Do not be overwhelmed by the terminologies used concerning the policy but try to go through the terms and conditions of the plan before buying it.

You can access all the required information on health insurance websites. If you have concerns, you can send an email or call the online health insurance company to know more about certain clauses. Spending some time educating yourself about health insurance details is way better than purchasing an unsuitable policy and regretting the decision during the claim settlement process.

Frequently Asked Questions:

This section highlights some of the common questions related to the waiting period, survival period, and health insurance.

Do all policies have a survival period?

Not all policies need to have a survival period clause. If the policy has such a clause, it will be mentioned in the Policy Wordings. It is better to clarify with the insurer by going through the brochure or asking directly about the inclusion and details of the survival period clause if any.

I have never availed any kind of health insurance. Should I wait till I am in my thirties or purchase it in my twenties itself? How does it affect the waiting period?

The sooner you purchase health insurance the better it is for you. Health issues usually occur as one ages. By purchasing the plan early, you can complete the waiting period when you are relatively healthy.

Can I buy an Individual Health Insurance policy from one insurer and a Critical Illness Cover from another insurer?

Yes, you have the flexibility to purchase an individual plan from one insurer and a disease-specific plan from another one.

Which is more common, waiting period or survival period?

Most health insurance policies have a waiting period. Comparatively, a smaller number of policies have a survival period clause.

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