IRDAI Lowers PED Waiting Period from 4 years to 3 years

In a welcoming move, the Insurance Regulatory and Development Authority of India (IRDAI) has reduced the health insurance waiting period for pre-existing diseases (PED) from 4 years to 3 years. The new rules came into effect on April 1, 2024, under the IRDAI (Insurance Products) Regulations, 2024.

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      Lower Waiting Periods May Increase Insurance Penetration

      As per the recent notification, the IRDAI has reduced the maximum PED waiting period under health insurance from 4 years to 3 years. This means policyholders will now be able to file claims arising out of pre-existing diseases like diabetes, hypertension, asthma, etc., after serving a maximum waiting period of 3 years.

      For the unversed, pre-existing diseases refer to any disease, medical condition, ailment or injury that was first diagnosed or for which medical treatment or advice was taken before the commencement of the policy.

      Additionally, the insurance regulator has lowered the waiting period for specific diseases/ procedures, such as joint replacement surgery, from 4 years to 3 years.

      Lower waiting periods are expected to increase health insurance penetration in India, as they reduce coverage uncertainty and, in turn, improve the trust of the people in the insurance industry.

      IRDAI Significantly Lowers Moratorium Period

      The IRDAI has also significantly reduced the moratorium period in health insurance from 8 years to 5 years. Doing so ensures that insurance companies now cannot deny any claims covered by the policy on grounds of misinterpretation or non-disclosure after 5 consecutive renewals unless it is a case of fraud.

      The new rules will apply to old as well as new policies and thus benefit both existing and new policyholders. IRDAI has directed all health insurance companies to compulsorily follow the new rules and amend their policy documents.

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