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Pre existing disease.

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04 Jun, 2021 by  Rajesh

Heath insurance underwriting guidelines are as per the experiences of the insurer. I have a friend who had a surgery to remove an AVM in the front lobe of the brain in October 1997. He was put on anti epileptic drugs since there was a surgical removal of the AVM. He is 50 years of age now and because of the surgery then , he is denied health insurance in India since he was not asked to discontinue the medication.

What is best suggested for people of this kind with a harmless pre existing disease which is being taken care of by the proposer ? There is no sufficient data to help this fellow with the industry. Do such people go uninsured for life if they declare under good faith ? What does the forum opine ?

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04 Jun, 2021

Desr Rajesh

Insurance is a Proposer and acceptance contract .underwriters evaluate each case on the basis of disease and its prognosis .proposer has nothing to loose . If case is not accepted then 100 % premium is refunded .

So without any prejudice . Propose and let underwriter decide . Each case is specific and general guidelines does not apply .

Your friend has nothing to loose . Be fair , declare and leave it to underwriter .

Good brokers represent client and send case to many insurers .

Best wishes

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19 Jun, 2021

Hey Rajesh,

I hear you and I empathise with your friend. The current regime of health insurance in India is not conducive for people like your friend who have undergone some form of treatment or diagnosed with a medical condition in the past.

Insurers prefer relatively healthy customer base to cover any future eventualities. They are biased against health histories of treatments and surgeries.

This does not mean that one hides this information while buying the cover. Because once the insurer knows that the history was hidden (trust me they will come to know somehow), then they will reject every claim citing non-disclosure of previous medical history, and in extreme cases they cancel the policy and pocket the premiums paid till date.

So yeah, your friend may have to go uninsured all his life. Ask him to create a savings pool and aggressively save in that fund. That's a good option to have in place of insurance.


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