Page 208 - Ebook health insurance IC27

The Insurance Times

Pre-existing diseases (PEDS) Most of the claim disputes in health insurance relate to
pre-existing diseases
In order to reduce the disputes the general insurance
councils issued a standard definition of pre-existing
diseases in the year 2008.
Pre-existing disease will be "any condition, ailment or
injury or related conditions for which insured had signs
or symptoms, and/or were diagnosed, and/or received
medical advice/treatment, within 48 months prior to
insured first policy with the insurer"
PED exclusion wordings-"benefits will not be available
for any conditions as defined in the policy, until 48
months of continuous coverage have elapsed, since
inception of the first policy with the insurer"
Insurance companies have a maximum period of four
years to deny cover relating to pre-existing diseases

Renewability of health IRDA has issued circulars on renewability of health
insurance policies insurance policies which has many provisions and lay
emphasis on adequate disclosures, and promoting
transparency and fair treatment for policyholders.

212 Guide for Health Insurance