Understand the difference between ' waiting period' and ' survival period'

In health insurance, a waiting period is a certain time before the start of the process of health claim. On the other hand, the survival period is the time during which the policyholder should survive after being diagnosed with the covered illness.

Factors related to ‘Waiting Period’ are as follows-

  • There is a waiting period in all the insurance policies. It is a period during which you cannot claim the benefits of the health insurance policy.  
  • Many health insurance plans come with long mandatory waiting periods for certain types of health problems such as:
  • Health issues such as cancer and cardiovascular care may have waiting periods of up to two years.
  • The maternity care waiting period varies from 10 to 12 months but commonly it is of 30 to 90 days.
  • The dental care waiting period is typically 6 to 12 months. 

There are three types of waiting period:

Initial Waiting Period:

In case you fall sick or hospitalized within 30-90 days of the start of your policy, in that case, you cannot avail of any of the benefits from the issuer regarding your health insurance policy. The waiting period in the initial days is not counted only in the case when you are hospitalized or bear any kind of medical expenses due to an accident.

Pre-existing Ailment 

If you are suffering from a disease or adverse medical condition before taking a health insurance plan. In that case, also, you are not liable to get any health coverage for any hospitalization expenses that occur because of the same. 

The waiting period for this clause varies from few months to few years based on the insurance company policies and guidelines. Secondly, it also depends on the kind of insurance cover you have chosen. A waiting period of 4 years for pre-existing diseases is a standard clause in almost all health policies. This is helpful for a policyholder as an insurance company cannot deny a claim after 4 years.

Disease-Specific Waiting Period

In this case, the insurer will provide you a list of the diseases for which you are eligible to claim as per the contract. This waiting period also lasts for around 2 years after the commencement of the policy. Common diseases in this list include (but are not limited to) hypertension, piles, hernia, ovarian diseases, and diabetes.

Is it possible to reduce the ‘Waiting Period’?

According to the guidelines of IRDA, employees who are a member of the group health plan offered by employers can convert their group covers into individual health policy, at the time of leaving the organization. In that case, the policy issued to the employee is without a waiting period because they already served the waiting time in the ‘Group Health Cover plan’ which is provided to them by respective health employers.

Factors related to ‘Survival Period’

  • Survival period is the length of time in which the insured must survive after being diagnosed with a covered critical illness. Once you have passed the survival period, the insurance benefit must be given to the insurer.
  • It is mostly applicable to critical illness insurance policies.
  • There are mainly three factors that decide the length of the waiting period- the disease, insurer, and policy. Here the waiting period is in addition to the normal waiting period as mentioned above.
  • The insurer will pay out an insurance claim if the insurer manages to survive the waiting period and that money can then be used for treatment, or if it is too late for treatment then the benefit amount can be used for any purpose.

Bottom Line

Read and scrutinize all aspects of your policy documents and compare insurers before choosing a health insurance plan. Also, research the claim to settlement ratios and claim honor ratios of the insurers you are planning on taking a policy from.