>> Will Zero Waiting Period Health Insurance Plans Disrupt the Insurance Industry?

Will Zero Waiting Period Health Insurance Plans Disrupt the Insurance Industry?


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    Will Zero Waiting Period Health Insurance Plans Disrupt the Insurance Industry?

    LinkedIn Highlights:

    • Zero waiting period health insurance plans are not completely free of waiting periods.
    • The zero waiting period is applicable only for Pre-existing conditions and the other waiting periods such as initial waiting period, specific disease waiting period, maternity waiting period etc. would remain the same for now.
    • High premiums, low sum insured, high co-payment could be the drawbacks of these plans.
    Types of Waiting Periods in Health Insurance

    What is the Waiting Period?

    As the name suggests, the waiting period is the time one has to wait before claiming the health insurance policy. It is known that the main aim of availing health insurance is to claim in case of an emergency such as an accident, illness, or disease. Still, one might get confused about the need for a waiting period in health insurance policies. A waiting period is deliberately included in health insurance plans to prevent the customers from availing undue benefits. For example, a terminally ill person may take a health insurance plan and then claim it immediately, using health insurance only when ill. The main concept of insurance is to protect in case of uncertainties that could arise in the future for which the premium would be paid in the present. Still, without a waiting period, customers can take the policy in the present for illnesses or diseases which are not anymore uncertain. There is no uncertainty if you take a health insurance policy and avail the claim after getting sick. Rather, it is an exploitation of the insurance policy. To prevent such things, insurance companies have included waiting periods in all the health insurance plans sold in the market.

    Waiting Period

    Exploring Different Waiting Periods Found in Health Insurance Policies

    Types of Waiting Periods


    At least 4-5 types of waiting periods in health insurance plans, such as pre-existing disease, specific waiting period, initial waiting period, maternity waiting period, critical illness waiting period, and terminal illness waiting period. These waiting periods are usually present in every insurance policy and differ from one insurance company to another.

    Type of Condition Waiting Period
    Pre-existing conditions such as diabetes, hypertension, cancer etc. 1 to 4 years
    Specific diseases such as knee replacement surgery, bariatric surgery, hernia etc. 1 to 2 years
    Maternity 9 months to 4 years
    Critical illness Up to 90 days
    Initial waiting period Up to 30 days
    Accidental waiting period 0 days
    Covid-19 waiting period Up to 30 days

    Check out the detailed explanation on waiting periods in health insurance here.

    What is Zero Waiting Period Health Insurance?

    Waiting Period The insurance industry has developed a concept of zero waiting period in health insurance plans. Under this concept, insurance companies are launching health insurance plans with a 0-day waiting period for pre-existing conditions. That means one can claim for a pre-existing condition immediately after taking the policy without waiting for a certain period. For example, if you have diabetes when taking the zero waiting period health insurance plan and declare the same in the proposal form, you need not wait to claim after taking the policy. You can claim immediately for any diabetes-related illnesses, and the insurance company will settle the claim. Suppose diabetes hits you after taking the policy. In that case, it isn't considered a pre-existing condition, and any expenses arising from it would be settled under the policy.

    The zero waiting period health insurance plans are not completely zero waiting period as they claim. Only the pre-existing waiting period is waived under these plans, leaving way for other waiting periods to exist. Many customers look to buy a health insurance plan only when they are not well or have experienced a hospitalization recently. But in such cases, the health conditions they develop would become pre-existing when taking the policy, and one needs to wait up to 4 years before claiming such illnesses. If the health insurance plans are completely free of waiting periods, then the claim ratio would be extraordinarily high as customers would only purchase health insurance plans when sick or admitted to a hospital. To provide levy to customers, insurance companies have introduced health insurance plans with reduced waiting periods and are even offering add-ons to reduce the waiting period.


    Comments on Zero Waiting Period Plans



    • The zero waiting plans would only cover pre-existing diseases from day 1, subject to these conditions being declared by the policyholder when taking the policy. If the pre-existing conditions are not declared when taking the policy, then the claims arising out of those conditions would not be covered under the policy.
    • These plans would not waive other waiting periods, such as specific disease, initial, maternity, etc. For example, a knee replacement surgery would still be covered only after the specific waiting period, i.e., 1 to 2 years.
    • The initial waiting period would not collide with the pre-existing diseases as these would be covered from day 1. Any other illnesses that occur immediately after the policy must satisfy the initial waiting period. For example, if you had diabetes when taking the policy and declared the same in the proposal form, any claims arising out of it would be covered from day 1. But if you contract diabetes within 30 days of taking the health insurance policy and make a claim for it, then it would not be covered as it comes under the initial waiting period exclusion.
    • The sum insured for zero waiting period plans would be lower, such as in the 1-5 lakhs, and may come with higher premiums as the claim ratio would inadvertently be high. Insurance companies are offering lower sum insured to check the customer behavior if there is zero waiting period for pre-existing conditions.
    • Insurance companies could expect most senior citizens and people with serious pre-existing conditions to avail of these plans. Customers whom the insurance companies reject for serious health conditions may be accepted under these plans.
    • Insurance companies may also come up with high co-payments under these plans. High premiums, low sum insured, and high co-payment may not make these plans attractive to senior citizens and others with not-so-serious pre-existing diseases. Customers who could wait 1-2 years for pre-existing diseases may go with regular plans, which offer a high sum insured and reasonable premiums instead of these plans.