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  • A Guide to Waiting Period & Survival Period

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    You’ve bought what appears to be an awesome new insurance policy from a man in a suit who refused to stop smiling at you. He probably didn’t answer any of your questions to the point or explain any of the fine print that could eventually lead to your insurance policy being rendered useless. That’s right, there are clauses in your policy that affect the possibility of your receiving any benefit right from day 1.

    Insurance companies today run like any other business, and having to give you a promised benefit is an activity that would cost the business money. No good business lets go of its money unless it absolutely has to, and unless it has exhausted all options of saving itself (legally) from the liability of having to pay you. Always be aware that insurance companies will do everything in their power to keep from paying you what’s due to you.

    Read your policy documents thoroughly and don’t ignore the fine print in sections marked “waiting period”, “survival period” or “exclusions”. Most of the big players will exhaust all legal clauses in their policy document before reluctantly parting from their money and paying it to you as a benefit. Any clause you find that you don’t like can, and should, be renegotiated with the company. Many insurers have different clauses, and some of them actually want to help you out and are a benefit to the community.

    Here’s some of the fine print relating to “Waiting Period” clauses:

    • All insurance policies come with a waiting period, which is basically a length of time in which you cannot claim any benefit from the insurance policy. Whatever happens to you, you have to wait for the waiting period to get over before you can make any claims and try to get any benefit.
    • There are three types of waiting periods – initial waiting period, pre-existing ailment waiting period and disease specific waiting period:
    • Types:
      1. Initial waiting period: Generally, if you fall sick or are hospitalised within 30-90 days (and in some cases 180 days) from the start of your policy, you will receive absolutely no help from the insurer whatsoever. The insurance policy is literally useless during this initial waiting period, except in the case of hospitalization or medical expenses arising due to an accident.
      2. Pre-existing ailment waiting period: If you have a disease or adverse medical condition that was present before, or at the time of, taking the insurance policy – you will not be covered for any hospitalization expenses that occur as a result of this “pre-existing ailment”. The waiting period for this clause could be anywhere from a few months to a few years (or many years) – depending on the type of medical condition you have and the insurer you choose.
      3. Disease-specific waiting period: Hospitalization expenses that arise out of – or can be traced back to – a list of pre-specified diseases will not be covered under your health insurance policy. What does that mean? It means that insurers will give you a list of diseases that, if contracted, will not be eligible for a claim. This waiting period also lasts for around 2 years after commencement of the policy. Common diseases in this list include (but are not limited to) hypertension, piles, hernia, ovarian diseases and diabetes.
    Waiting-Period-&-Survival-Period-in-Health-Insurance

    You have to fall the right amount of ill, with the right disease, at the right time, in the right hospital, under the right conditions and circumstances and inform the insurer at the right time to be eligible for any benefit. The insurance company will make sure of that. Make sure you read, and re-read all your policy documents and re-negotiate with your insurer until you are satisfied.

    Here’s what’s written between the lines with regard to “Survival Period” clauses:

    • As gruesome and pitiable as this clause sounds, it literally means that in order to receive any benefit whatsoever from your insurer – you must survive for a certain period of time after being diagnosed by a critical illness.
    • Mostly applies to critical illness policies.
    • There are three primary factors that decide the length of the waiting period – the disease, the insurer and the policy.
    • This waiting period is in addition to the regular waiting period that’s mentioned above.
    • Insurer will pay out a lump sum of money if you manage to survive the waiting period – and that money can then be used for treatment, or if it’s too late for treatment – your last vacation. Really, the benefit amount can be used for any purpose.

    The fact that these clauses exist is a sad reminder of the power of the almighty dollar (or in this case, rupee). Even large organizations that claim to look after your family, or provide an umbrella under which you’ll be “protected” from the harsh realities of the world change their tone when it comes time to honour their claims. Insurers will scrutinize every clause in their policies looking for some aspect of your particular case that will relieve them of their legal obligation to pay you the benefit. Read and scrutinize every aspect of your policy documents and compare between insurers before taking a decision on one. Also research the claim to settlement ratios and claim honour ratios of the insurers you’re planning on taking a policy from.

    GST rate of 18% applicable for all financial services effective July 1, 2017.

    Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.

    A Guide to Waiting Period & Survival Period Reviews

  • Page 1 of 2 1 2
    • HDFC Ergo Health Insurance
      "Recommendble Top up policy"
      0.5 5.0/5 "Blown Away!"
      I have done health policy top up with HDFC Ergo, the customer service is also very good. There is no processing fee for the top up, they gave me the medical amount Rs. 12 lakhs for entire family its for 3 person, I don't have claim experience. They are covering major or minor but for waiting period for pre existing is three years.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Nov 13, 2018
    • Religare Health Insurance
      "Good protection for health"
      0.5 4.0/5 "Great!"
      Major factor to avail Religare health is because of the premium amount is low and few more options are good with them. But there is a waiting period for pre existing disease benefits however I got the medical card on time with the coverage value of Rs.5 lakhs.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Nov 10, 2018
    • Star Health Health Insurance
      "Bad experience"
      0.5 1.0/5 "Really Bad"
      This is the worst company. My son is sitting on the road outside max hospital Mohali from 11 AM waiting for approval from star health. They are negotiating with the hospital till that time. If hospitalI is charging more then why don't you blacklist it and why the patient suffer because of your inefficiency. Further I don't recommend anyone for buying star health policy. My claim no. is 0364312.
      Was this review helpful? 1
      , shimla
      Reviewed on Oct 11, 2017
    • ICICI Lombard Health Insurance
      "ICICI Lombard "
      0.5 0.5/5 "Unacceptable"
      I have joined IT company and applied for ICICI Lombard Health insurance(company's choose). Due to miss-communication between myself and my company, insurance has been applied including all my dependent and premium amount is deducted from my salary. This happened in April 2017 and on May 3rd I have raised cancellation request via my company. 101 days(may 3rd 2017 to Aug 11 2017) completed till today. No informative response for the status. One fine day I have requested for more detailed information about status, and they told a wired answer. "Since my dependent policy is not yet applied/processed, they cant cancel the policy." "So they will apply first and then they will submit request for cancellation." Also they will deduct some% of amount for Service Tax and one month premium amount before cancellations! STILL THE PROCESS WILL TAKE 2 OR 3 WORKING DAYS! STILL I AM WAITING!
      Was this review helpful? 0
      , chennai
      Reviewed on Aug 11, 2017
    • Star Health Health Insurance
      "Health insurance is very fine"
      0.5 4.0/5 "Great!"
      Star health insurance is fine, I am holding this insurance for a period of 2 years. No drawback nor any challenges. The policy coverage is 4 lakhs and I am supposed to pay around 13.5 k . It is very easy for me to check and there is no waiting period for it
      Was this review helpful? 0
      , bangalore
      Reviewed on Jan 16, 2017
    • Reliance General Health Insurance
      "Bed company think twice before take insurance"
      0.5 1.0/5 "Really Bad"
      I took health insurance form this company, once I hospitalised and submitted all the documents for claim but I am waiting from last 4 months they are saying to give in 1 week but not giving till now. Bed company think twice before take insurance
      Was this review helpful? 1
      , gwalior
      Reviewed on Oct 18, 2016
    • HDFC Ergo Health Insurance
      "Poor service"
      0.5 1.0/5 "Really Bad"
      Lot of things which were hidden, I am supposed to get some matnerity benefit but after a waiting period of 4 years the policy got changed therefore they mentioned that I am not entilted for that benefit, also they refused to give a claim. Later they confirmed that this benefit is avilaiable with some other policy.
      Was this review helpful? 1
      , bangalore
      Reviewed on Sep 03, 2016
    • National Insurance Health Insurance
      "Not yet claimed "
      0.5 5.0/5 "Blown Away!"
      They provided the soft copy of Insurance details very immediately but they have not given the hard copy yet.It takes 4years tenure for covering pre-existing disease in the Insurance.The critical illness also has some particular waiting period.
      Was this review helpful? 1
      , pune
      Reviewed on Aug 05, 2016
    • L and T Health Insurance
      "Not yet used "
      0.5 5.0/5 "Blown Away!"
      Its good experience from L&T in case of health Insurance services.The documents related to the insurance were received within 10-15days.It takes 3years tenure for covering pre-existing disease in the Insurance.The critical illness also has some particular waiting period.
      Was this review helpful? 0
      , pune
      Reviewed on Aug 05, 2016
    • Max Bupa Health Insurance
      "No clear information"
      0.5 1.0/5 "Really Bad"
      Earlier it was mentioned the waiting period for the risky coverage will be around 1year but later they said its 3years so I dropped the Insurance with Max Bupa.They have not returned the premium amount as of now.The coverage and benefits offered by Max Bupa was good.
      Was this review helpful? 1
      , hyderabad
      Reviewed on Jun 07, 2016
    • HDFC Ergo Health Insurance
      "Can be streamlined"
      0.5 4.0/5 "Great!"
      The service provided was very good in the Insurance category.The claim settlement was good.They can streamline the process for providing better service.They have clearly mentioned about the waiting period and the offers related to the health Insurance with HDFC ERGO
      Was this review helpful? 0
      , hyderabad
      Reviewed on Jun 07, 2016
    • National Insurance Health Insurance
      "Very good package for senior citizens..."
      0.5 5.0/5 "Blown Away!"
      National Insurance has tie up with international India health organization and I have opted the health insurance. Twice I had claimed where first time it was a cashless and next one was reimbursement.One more advantage on this health insurance is as no waiting period of six months as in month the settlement will be done. They do have very good package for senior citizens.
      Was this review helpful? 0
      , chennai
      Reviewed on Dec 22, 2015
    • Star Health Health Insurance
      "Bad Service"
      0.5 0.5/5 "Unacceptable"
      I am really unhappy with the service of Star health. My patient was so serious and waiting for a admission in hospital. But the Star health people told me to complete the paperwork before admission. So I agreed. Then they provide me a chair outside of their office. After half an hour I requested again to make fast because the condition of patient was so bad, But they behave with me so rudely and told to go outside of office. i noticed them in the glass door that they have really no time to do the paperwork, because they are investing more time on gossiping. Then I forcely entered the room and told them to make it in five minutes or I will call the Authority. Then they made it in 2 minutes.
      Was this review helpful? 0
      , kolkata
      Reviewed on Dec 19, 2015
    • Max Bupa Health Insurance
      "Best "
      0.5 4.0/5 "Great!"
      I am having the health insurance policy with the Max Bupa health insurance because of the facilities like there is no health check up and waiting period. They are having the lot of tie up with the hospital and the customer service which are good.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Oct 12, 2015
    • Religare Health Insurance
      "Attractive Plans But No Benefits..."
      0.5 0.5/5 "Unacceptable"
      I have a health insurance from religare. I was suffering from jaundice and I was hospitalized for 2 days. They took 8 months to provide me the claim amount. When I was looking for a support to get cashless treatment, I called the customer care, there was no response from them. Even to do a free medical check up, I was waiting for their approval. But they did not respond me. It was really bad.
      Was this review helpful? 12
      , new delhi
      Reviewed on Aug 26, 2015
    • Religare Health Insurance
      "Customer friendly..."
      0.5 4.0/5 "Great!"
      Religare Health is covering all types of critical illness except dental and AIDs. According to my point of view, AIDs should be covered as it is necessary. Customer service is very good in Religare. Pre existing diseases will be covered but the waiting time is of 2 years. No claim bonus is up to 10%.
      Was this review helpful? 0
      , pune
      Reviewed on Jun 19, 2015
    • Max Bupa Health Insurance
      "Max Bupa or Max Fraud!!"
      0.5 0.5/5 "Unacceptable"
      I myself is a doctor and specialize in Gastro- Most of the doctors who treated me are DM Gastro and are considered to be best in the country in Gastro- Both the hospitals where I was treated are network hospitals of MaxBupa. Paras HMRI is the most reputed Hospital of Bihar & Sir Gargaram Hospital is the most respected Gastro Hospital in N.Delhi. But ironically Max Bupa internal team disagree with all of them and they rejected both my Patna & New Delhi claims. Different reasons given: 1) Excuse 1: First 90 days only accidental claims: Though the policy states Emergency or accidents 2) Excuse 2: Itâ??s not an emergency- All DM Gastro doctors are wrongs, without seeing the patient MaxBupa team came to this conclusion. 3) Excuse 3: Itâ??s a chronic condition: Though it has never happened before and the tests reports suggest otherwise. 4) Excuse 4: Waiting for it!!
      Was this review helpful? 8
      , muzaffarpur
      Reviewed on May 11, 2015
    • HDFC Ergo Health Insurance
      "Good"
      0.5 5.0/5 "Blown Away!"
      HDFC ERGO was good ,when I took this I felt like its nice to move with but after filling the form they said like its compulsory to get accident insurance also. They were hiding to share little things at the beginning,and also I was informed that I will be getting 5% cash back if the payment is done through credit card but still I havent got it. I was supposed to get a call me as per they said but still i am waiting around 2 months for them to call .
      Was this review helpful? 1
      , bangalore
      Reviewed on Apr 07, 2015
    • Star Health Health Insurance
      "Good!!!"
      0.5 4.0/5 "Great!"
      Some hospitals are not allowing cashless treatment and I got this info from my friends because so far I never experienced with Star Health & Allied insurance. At the start they are not including pre existing health issues as there are some waiting period. OPT is not included as only inpatient is being covered. I was informed that they would cover medical expenses and ambulance but yet to experience the services.
      Was this review helpful? 1
      , coimbatore
      Reviewed on Apr 02, 2015
    • Star Health Health Insurance
      "Excellent!!!"
      0.5 5.0/5 "Blown Away!"
      In my experience I would say that Star Health & Allied Insurance is good because my claim experience is good and waiting for reimbursement. One of my friend claimed for reimbursement but the paper works were a lot but in my case I did not submit any documents. Cashless treatment is very good but hospitals in my area have no tie up with Star Health. Infact this health insurance was opened by my company.
      Was this review helpful? 1
      , delhi
      Reviewed on Mar 30, 2015
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