While filling your proposal form for new policy as well as for renewal you will be asked about your prexisitng disease. You are required to disclose them otherwise they may lead to disputes at the time of your claim.
For example if you have diabetes , then all diabetes related complications will be excluded from your claim in the first 26 – 48 months of start and continuation of the policy without break. The exact duration depends on the policy. In case you get an attack of sudden fall of blood sugar after 2 1/2 years of start of policy which requires you to be hospitalised, then the claim will not be paid by the Insurance company. Even some heart diseases or paralytic strokes may also be excluded by the insurance company arguing that it is related to diabetes.
However, if you have discosed a prexisiting disease, then it is covered by the same policy after 36 – 48 months of continuous running of the policy with premium.
How does the Insurance Company know about your pre exisitng disease ? Pre exisiting is disease is mentioned in the Hospital records for all treatments . Here is an example :
Mrs X did not disclose her blood pressure treatment at the time of filling the policy. She gets an attack of stroke in the third year after starting her policy. In the Hospital records the Insurance Comapny finds a a note from the doctors “ History of hypertension under treatment with medicines for 6 years “ and “ haemorrhagic stroke “ in the Hospital diagnosis. The Insurance claim will be denied.
If she gets the same attack of haemorrhagic stroke in the sixth year of her policy, the Insurance company can still deny the claim arguing that she had not filled up her proposal form correctly and had not mentioned about the treatment of hypertension which she was taking. However, if she had disclosed this in her initial proposal form, then the claim will be accepted after the waiting period.
The same waiting period for coverage of prexisiting disease applies for increase of Insurance amount. If Mrs X had a continuous policy for 6 years but had increased the sum insured from 3 lacs to 4 lacs one year ago, the sum insured of 1 lac will not be considered for prexisiting disease before the waiting period.