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ARTICLE · 10 JUNE 2025

Pre-Existing Diseases Rules Changed In Health Insurance To Benefit Policyholders

In a bid to make health insurance more simple and customer-friendly, the Insurance Regulator and Development Authority of India (IRDAI) recently amended the definition...

IndiaInsurance

In a bid to make health insurance more simple and customer-friendly, the Insurance Regulator and Development Authority of India (IRDAI) recently amended the definition of pre-existing diseases. It deleted 'the additional/modified clause' in its current definition of pre-existing diseases through a circular dated 10 February 2020. This move could definitely help in reducing claim rejection rates by the health insurance companies.

Pre-existing disease is a condition, ailment or injury that already exists at the time of buying a health insurance policy. Conditions like diabetes, epilepsy, lupus, sleep apnea, depression and anxiety are considered as pre-existing health conditions.

To include certain illness under health insurance policy, the regulator had modified the definition of pre-existing disease through a circular in September, 2019. It added that if certain illnesses were diagnosed within 3 months of buying the health insurance policy, those would be considered

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