What to do if you miss declaring your health condition while buying an insurance policy?

Making a mistake while filling out the application form or intentionally hiding a health condition can lead to serious consequences for the health insurance holder. The insurance company has the right to cancel the policy in case details about the health condition of the policyholder are found inaccurate.

 health insurance application

A health insurance policy is one of the most common policies purchased as it is essential to safeguard life in a medical emergency. When clients purchase health insurance, they must disclose all information about their health condition before the insurance policy is finalized. 

What is a Health Insurance?

Health insurance is a form of insurance which provides coverage for medical expenses incurred by the client during the policy term. Health insurance safeguards the client and their families from paying a large sum if a medical emergency occurs. The following expenses are covered:

  1. Expenses incurred due to hospitalization
  2. Expenses incurred before and after hospitalization
  3. Cost of day-to-day procedures
  4. Cost of tests, consultations, and medications.
  5. Transport costs for Ambulances

Note: The expenses covered by the health insurance depend upon the policy purchased by the client. The limit up to which the client is insured also depends upon the policy purchased.

Also Read: Reasons to get health insurance.

While filling out an application form for an insurance policy, it is crucial to provide details about health conditions. These details allow the insurance company to analyse the coverage required for the client, the premium to be paid and the waiting period for the policy.

To avoid long waiting periods or pay a high premium, the client may hide certain health conditions from the insurance company. Although non-disclosure of health conditions can also occur unintentionally, it still impacts the processing of claims and the decisions made by the insurance company regarding the policy. 

Also Read: How to Avoid health uncertainties.

Consequences of withholding information about health conditions

The health insurance company requires clients to disclose details about their health conditions. If the client mistakenly fails to do or unintentionally omits the details, the insurance company has the right to cancel the policy for the client and their families. 

The details about the health conditions can be easily discovered when a claim has been made as the company verifies all the documents related to the medical expenses. Even if the medical expenses are not related to the health conditions hidden from them, the company can still cancel the policy and stop providing coverage to the client.

Remedies for non-disclosure of health condition while buying an insurance

Even though the consequences of non-disclosure of health conditions are serious, they can be avoided by taking the following actions:

Provide the details about the health condition during the free-look period

Every insurance policy in India has a free-look period. During this free-look period, a client can cancel their policy or modify the details of the policy. If clients fail to inform the health conditions while purchasing the policy, they can modify the details within the free-look period.

Provide the information during the renewal of the policy

A client can choose to provide the information during the renewal process of the policy. Even though the company may choose not to renew the policy, the client will avert the cancellation of the policy at a later stage.

Look for another policy.

The client can look for another health insurance policy and diligently provide the details about health conditions while purchasing the policy.

It is important to note the following attributes:

  • If the client has been paying the premiums for eight continuous years before the medical conditions are discovered, the insurance policy cannot be cancelled by the company.
  • If the health condition develops after purchasing the policy, it will be covered under the policy.
  • Conditions like Fracture, appendix surgery or even Covid-19 are not considered undisclosed health conditions. 

Final words

A health insurance policy protects the client and their family from unbearable expenses during a medical emergency. Therefore, a client must always diligently provide the company with details regarding their health condition to avoid cancellation of the policy. If the mistake has been made, the client can still choose to remedy it by carrying out the actions mentioned above.

Disclaimer: This article is intended for general information purposes only and should not be construed as investment or legal advice. You should separately obtain independent advice when making decisions in these areas.


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