{"id":3140,"date":"2023-07-26T11:05:12","date_gmt":"2023-07-26T05:35:12","guid":{"rendered":"https:\/\/www.insurancesamadhan.com\/blog\/?p=3140"},"modified":"2025-03-27T10:23:47","modified_gmt":"2025-03-27T04:53:47","slug":"what-are-the-most-common-reasons-for-health-claims-rejection-the-series-part-5","status":"publish","type":"post","link":"http:\/\/www.insurancesamadhan.com\/blog\/what-are-the-most-common-reasons-for-health-claims-rejection-the-series-part-5\/","title":{"rendered":"What are the most common reasons for Health Claims Rejection: The Series: Part 5"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_76 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Table of Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"http:\/\/www.insurancesamadhan.com\/blog\/what-are-the-most-common-reasons-for-health-claims-rejection-the-series-part-5\/#Waiting_Period_as_a_Reason_for_Health_Claim_Rejection\" >Waiting Period as a Reason for Health Claim Rejection<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"http:\/\/www.insurancesamadhan.com\/blog\/what-are-the-most-common-reasons-for-health-claims-rejection-the-series-part-5\/#What_is_a_Waiting_Period_for_Health_Insurance\" >What is a Waiting Period for Health Insurance?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"http:\/\/www.insurancesamadhan.com\/blog\/what-are-the-most-common-reasons-for-health-claims-rejection-the-series-part-5\/#Types_of_Waiting_Periods_in_Health_Insurance\" >Types of Waiting Periods in Health Insurance\u00a0<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"http:\/\/www.insurancesamadhan.com\/blog\/what-are-the-most-common-reasons-for-health-claims-rejection-the-series-part-5\/#Initial_Waiting_Period\" >Initial Waiting Period\u00a0<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"http:\/\/www.insurancesamadhan.com\/blog\/what-are-the-most-common-reasons-for-health-claims-rejection-the-series-part-5\/#Maternity_Benefit_Cover_Waiting_Period\" >Maternity Benefit Cover Waiting Period<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"http:\/\/www.insurancesamadhan.com\/blog\/what-are-the-most-common-reasons-for-health-claims-rejection-the-series-part-5\/#Pre-Existing_Diseases_PED_Waiting_Period\" >Pre-Existing Diseases (PED) Waiting Period<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"http:\/\/www.insurancesamadhan.com\/blog\/what-are-the-most-common-reasons-for-health-claims-rejection-the-series-part-5\/#Waiting_Period_Related_to_Specific_Diseases\" >Waiting Period Related to Specific Diseases<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"http:\/\/www.insurancesamadhan.com\/blog\/what-are-the-most-common-reasons-for-health-claims-rejection-the-series-part-5\/#What_More_You_Should_Know\" >What More You Should Know?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"http:\/\/www.insurancesamadhan.com\/blog\/what-are-the-most-common-reasons-for-health-claims-rejection-the-series-part-5\/#Tips\" >Tips<\/a><\/li><\/ul><\/nav><\/div>\n<h3><span class=\"ez-toc-section\" id=\"Waiting_Period_as_a_Reason_for_Health_Claim_Rejection\"><\/span><span style=\"font-weight: 400;\">Waiting Period as a Reason for Health Claim Rejection<\/span><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Health insurance is a vast subject with many technicalities often overlooked by the buyer when purchasing health insurance. We often buy insurance with the mentality that we are paying the premiums so we will get the claim money. But, it is a contract of trust. And remember, the insurance company is a company whose motive is to earn money so they will do a thorough inspection while processing the claim. A thorough scrutiny of the policyholder and its case ensures that the claim amount is given for a fair reason.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">This series of blogs lets you know the common reasons that can lead to the rejection of your health insurance claim. And today, we will learn about the importance of understanding the waiting period.<\/span><\/p>\n<p><a href=\"https:\/\/www.insurancesamadhan.com\/register?utm_source=organic&amp;utm_medium=blog&amp;utm_campaign=blog_post&amp;utm_term=blog_term\"><img decoding=\"async\" class=\"aligncenter\" src=\"https:\/\/stage.insurancesamadhan.com\/assets\/img\/contact.png\" alt=\"Insurance Samadhan\" width=\"500\" height=\"70\" border=\"0\" \/><\/a><\/p>\n<h2><span class=\"ez-toc-section\" id=\"What_is_a_Waiting_Period_for_Health_Insurance\"><\/span><span style=\"font-weight: 400;\">What is a Waiting Period for Health Insurance?<\/span><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span style=\"font-weight: 400;\">When buying health insurance, the waiting period is an important term everyone must know. In health insurance, a waiting period refers to the duration that must pass before an individual can access the complete benefits of the coverage. Insurance Samadhan wants you to have the deep knowledge to reduce the chances of claim rejection.<\/span>\u00a0<img fetchpriority=\"high\" decoding=\"async\" class=\"alignnone size-full wp-image-3142\" src=\"https:\/\/www.insurancesamadhan.com\/blog\/wp-content\/uploads\/2023\/07\/larger-2.png\" alt=\"Health insurance waiting period \" width=\"1920\" height=\"1080\" srcset=\"http:\/\/www.insurancesamadhan.com\/blog\/wp-content\/uploads\/2023\/07\/larger-2.png 1920w, http:\/\/www.insurancesamadhan.com\/blog\/wp-content\/uploads\/2023\/07\/larger-2-300x169.png 300w, http:\/\/www.insurancesamadhan.com\/blog\/wp-content\/uploads\/2023\/07\/larger-2-1024x576.png 1024w, http:\/\/www.insurancesamadhan.com\/blog\/wp-content\/uploads\/2023\/07\/larger-2-150x84.png 150w, http:\/\/www.insurancesamadhan.com\/blog\/wp-content\/uploads\/2023\/07\/larger-2-768x432.png 768w, http:\/\/www.insurancesamadhan.com\/blog\/wp-content\/uploads\/2023\/07\/larger-2-1536x864.png 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\" \/><\/p>\n<h2><span class=\"ez-toc-section\" id=\"Types_of_Waiting_Periods_in_Health_Insurance\"><\/span><span style=\"font-weight: 400;\">Types of Waiting Periods in Health Insurance\u00a0<\/span><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<h3><span class=\"ez-toc-section\" id=\"Initial_Waiting_Period\"><\/span><span style=\"font-weight: 400;\">Initial Waiting Period\u00a0<\/span><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The waiting period starts with a 30-day period as soon as you buy the health plan, also known as the cooling period. The important thing to note here is that if you are involved in an accident, only then you will be able to make a claim; otherwise, there is no exception in the first 30 days of the waiting period.\u00a0<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"Maternity_Benefit_Cover_Waiting_Period\"><\/span><span style=\"font-weight: 400;\">Maternity Benefit Cover Waiting Period<\/span><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Second, comes the maternity benefits, for which the health claim will only be given after 9 &#8211; 12 months of the policy. Certain companies have a waiting period of 2 years for maternity claims, indicating that customers are eligible for such claims only after these 2 years. It&#8217;s important to mention that there is no waiting period if you are covered by group insurance through a corporate company.<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"Pre-Existing_Diseases_PED_Waiting_Period\"><\/span><span style=\"font-weight: 400;\">Pre-Existing Diseases (PED) Waiting Period<\/span><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">According to the IRDAI, a pre-existing disease is defined as any condition, ailment, injury, or disease that has been diagnosed within the 48 months preceding the purchase of your health insurance policy.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Examples of pre-existing diseases include diabetes, hypertension, thyroid conditions, diabetes, asthma, and others. If you have a pre-existing disease, you must wait for the specified period before making any claims for hospitalization or treatment related to that particular disease. Typically, the waiting period for pre-existing diseases ranges from one to four years, depending on the insurance company and the type of health insurance plan you have selected.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The waiting period for these diseases aims to prevent individuals from buying health insurance to seek benefits specifically for pre-existing conditions.<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"Waiting_Period_Related_to_Specific_Diseases\"><\/span><span style=\"font-weight: 400;\">Waiting Period Related to Specific Diseases<\/span><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The title is self-explanatory: waiting periods for specific diseases mean waiting for a certain period before making claims for treatment and hospitalization related to those illnesses listed. Typically, the waiting period for these situations ranges from one to four years.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">These are the common types of waiting periods found in health insurance plans in India.\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/www.insurancesamadhan.com\/register?utm_source=organic&amp;utm_medium=blog&amp;utm_campaign=blog_post&amp;utm_term=blog_term\"><img decoding=\"async\" class=\"aligncenter\" src=\"https:\/\/stage.insurancesamadhan.com\/assets\/img\/contact.png\" alt=\"Insurance Samadhan\" width=\"500\" height=\"70\" border=\"0\" \/><\/a><\/p>\n<h2><span class=\"ez-toc-section\" id=\"What_More_You_Should_Know\"><\/span><span style=\"font-weight: 400;\">What More You Should Know?<\/span><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Now that we have understood the meaning of the waiting period and the types of waiting periods, the next step is to see the view of the insurance regulatory body on the waiting period.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The insurance regulatory body&#8217;s perspective on the waiting period is that it serves as an essential measure to maintain the integrity and sustainability of the insurance system. By implementing waiting periods for certain conditions, the regulatory body aims to prevent individuals from obtaining insurance solely to seek immediate benefits for pre-existing illnesses.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The thing is that many people are not aware of all this information and become a victim of health claim rejection.\u00a0<\/span><\/p>\n<h2><span class=\"ez-toc-section\" id=\"Tips\"><\/span><span style=\"font-weight: 400;\">Tips<\/span><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span style=\"font-weight: 400;\">It is important to read all the terms and conditions of the health plan that you are buying. This will ensure that you clearly understand the coverage, benefits, limitations, and exclusions associated with the policy.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Insurance Samadhan constantly seeks the best interest of the policyholders so that nobody loses their hard-earned money.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Stay tuned for more valuable information about the different health claim rejection reasons coming this week. Stay healthy and stay safe!<\/span><\/p>\n<p><a href=\"https:\/\/www.insurancesamadhan.com\/register?utm_source=organic&amp;utm_medium=blog&amp;utm_campaign=blog_post&amp;utm_term=blog_term\"><strong>Click here<\/strong><\/a>\u00a0to register your complaint with Insurance Samadhan<\/p>\n<p>You can also<\/p>\n<p>Visit our website:\u00a0<a href=\"https:\/\/www.insurancesamadhan.com\/\">insurancesamadhan.com<\/a><\/p>\n<p>Call us on +91 9513631312<\/p>\n<p>WhatsApp:\u00a0<a href=\"https:\/\/api.whatsapp.com\/send?phone=+919910998252&amp;text=Hi\">\u00a09910998252<\/a><\/p>\n<p>Mail us at\u00a0<a href=\"mailto:corporate@insurancesamadhan.com\">corporate@insurancesamadhan.com<\/a><\/p>\n<p><script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\/\",\n  \"@type\": \"Article\",\n  \"mainEntityOfPage\": {\n    \"@type\": \"WebPage\",\n    \"@id\": \"https:\/\/www.insurancesamadhan.com\/blog\/what-are-the-most-common-reasons-for-health-claims-rejection-the-series-part-5\/\"\n  },\n  \"headline\": \"What are the most common reasons for Health Claims Rejection: The Series: Part 5\",\n  \"description\": \"Learn about common health claim rejections in our series. Part 5 delves into waiting periods for health insurance, their importance, and how to reduce chances of claim rejection. Stay informed with Insurance Samadhan.\",\n  \"image\": {\n    \"@type\": \"ImageObject\",\n    \"url\": \"https:\/\/i0.wp.com\/www.insurancesamadhan.com\/blog\/wp-content\/uploads\/2023\/07\/larger-2.png?resize=768%2C432&ssl=1\",\n    \"width\": \"1920\",\n    \"height\": \"1080\"\n  },\n  \"author\": {\n    \"@type\": \"Person\",\n    \"name\": \"Shikhar Vashisht\"\n  },\n  \"publisher\": {\n    \"@type\": \"Organization\",\n    \"name\": \"Insurance Samadhan\",\n    \"logo\": {\n      \"@type\": \"ImageObject\",\n      \"url\": \"https:\/\/insurancesamadhan.com\/images\/logo.svg\",\n      \"width\": \"224\",\n      \"height\": \"47\"\n    }\n  },\n  \"datePublished\": \"2023-07-26\",\n  \"dateModified\": \"2023-07-26\"\n}\n<\/script><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Waiting Period as a Reason for Health Claim Rejection Health insurance is a vast subject with many technicalities often overlooked by the buyer when purchasing health insurance. We often buy insurance with the mentality that we are paying the premiums&hellip; <a href=\"http:\/\/www.insurancesamadhan.com\/blog\/what-are-the-most-common-reasons-for-health-claims-rejection-the-series-part-5\/\" class=\"more-link\">Continue Reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":12,"featured_media":3141,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_uag_custom_page_level_css":"","footnotes":""},"categories":[3,313,311],"tags":[],"class_list":["post-3140","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-insurance","category-health-insurance-claim","category-insurance-claim-rejection"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Top Reasons for Health Insurance Claim Rejection \u2013 The Series: Part 5<\/title>\n<meta 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