Health Insurance: Eligibility & underwriting

Eligibility and underwriting decide whether you are offered cover and at what price. Here is what to expect.

Most insurers accept children from about three months of age (sometimes with a parent), and adults of any age. Since 2024, insurers cannot refuse a health policy solely because of age, although premiums rise with age.

Pre-existing conditions such as diabetes, hypertension or thyroid disorders must be declared. Insurers may accept them with a waiting period, loading or exclusion. Hiding them is the single most common reason for rejected claims.

Under IRDAI rules, the maximum waiting period for pre-existing diseases is capped at three years, and after 60 months of continuous cover (the moratorium) a claim cannot be rejected for non-disclosure except in case of proven fraud. Confirm the exact terms in your policy wording.

Medical tests may be required depending on age, sum insured and declared conditions. A family floater can usually include spouse, dependent children and parents or parents-in-law depending on the product.