Agent Told You to Hide Your Diabetes? Stop! Why 'Non-Disclosure' Will Lead to 100% Claim Rejection
You are buying a health insurance policy. The agent fills out the form for you.
He asks: "Do you have BP or Diabetes?"
You say: "Yes, I take one pill for blood pressure."
He says: "Let's not mention it. If we write it, the premium will go up or you will get a medical test. Just hide it. After a few years, everything is covered."
This is the biggest lie in the Indian insurance industry.
If you listen to him, you are paying premiums for a policy that is practically useless. Here is why "Non-Disclosure" of Pre-Existing Diseases (PED) is a ticking time bomb in 2026.
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| Why 'Non-Disclosure' Will Lead to 100% Claim Rejection |
1. The "Investigation" Trigger
Insurers don't investigate when you buy the policy. They investigate when you make a large claim.
Imagine 4 years later, you get admitted for a Kidney problem. The bill is ₹5 Lakhs.
The insurer's investigation team will check your past medical records. If they find a doctor's prescription from 5 years ago mentioning "Hypertension," they will reject your claim instantly.
The Reason: You breached the principle of "Uberrima Fides" (Utmost Good Faith).
2. The "Moratorium Period" Update (5 Years, Not 8)
Agents often quote the old rule: "After 8 years, no claim can be rejected."
The 2026 Reality: The IRDAI has made it better for you. Effective April 2024, the Moratorium Period was reduced to 5 Years (60 months). After 5 continuous years, the insurer cannot contest your policy for non-disclosure.
BUT there is a massive catch: "Proven Fraud."
If the insurer can prove you deliberately hid a major condition (like Cancer history or a Heart condition) specifically to cheat the system, this protection DOES NOT apply. Do you want to gamble your life savings on a legal definition of "Fraud"?
3. "Waiting Period" vs. "Permanent Exclusion"
It is always better to tell the truth. The rules have changed in your favor.
- Scenario A (Lying): You save ₹2,000 on premium. Claim rejected 100% later. Loss: ₹5 Lakhs.
- Scenario B (Truth): You declare Diabetes.
- The insurer might apply a "Loading" (extra premium) of 10-20%.
- They will apply a PED Waiting Period. (Note: IRDAI reduced the maximum waiting period to just 3 Years).
- Result: After 3 years, your claim is 100% genuine and payable.
4. Action Plan: What If You Already Lied?
If you realized you (or your agent) hid a condition in your existing policy, fix it NOW.
- Write a Mail: Email the insurer's grievance cell immediately. Subject: "Correction of Material Fact in Policy No. XYZ".
- Declare It: State clearly: "I want to update my records. I have been taking thyroid medication since 2018, which was missed in the proposal form."
- Face the Consequence: They might increase your premium or ask for a medical test. Do it. It is better to pay extra now than to have your claim rejected later when you are in the hospital bed.
An Honest Policy is the Only Real Policy
Your agent wants his commission. He won't be there when your claim is rejected.
Be honest. An insurance policy based on a lie is just a piece of paper. Declare your health issues, serve the 3-year waiting period, and sleep peacefully.
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