Skip to content

NISM Certifications · NISM-Series-X-B: Investment Adviser (Level 2) · Non-Life Insurance Products

Ms. Iyer, 35, buys an individual health policy with a sum insured of Rs 10 lakh and a 2-year waiting period for pre-existing diseases. In the first year she is hospitalised for a treatment related to diabetes diagnosed before she bought the policy. How will the insurer typically treat this claim?

The insurer would typically reject the claim because it relates to a pre-existing disease and the 2-year waiting period has not yet completed. An active policy does not override waiting period exclusions; the cover for that condition begins only after the waiting period ends.

  1. APay in full because the policy is active
  2. BReject it as the pre-existing disease waiting period has not endedCorrect
  3. CPay 50% as co-payment always
  4. DPay only if she pays an extra premium after the claim

Explanation

Pre-existing disease waiting period means claims related to that disease are not payable until the period lapses. Her claim in year one falls within the 2-year waiting period, so it is typically rejected. Active status does not override waiting periods.

Did you get it right without looking?

One question tells you little. A timed set on Non-Life Insurance Products shows your real accuracy, how long you take and where you lose marks.

Practise Non-Life Insurance ProductsFree diagnostic mock

More Non-Life Insurance Products questions