Most diseases do not reach an acute stage suddenly. A diabetic is likely to have a mild form of it for which he will initially take oral medicines, and only later graduate to insulin injections. Suppose that a person buys a policy at 35, does not reveal his blood sugar problem, and then makes a claim at 37. When a claim arises soon after purchase, insurers turn suspicious. In such cases, the onus of proving that the disease happened after the person took the policy is on the insured. "The insurer will demand proof that the condition developed after buying the policy. The patient could be asked to submit his doctor's prescription, or medical reports from the time when he was first diagnosed with blood sugar," says Mohata.
Sometimes, a person may be disease-free at the time of buying the policy, but may develop a condition after three or four years. Should he disclose this condition to the insurer? "Insurers typically ask for more disclosure only if you apply for higher coverage. Otherwise, renewal is on the as-is basis. They don't ask for additional information about your health at the time of renewal," says Prawal Kalita, director-benefit solutions, JLT Independent Insurance
Experts, however, say that it is a good practice to reveal major changes. Says Vaidyanathan Ramani, head of product and innovation, PolicyBazaar.com: "As a good practice, policyholders should disclose if there are any changes in their health conditions as their insurer can guide and help them with their conditions.” Many health insurers provide complimentary expert advice and wellness programmes to customers to help them recover. The policyholder's premium will not be affected on account of revealing. Premium is hiked only with age, or if the policyholder wants to increase his sum insured. The same principles apply for lifestyle changes like smoking.
Do's and don'ts for insured
If you are less than 45, you won't have to undergo medical tests. Nonetheless, reveal all pre-existing diseases
If a claim arises soon after buying the policy, insurers turn suspicious
If a new condition develops after buying a policy, it is not essential to reveal this to the insurer, but it is better to do so
Changes in lifestyle that could impact your health should also be voluntarily revealed