Most of us fill out a health insurance proposal form the same way we accept app terms and conditions. Quickly, and without much thought. Questions about old illnesses, medicines and family health feel personal, and some people tick “No” thinking it will keep the premium low. It might, for now. But when a claim comes up, that small shortcut can turn into a big headache.
Insurers decide your premium, waiting period and cover on the basis of what you write in that form. If something important is missing, the policy you think you have may not be the policy you actually have. That’s why it’s worth knowing which health insurance details you need to share before you sign.
Why Should You Be Honest?
Insurance is based on a principle called “utmost good faith.” In plain words, the company must clearly state what it covers, and you must be truthful about your health. Both sides depend on the other being honest.
Suppose you skip mentioning your blood pressure and are later admitted for a heart-related problem. The hospital records will show your BP history. From then on, the insurer will be able to deny coverage and, in certain situations, even terminate the policy. It may have been a bit more expensive or a wait, but you would have had a claim that would be safe.
What Health Details Should You Share?
Below are some of the details which you must share with the health insurance company:
Existing Illnesses
You must declare any condition you’ve been diagnosed with or treated for before taking the policy. Diabetes, thyroid, asthma, high BP, heart or kidney issues are common ones. People often leave these out, thinking “it’s under control”. Controlled or not, it still needs to go in the form.
Surgeries and Hospitalisation
Gallbladder removed in 2019? Stitches after a bike accident that needed a night in hospital? Write them down. The form usually asks about a certain number of past years, so check that and mention dates if you remember them.
Medicines You Take Regularly
Many people forget this part. If you take a tablet every morning, even a small one for thyroid or cholesterol, mention it and what it’s for. The same goes for any treatment that’s still going on.
Smoking, Tobacco and Alcohol
Be honest about these, including how much and how often. Many people write “occasional” when it’s actually daily. Blood tests and doctor’s notes can show tobacco use effortlessly, and if your form says otherwise, the insurer has a reason to question your claim.
Family History
If your father had a heart attack or your mother has diabetes, the form may ask about it. This doesn’t automatically mean you’ll be charged more. It just helps the insurer understand your possible risks.
Height, Weight and Recent Health Issues
BMI is calculated by using your height and weight. Include any recent symptoms, such as chest pain or breathlessness, even if they haven’t been diagnosed by a doctor.
Pregnancy
If you are a pregnant woman, inform about it in the form. Typically, maternity cover comes with a waiting period, and it is best to be made aware of it from the start.
Other Health Policies
Already have a policy from your employer or another insurer? Has any company ever rejected your application? These questions are usually on the form, so answer them correctly.
What If You Don’t Disclose Something?
Nothing happens at first, and that’s why people take it lightly. The trouble starts when you claim. The insurer checks your medical history, and if an old condition shows up that wasn’t declared, the claim can be rejected.
IRDAI has given policyholders some relief here. From April 2024, if your policy has been running continuously for five years, the insurer cannot reject a claim on the grounds of non-disclosure unless fraud is proven. This period used to be eight years. Even so, nobody wants to spend five years hoping a hidden condition doesn’t come up.
The good news is that declaring your conditions has become less painful. IRDAI has capped the waiting period for disclosed pre-existing diseases at three years.
Before You Fill the Form
Keep your old prescriptions, discharge papers and test reports with you so you don’t have to guess. Even if an agent is filling the form on your behalf, go through each answer yourself, since your signature is what counts. Not sure whether something is worth mentioning? Mention it anyway. Ask the insurer how long you’d have to wait for your specific condition to be covered, and keep a copy of the form once it’s submitted.
Final Word
Telling everything may feel like extra effort, and it may cost you a little more in premium. But the whole point of buying health insurance is to have support when you’re in hospital. A few honest answers today make sure that support is actually there when you need it.
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