Why Undisclosed Medical History Can Make Insurance Claims Invalid

The Moratorium Rule Bars Claim Rejections for Non-Disclosure After Five Years, Unless Fraud Has Been Proven

- Jash Kriplani

When buying health insurance, one of the most crucial steps is disclosing any pre-existing diseases (PEDs). Failure to do so can lead to a rude shock later, especially if a genuine claim is denied because of a past medical condition you didn't disclose.

So, what counts as a pre-existing condition, and how far back must you go in your medical history? Besides, are there any exceptions? Here's a detailed look.

What is pre-existing disease? The term "pre-existing disease" typically refers to any condition, illness, or injury that an individual has been diagnosed with or treated for before purchasing the health insurance policy.

This includes chronic ailments like diabetes, high blood pressure, asthma, chronic kidney disease, heart-related issues, epilepsy, and others that require ongoing treatment or have long-term effects on health. Serious health episodes requiring hospitalization—like surgeries, strokes, or cancer—also fall into this category.

If the applicant misses disclosing issues like a viral fever or an old injury that was treated and cured, it will generally not be an issue.

How far back do you need to go? There is often confusion around how many years of medical history need to be disclosed. There is no official limit or exhaustive list that prescribes a specific time frame.