Health Insurance | Pre Policy Medical Check Up In Health Insurance - Greyfont

Pre Policy Medical Checkup in Health Insurance


Getting a health insurance policy is a good way to overcome financial difficulties arising out of medical problems. You are required to pay a specific sum of amount on a monthly or yearly basis and in exchange you are eligible to receive health coverage by the insurance company. However, to minimize the risk of providing you coverage, health insurance companies require you to go through a pre-policy medical checkup on the basis of which you are eligible to receive the coverage. Opting for a pre policy medical checkup has been made mandatory by few insurance companies in India. If you are wondering about this type of medical checkup and why it is mandatory, then read the below guide to know everything about this concept in brief.


What is a pre policy medical checkup?


This is nothing but a pre policy issuance procedure that a policyholder has to undergo before the insurance company issues a health policy to him. Individuals above the age of 40 are required to undergo the pre policy medical checkup before the insurance company decides to give him the required coverage. However, not all health insurers in India require you to undergo the pre policy medical checkup. Generally, insurers can also ask policy seekers to undergo a pre policy medical checkup if they wish to opt for a higher coverage, irrespective of their age.


Why is pre policy medical checkup important?


By opting for a pre medical checkup lessens your chances of claim rejection in future and also provides an element of certainty to the insurance companies to provide you the coverage. This checkup is simply conducted to gauge if you are suffering from any preexisting diseases. This test allows the insurance company to make a decision on appropriate cover required for you.


What medical tests are conducted?


Under a pre policy medical checkup, you will have to undergo array of medical tests such as blood sugar, blood pressure, lipid profile, blood serum test, etc. Depending on your age and coverage amount you want to opt for, the insurer can ask you to undergo other tests too as they have a grid pattern that specifies the number of tests that an individual of a particular age has to go through.


Who bears the cost of the pre policy medical checkup?


The insurance Regulatory and Development Authority of India has made it compulsory for insurance companies to bear at least 50% cost of the medical checkup that the policy seeker has to undergo. However, few insurance companies also offer free medical checkup facility.


What happens after the pre policy medical checkup?


Once you undergo the specified tests mentioned by the insurance company, the reports are sent to the underwriting department for review. If no ailment is detected, the policy is issued to you at a nominal premium rate. However, if any ailment is detected, the following scenarios are likely to crop up.


  • High premium: You can be asked to pay a high premium if you are having any preexisting ailment.


  • Disease excluded: If a severe ailment is detected, then the insurance company can decide not to provide you any coverage for the same.


  • Reject the proposal: Insurance Company can decide to reject your proposal if the ailment is risky and is bound to receive frequent hospitalization.


Can you opt for a health insurance policy without a pre policy medical checkup?


If you opt to buy a health plan without any pre policy medical checkup, then it is important you disclose the facts about your health including the pre-existing disease, if any. If you make a claim in the future and if the cause of the hospitalization is due to a pre-existing ailment, then the company can reject your claim.


    Need Help in choosing right product

ORplease reach out to us at (022) 4891 3051


Contact Us

We want to hear from you