Can an Insurer Investigate Your Past Malaria History After the Moratorium Period

Yes, an insurer can investigate your past malaria history during claim assessment after the moratorium period under specific conditions. However, this is possible only under certain rules & regulations and valid reasons such as suspected non-disclosure or incorrect information.

What is the Moratorium Period in Health Insurance?

The moratorium period in health insurance refers to a fixed time period after which the health insurance companies are not eligible to reject any claims based on non-disclosure, misrepresentation, or pre-existing conditions (PEDs) unless fraud is demonstrated.

In simple terms, the moratorium period is about 5 years, and it helps keep your insurance safe and secure. Once this time frame is completed, insurers are generally restricted from questioning pre-existing conditions that were not disclosed earlier, unless there is evidence of fraud or deliberate misrepresentation. This makes sure that there is stability in long-term health insurance policies. Additionally, it reduces disputes over older medical conditions.

Can Past Malaria History Still Be Checked after the Moratorium Period?

Yes! Past malaria history can still be checked by the insurer if the policyholder submits a claim related to malaria or its complications. This review is based on medical documents such as hospital records, diagnostic reports, and treatment history. However, the main purpose of this is not routine investigation but claim validation.

If medical records show repeated malaria episodes before the policy began and these were not disclosed, the insurer may examine whether it should have been declared as part of the medical history. This is particularly relevant in cases involving recurrent infections or complications like severe anaemia or cerebral malaria.

When Can an Insurer Investigate Past Malaria History After the Moratorium Period?

Your insurer can review your past malaria history in such cases:

• When a claim is filed related to malaria or its complications


• If they found that the information you have provided is wrong or incomplete.


• If medical records are required to validate treatment history

When is an Insurer's Investigation Not Allowed?

The insurer cannot investigate during the following scenarios:

• Insurers are not allowed to open old medical history without a valid claim trigger.


• They can’t reject claims solely based on pre-moratorium non-disclosure after completion of the moratorium period.