Does Family History of a Disease Count as Pre-Existing?

A family history of a disease is not treated solely as a pre-existing condition. While looking for health insurance, you may worry that your medical background could prevent you from getting coverage. However, pre-existing conditions are typically covered, but only after certain terms, such as a waiting period, are met.

It is important to understand that any illness you develop after your policy starts is not considered a pre-existing condition. Similarly, any condition not diagnosed before you bought the policy will not be treated as pre-existing. This includes diseases that may run in your family. Read on to know more.

Which Diseases are Counted as Pre-Existing Conditions in Health Insurance?

The health insurance companies only classify a disease as a pre-existing condition in case:

• Any condition that was diagnosed by a doctor within the 48 months before the policy starts or was reinstated.


• Any condition for which you received medical advice, consultation, or treatment from a doctor during those 48 months.

It is also essential to understand that a family history of a disease, such as conditions affecting your parents or any other member of your family, doesn't count as a pre-existing disease on its own.

It only becomes relevant if you have personally been diagnosed with or treated for that condition within the specified period. However, many insurers may also have specific rules in place when applying the pre-existing disease terms at the time of policy reinstatement.

What Happens If You Develop a Genetic Disease After Buying a Policy?

If you develop a genetic or hereditary disease after purchasing your health insurance policy, it is generally not treated as a pre-existing condition, provided you had no prior diagnosis or symptoms before the policy started.

According to the IRDAI-set rule, illness in such cases is considered a new condition and is usually covered under the standard terms of the policy. However, you may still need to complete any initial waiting period mentioned in your plan before making a claim.

Why do Insurers Ask about Family History while Purchasing a Health Cover?

The health insurance companies generally ask about your family's health history to understand the following aspects:

• Assess your health risk


• Decide on your premiums


• Offer suitable coverage

However, this information is used only for risk evaluation, not to classify a condition as a pre-existing disease.

You can choose a suitable plan by understanding your health condition, checking for waiting periods, and carefully comparing different policies. Additionally, it is also essential to understand that a family history alone is not treated as a pre-existing disease unless you have been diagnosed with it yourself.