What is PED in health insurance?

PED, or a pre-existing disease, is a medical condition that the customer has before he buys a health insurance policy. According to the latest IRDAI (Insurance Regulatory and Development Authority of India), a health condition diagnosed up to 3 years before purchasing a health insurance policy is considered a pre-existing condition.

Some common examples of PED include various long-term health conditions like thyroid, high blood pressure, diabetes, asthma, and so on. As we grow older, the risk of pre-existing disease also increases, although it is more common in older adults.

Benefits of Health Insurance for People with PEDs

The following are the benefits:

• Broad Coverage: Health insurance plans with PEDs come up with extensive coverage for treating all long-term medical conditions.


• Cashless Hospitalisation: Many policies provide a cashless treatment facility, eventually making it easier to get the necessary medical attention.


• OPD & Diagnostic Cover: Most health insurance plans offer coverage for OPD consultations, lab tests, diagnostic procedures and more, thus making it easy to manage pre-existing conditions.


• Additional Benefits: Additional benefits and services like annual health check-ups and healthcare services are provided at your comfort by a health insurance policy.

Why should you tell your insurer about pre- existing conditions?

It is very important for everyone to inform the insurance company about their pre-existing conditions/diseases while purchasing a health insurance policy, as it can lead to serious consequences later on. Many don’t stay honest and hide their diseases so that they can have health insurance with a lower premium, but by doing so, they risk claim rejection, policy cancellation, or even legal consequences.

Later, if the insurance company comes to know that you have not disclosed your pre-existing disease, they may reject your claim, mainly if the treatment is connected to that undisclosed illness. Thus, this can leave you in situations where you may have to face high medical expenses without any financial support.

Tips for Choosing the Right Plan If You Have a Pre-existing Disease

• Individuals can buy a health insurance policy with pre-existing disease coverage 3 years after the pre-existing disease was diagnosed/cured.


• Be aware to disclose your pre-existing illness, if any, to the insurance company at the time of purchasing the policy.


• Select a health insurance policy that has a lower pre-existing disease waiting period.


• Try to avoid choosing health insurance plans that charge a co-payment for PED Coverage.

Summing Up

A pre-existing disease refers to a medical condition or illness that is diagnosed within 36 months before buying a policy. The medical care expenses of a pre-existing disease are generally high, due to which some health insurance companies come up with higher premiums for PED coverage.