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Health insurance waiting periods & the 60-month moratorium

A waiting period is a window during which a particular claim isn't payable yet, even though the policy is active. IRDAI's 2024 reforms shortened several of these in the policyholder's favour — knowing the current limits is how you tell a fair denial from an outdated one.

Initial waiting period — 30 days

For most policies, illnesses are not covered for the first 30 days of a brand-new policy. Accidental injury is the standard exception — it's covered from day one.

Pre-existing diseases (PED) — capped at 36 months

A pre-existing condition can carry a waiting period, but IRDAI has capped it at 36 months (reduced from the earlier 48), effective 1 April 2024. After you've served that period on continuous cover, a PED-related claim can't be refused on the ground that the condition pre-dated the policy.

Specific illnesses & procedures — up to 36 months

Policies may list named conditions or procedures — commonly cataract, hernia, joint replacement and similar — with their own waiting period of up to 36 months. This applies only where the policy actually lists them, so check your wording.

The 60-month moratorium

After 60 months of continuous health cover, the moratorium applies: the insurer can no longer contest or deny a claim on grounds of non-disclosure or misrepresentation — the only exception is proven fraud. This is a health-insurance rule and is different from life insurance's Section 45 three-year rule; don't confuse the two.

General guidance — verify with your insurer and policy wording. Sources: IRDAI Master Circular on Health Insurance Business, 29 May 2024; IRDAI (Insurance Products) Regulations, 2024.

Frequently asked

What is the maximum a pre-existing-disease waiting period can be?

36 months, reduced from the earlier 48, effective 1 April 2024 under IRDAI's rules. After that period on continuous cover, a claim can't be denied merely because the condition pre-dated the policy.

Is the 60-month moratorium the same as Section 45?

No. The 60-month moratorium is a health-insurance rule; Section 45's three-year rule is life insurance. Both bar contesting a claim after the period (fraud excepted), but they are separate statutes for different products.

Are accidents subject to the 30-day initial wait?

No. Accidental injury is the standard exception to the initial 30-day waiting period and is typically covered from day one — check your policy wording.

IRDAI Master Circular on Health Insurance Business, 29 May 2024; IRDAI (Insurance Products) Regulations, 2024 · As of 2026-07-02