Standard exclusion — Excl02

Specified disease/procedure waiting period

These are IRDAI's codes and IRDAI's words, not ours.

Official wording — reproduced verbatim

What the standard text says

a) Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of <####> months of continuous coverage after the date of inception of the first policy with us. This exclusion shall not be applicable for claims arising due to an accident. (Explanation: Subject to product design the number of months, not exceeding 48 months, shall be specified)

b) In case of enhancement of sum insured the exclusion shall apply afresh to the extent of sum insured increase.

c) If any of the specified disease/procedure falls under the waiting period specified for pre-Existing diseases, then the longer of the two waiting periods shall apply.

d) The waiting period for listed conditions shall apply even if contracted after the policy or declared and accepted without a specific exclusion.

e) If the Insured Person is continuously covered without any break as defined under the applicable norms on portability stipulated by IRDAI, then waiting period for the same would be reduced to the extent of prior coverage.

f) List of specific diseases/procedures (Explanation: “List of specific diseases / Procedures in respect of which waiting period is imposed shall be specified here or reference to be furnished”.)

The hash marks appear in IRDAI's official template. Each insurer must replace them with the period used in that filed product.

Source: IRDAI, Guidelines on Standardization of Exclusions in Health Insurance Contracts, page 6. Open the official PDF ↗

In plain English — our reading

What that means on the page

A policy can name particular conditions or procedures that carry their own waiting period. The policy must state the list and the period. Accident claims are treated separately where the policy covers them, and portability credit can reduce the wait.

This explains the standard wording. Your policy schedule, endorsements and other clauses may change how the document applies to you.