What is the insurance waiting period?

The insurance waiting period, also known as the observation period, refers to the specified period when the insurance contract takes effect, even if an insured accident occurs, the beneficiary cannot obtain insurance compensation. This period is called the waiting period. The purpose of setting the waiting period is to prevent the insured from knowing that an insured accident will occur and immediately apply for insurance to obtain it.

Under normal circumstances, the waiting period for critical illness insurance is 90-180 days, and the waiting period for medical insurance is 30 days. The waiting period is generally calculated from the effective date or reinstatement date of the contract and is only applicable to the first insurance year. For renewable policies, there is generally no waiting period for the renewal year.

The waiting period can be understood as a “passive protection period” given by laws and regulations to insurance companies to avoid the risk of insuring with illness.

General medical insurance waiting period

Ordinary medical insurance is out of danger during the waiting period, no compensation but the contract continues to be valid. Unlike fixed-payment insurance, ordinary medical insurance will not terminate the insurance liability if the insurance is out during the waiting period. The original intention of the design of ordinary medical insurance is to protect the insurance consumers’ medical expenses. The reimbursement system is adopted to provide a claim for each risk occurrence. Therefore, you can get a claim even for the same reasons. The setting of the waiting period is mainly to avoid the problem of insurance before surgery for accidents or diseases.

Accidental medical insurance generally does not have a waiting period

Since accidental injury is not predictable, and the setting of accidental injury medical insurance is based on the condition that the accident occurs after the insurance period begins, there is no need to set a waiting period.

Millions of Medical Insurance Waiting Period Exclusions

Since the protection object of the millions of medical insurance product design is the treatment risk of major diseases, the setting of the waiting period is necessary, but due to its reimbursement-type insurance liability, the treatment method of “exemption from danger” is adopted, that is, waiting for Diseases diagnosed during the period will no longer be covered by insurance for the disease.

Critical illness insurance waiting period

At present, most insurance companies have adopted a 90-day waiting period and the system of direct termination of the contract during the waiting period. The following is an analysis of common situations during the waiting period of critical illness insurance:

1. What should I do if the physical examination is abnormal or the problems mentioned in the health notice are found during the waiting period?

For example, during the waiting period after applying for insurance, the unit will organize a physical examination and find out that there is a thyroid nodule. What should I do? Do I need to tell the insurance company?

Under normal circumstances, the choice is selective notification according to the condition. In principle, as long as there is no such thyroid nodule before the insurance, and it meets the “health notice”, it will not affect the subsequent claims of the purchased critical illness insurance. To put it simply: “No matter how many types of critical illness insurance are available, most of them cannot be obtained in one or two days. There is no reason to get sick without buying insurance.”

2. Directly diagnosed with a serious illness during the waiting period

In this case, regardless of whether you have symptoms before applying for the insurance, the accumulated premiums will be refunded and the contract will be terminated. For some products that are set to return cash value, you can try to maintain your rights and interests through negotiation, complaint, and litigation.

3. Waiting period setting for critical illness insurance and mild illness

For the treatment of mild illness, there are different ways depending on the type of insurance. In the products of some insurance companies, minor illness liability is included in the critical illness insurance product. Then, the “mild” treatment of this type of product is the same as the above-mentioned serious illness treatment. During the waiting period, the insurance will either settle the claim or terminate the contract. There are also products of some insurance companies, where the liability for minor illness exists as separate additional insurance, so the “minor illness” liability of such products can be terminated separately from the additional insurance for the minor illness during the waiting period, to continue to protect the liability for serious illness.

In general insurance practice, once there is a minor illness liability claim, likely, the major illness insurance will also encounter delays, refusal, increase fees, exemptions, etc.

By Cary Grant

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