# Pre-Existing Disease in Health Insurance: PED Rules > Pre-existing disease (PED) in health insurance: what counts as PED, the 36-month waiting cap, how to disclose, and the 60-month moratorium on disputes. - **Published**: 2026-10-18 - **Modified**: 2026-10-18 - **Category**: health-insurance - **URL**: https://www.tldr.money/articles/health-insurance/pre-existing-disease-health-insurance --- Start with our [health insurance in India](/health-insurance) hub if you are new to this. This guide covers **pre-existing disease (PED) in health insurance**: what counts, how long you wait, what to disclose, and the rules that protect you after five years. ## What counts as a pre-existing disease IRDAI's Insurance Products Regulations, 2024 define a pre-existing disease as any condition, ailment, injury or disease that: - was **diagnosed by a physician** not more than 36 months before the policy starts, or - for which **medical advice or treatment was recommended or received** from a physician in those 36 months. So the look-back is three years, and it covers more than formal diagnoses. If a doctor advised tests or medication for something in that window, it can count. Typical PEDs include diabetes, hypertension, thyroid disorders, asthma, high cholesterol and heart conditions. ## The PED waiting period: 36 months at most Once you declare a PED and the insurer accepts the proposal, the condition is excluded for a waiting period. Under the 2024 regulations the waiting period for disclosed pre-existing diseases can be **at most 36 months of continuous coverage**, and IRDAI asks insurers to try to offer less. Before these rules the cap was 48 months. What that means in practice: - **It runs from the first policy with the insurer**, and keeps running across renewals as long as there is no break. A renewal within the 30-day grace period is not a break. - **It applies afresh to any increase in sum insured.** If you raise cover from Rs 5 lakh to Rs 10 lakh in year two, the extra Rs 5 lakh starts its own waiting period. - **It overlaps with specific-illness waiting periods.** If a condition falls under both, the longer of the two applies, under IRDAI's standard exclusion wording. ### Worked example You buy a policy on 1 November 2026 and declare type 2 diabetes. The plan has a 36-month PED waiting period. - Diabetes-related hospitalisation is excluded until **1 November 2029**. - An unrelated illness, say dengue, is covered after the initial 30-day wait, from **1 December 2026**. - An accident is covered from day one. If the insurer offered a 24-month PED option or a PED-reduction add-on, the diabetes cover would start from 1 November 2028. Our [waiting periods guide](/articles/health-insurance/health-insurance-waiting-periods) covers the other clocks running at the same time. ### Options to shorten the wait IRDAI's 2024 health master circular requires insurers to make products, add-ons or riders available for pre-existing and chronic conditions. In the market that shows up as: - plans with a shorter standard PED wait than the 36-month maximum, - paid add-ons that cut the PED wait, sometimes to day one, and - disease-management plans built for people with diabetes or heart conditions. Shorter waits cost more. Compare the extra premium with how soon you are likely to need treatment. ## Disclosure: what to declare and why The proposal form is the contract's foundation. Answer every medical question fully, including: - conditions you are on medication for, even if well controlled, - past surgeries and hospitalisations, - conditions a doctor investigated or advised treatment for, and - lifestyle questions such as tobacco and alcohol use. If you are unsure whether something matters, declare it and attach the reports. The insurer may accept it with a waiting period, add a loading, or exclude it. All three are better than having a claim rejected years later. ## The 60-month moratorium: when non-disclosure stops mattering The moratorium is the most important protection most buyers have not heard of. IRDAI's rules say that after **60 continuous months of coverage**, no health policy or claim can be contested by the insurer on grounds of non-disclosure or misrepresentation, **except for established fraud**. Key points: - **Five years, continuous.** The 60 months must be unbroken. A lapse restarts the count. - **Porting and migration count.** Time with your previous insurer counts towards the 60 months. - **Applies per tranche of cover.** The moratorium applies to the sum insured of the first policy. Any increase in sum insured has to complete its own 60 months. - **Fraud is still fraud.** Deliberately hiding a serious condition is not protected. Before IRDAI's 2024 rules the moratorium was eight years. The shorter period helps, but it does not make honest disclosure optional: in years one to five, a missed disclosure is one of the most common [reasons health claims get rejected](/articles/health-insurance/health-insurance-claim-rejection-reasons). ## Porting keeps your PED credit If you move to a new insurer, IRDAI requires the credit you have earned for pre-existing disease waiting periods, specific waiting periods and the moratorium to move with you, up to the sum insured and no-claim bonus you had. So two years served on a 36-month PED wait leaves 12 months with the new insurer, if its PED wait is also 36 months. See our [health insurance portability guide](/articles/health-insurance/health-insurance-portability) for the process. ## If you or your parents already have a PED - **Buy sooner.** The waiting period starts only when the policy does. - **Look at PED-reduction options** if treatment is likely within three years. - **Consider a separate policy for older parents** rather than adding them to your floater. See [health insurance for parents](/articles/health-insurance/health-insurance-for-parents). - **Keep your medical records organised.** Reports from before the policy help settle any later dispute about when a condition began. Shortlist plans with the [health insurance buying checklist](/articles/health-insurance/health-insurance-checklist) and compare insurers on the [all health insurance companies](/health-insurance/insurers) page. The glossary entry on [waiting periods](/glossary/waiting-period) has the short version. Plans with shorter PED waits are compared in [best health insurance for senior citizens](/articles/health-insurance/best-health-insurance-senior-citizens). ## Sources - IRDAI (Insurance Products) Regulations, 2024, Schedule III, paras 1.6 (definition of PED), 7 (36-month PED cap) and 8 (60-month moratorium): https://irdai.gov.in/consolidated-gazette-notified-regulations - IRDAI, Master Circular on Health Insurance Business, 29 May 2024, Chapter I (products for pre-existing and chronic conditions; portability credits): https://irdai.gov.in/en/document-detail?documentId=4942918 - IRDAI, Master Circular on Standardization of Health Insurance Products, 22 Jul 2020 (standard PED and specific waiting-period exclusion wording): https://irdai.gov.in/documents/37343/366029/Master+Circular+on+Standardization+of+Health+Insurance+Products.pdf/40548736-71a8-1b76-e28d-0df899407e1e --- - [More health-insurance articles](https://www.tldr.money/articles/category/health-insurance) - [All articles](https://www.tldr.money/articles)