Understanding Moratorium Period in Health Insurance

The moratorium period ensures claim security for long-term policyholders. Here’s everything you need to know about its purpose and benefits.
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3 min
12-June-2025

Understanding policy terms in health insurance is vital for maximising your benefits.

One such term is the moratorium period, introduced by IRDAI to protect long-term policyholders. Especially important for those with pre-existing or chronic conditions, it offers lasting security against claim rejections based on past non-disclosures.

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What is the moratorium period in health insurance?

The moratorium period refers to the duration a policyholder must wait before their pre-existing conditions (PEDs) are covered under a health insurance plan.

Pre-existing conditions are any illnesses or medical conditions—such as diabetes, hypertension, asthma, arthritis, or thyroid disorders—that were diagnosed or treated before purchasing a health insurance policy.

As per the latest IRDAI (Insurance Regulatory and Development Authority of India) guidelines, effective 1st April 2024, the moratorium period has been reduced from 8 years to 5 years. This means insurers must cover PEDs after 5 continuous years of uninterrupted coverage.

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What Is the purpose of the moratorium period?

The moratorium period in health insurance is designed to discourage individuals from purchasing a policy only after being diagnosed with a pre-existing condition. Without this safeguard, there would be a surge in claims, leading to significantly higher premiums for everyone.

By implementing a moratorium period, insurers encourage people—especially those at higher health risk—to buy health insurance early, reducing overall financial risk for the provider. This helps maintain fair and affordable premiums across all policyholders.

Additionally, the moratorium period serves another important purpose: it promotes honest medical disclosure. Knowing that pre-existing conditions will be covered after five years of continuous coverage, applicants are more likely to report their health conditions truthfully during the policy application process.

IRDAI guidelines on moratorium period

IRDAI mandates the moratorium period to increase consumer protection. After eight consecutive claim-free years:

  • Claims become non-contestable.
  • Your policy’s validity or claim eligibility cannot be challenged for past disclosure errors.
  • Fraud remains the only exception.

This regulatory move builds transparency, trust, and fairness in the health insurance ecosystem.

How does the moratorium period work?

The moratorium period in health insurance functions in the following manner:

  • At the Time of Policy Purchase:
    When you buy a health insurance policy, the insurer will assess your medical history for any pre-existing conditions (PEDs). If any such conditions are identified, they will not be covered during the moratorium period.
    However, during this period, the insurer will still cover accidents and unrelated medical emergencies, provided they are not linked to your pre-existing condition.
  • After the Moratorium Period:

Once the moratorium period—typically 5 years—is complete, your pre-existing conditions will be covered by the insurer. That said, coverage may vary by insurer, as some plans may exclude specific PEDs. It’s important to read the policy documents carefully to understand these exclusions.

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End Uses

Benefits of Moratorium Period in Health Insurance

1. Claim security after 8 years

Say goodbye to worries over forgotten declarations—after 8 years, your coverage is locked in.

2. Supports genuine policyholders

Honest mistakes won’t cost you your claim. The moratorium recognises human error.

3. Encourages long-term renewals

It rewards disciplined renewers—adding long-term value to your plan.

4. Reduces disputes with insurers

Fewer disputes = faster approvals, smoother claim experiences.

5. Applicable across insurers

This isn’t an insurer-specific perk—IRDAI mandates this across all providers.

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Why does the Moratorium Period matter?

It protects insurers from unfair claims while rewarding honest disclosures—ensuring fair pricing and access for all.

Helps maintain a balanced risk pool

The moratorium period prevents misuse of health insurance by restricting coverage for undisclosed or recent pre-existing conditions. This ensures that only genuine claims are made, helping insurers maintain a balanced risk pool and offer affordable premiums across the board.

Encourages people to buy health insurance early

Since coverage for pre-existing conditions begins only after the moratorium period, individuals are more likely to purchase health insurance early—when they’re healthier and premiums are lower. This proactive approach benefits both the insured and the insurer in the long run.

Moratorium period is mandatory

As per IRDAI regulations, the moratorium period is a compulsory component of health insurance policies. Currently set at 5 years, it ensures that health plans remain sustainable while eventually extending coverage for long-term policyholders with pre-existing diseases.

Impact of moratorium on pre-existing disease claims

1. No rejection after 8 years for old conditions

Once the moratorium period is over—previously 8 years, now reduced to 5 years—your insurer can no longer reject claims based on pre-existing conditions that you disclosed at the time of policy purchase. Even if your health history includes chronic issues like diabetes, hypertension, or asthma, your insurer cannot deny claims for these conditions, provided there’s no proven fraud or misrepresentation. This gives you long-term peace of mind and greater security in accessing treatment.

2. Improves access to treatment

With the moratorium period complete, your health insurance plan becomes more comprehensive. You can now confidently seek treatment for chronic, lifestyle-related, or long-standing conditions without worrying about exclusions or denials. This especially helps people who depend on long-term medications or therapies and ensures cashless hospitalisation and hassle-free care even for complex health conditions.

3. Helps high-risk individuals

People with multiple pre-existing ailments, hereditary diseases, or complex medical histories often face difficulty getting full coverage. The moratorium period acts as a protective layer for such individuals—ensuring that, over time, they become eligible for full benefits without being penalised for their health risks. It's an inclusive provision that promotes healthcare access for vulnerable policyholders.

4. Reinforces the non-contestability clause

The moratorium aligns with the non-contestability clause under IRDAI regulations. Once the moratorium period is over, your insurer cannot question or dispute your claim for old medical issues—unless there is a case of fraud. It is a legally backed assurance that if you’ve honestly declared your health conditions, you are fully protected and your claim will stand.

5. Reduces need for exhaustive documentation

Post-moratorium, the claims process becomes significantly simpler. There is less scrutiny of old medical records, fewer documents required, and a smoother claims approval experience. This makes it easier for policyholders—especially seniors and those managing chronic conditions—to file claims quickly and stress-free, reducing delays in treatment.

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Difference between waiting period and moratorium period

Aspect Waiting Period Moratorium Period
Purpose Early-stage condition restriction Long-term claim protection
Duration 1–4 years 8 claim-free years
Impact on Claims Can restrict early claims No rejection for past errors post 8 years
Scope Condition-specific Broad—applies to all disclosures
Benefit Focus Short-term Long-term protection



Together, these timelines guide both your early expectations and future protections under health insurance.

Conclusion

The moratorium period is not just legal jargon—it’s a game-changer for loyal policyholders. It guarantees that after 8 clean years, your health insurance stands by you, even if there were minor slip-ups at the beginning.

This provision:

  • Rewards consistent renewals
  • Protects long-term health planning
  • Reduces disputes and delays
  • Encourages transparency and coverage loyalty

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Frequently asked questions

How long is the moratorium period in health insurance policies?
The moratorium period in health insurance is 8 continuous claim-free years. After this duration, insurers cannot reject claims based on non-disclosure or misrepresentation, unless fraud is proven. It applies across all IRDAI-regulated health insurance policies in India.

Are pre-existing diseases covered after the moratorium period?
Yes, after completing the 8-year moratorium period, claims related to pre-existing diseases cannot be denied due to past non-disclosures, unless there’s evidence of fraud. This offers long-term protection and reduces claim disputes for chronic or undiagnosed conditions.

Does every health insurance policy have a moratorium period?
Yes, all individual and family health insurance policies regulated by IRDAI include a moratorium period clause. It applies uniformly across insurers, ensuring long-term policyholders receive consistent protection regardless of the company or plan selected.

What is the moratorium period in medical insurance?

The moratorium period is the time (now reduced to 5 years by IRDAI) during which a health insurance provider can review and deny claims related to pre-existing diseases or past health conditions. Once you’ve completed 5 continuous claim-free years, your insurer cannot reject any claims for disclosed illnesses—except in cases of fraud or misrepresentation.

Can health insurance companies reject claims after 3 years?

Yes, insurers can reject claims within the first 5 years (earlier 8 years) of the moratorium period—if the claim is related to a pre-existing condition not covered yet, or if there's any non-disclosure or misrepresentation. However, once the moratorium period ends, your policy becomes non-contestable, and claims cannot be denied on health history grounds.

What is the difference between waiting period and moratorium?

Feature

Waiting Period

Moratorium Period

Purpose

Delays coverage for specific treatments/conditions

Limits claim rejection due to past health history

Applies To

PEDs, maternity, specific surgeries

Mainly pre-existing diseases

Duration

1–4 years (varies by insurer & condition)

5 years (as per IRDAI from April 2024)

Claim Rejection

Claims denied during the waiting period

Claims can't be denied post-moratorium (unless fraud)


The waiting period is shorter and condition-specific, while the moratorium period ensures long-term claim security and protects your right to coverage after a defined tenure.

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