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Ailments that your health insurance does not cover

Before taking out a health insurance policy, make sure you are aware of these ailments that are not covered

M Saraswathy  |  Mumbai 

is a segment that has seen launch of several niche covers. However, there are still a lot of areas in health and medical illnesses which are excluded from the ambit of Here are some of the which are currently not covered in India.

HIV/AIDS: Caused by the HIV virus that is communicable through blood transfusion, infected syringes or contact with body fluids of the infected person, no concrete medicine has been discovered to completely cure a person. Though insurers say that it is not fatal if discovered in the initial stages, these individuals are considered high-risk and are not offered insurance for life or health

Infertility: Not able to conceive a child among women is an area which is not covered by insurance. This involves several rounds of treatment for investigating the causes and also involves manual injections and in-vitro fertilization (IVF); procedures which are considered risky to be covered by insurance. Though these treatments are costly, they are not covered.

disorders: Medical conditions related to issues are excluded from since they are considered as high-risk pre-existing medical conditions. These may include some forms of anaemia, thalassemia and Down's Syndrome among others.

use and related complications: While each individual is asked to disclose their usage to determine their insurance premium, those addicted to and having signs of associated like throat are not covered. Even if somebody fails to disclose their tobacco usage and later claims for a related ailment, their claim is rejected.

Advanced stages of cancer: While policies are available in the market and are available for people to purchase to act as a buffer if they contract in the future. But those who already have cancer or are in the advanced stages of cancer are not offered policies, since there is an imminent risk of high claims and threat of anti-selection. Anti-selection occurs when an individual aware of their take a medical and takes it on favourable terms than what would have been offered if they had disclosed their conditions.

Since insurance works on the principle of pooling where the pooled from all policyholders is used to pay claims, insurers wish to avoid those customers with a morbid condition who would claim higher and would impact the claim payments to otherwise healthy customers.

First Published: Fri, July 24 2015. 13:03 IST