Health Insurance for Pre-Existing Diseases 2026: What the 36-Month Rule Means for Diabetes, BP and Thyroid

Under IRDAI's 2024 rules, a pre-existing disease (PED) is any condition diagnosed, or for which a doctor advised or gave treatment, within 36 months before your policy starts. An insurer can exclude a disclosed PED for at most 36 months of continuous cover, and may offer a shorter wait. Diabetes, high blood pressure and thyroid disorders normally fall in this group, so you can buy cover, but the condition itself may not be payable for a while.

What counts as a pre-existing disease

Schedule III of the IRDAI (Insurance Products) Regulations, 2024 defines a PED as a condition, ailment, injury or disease that (a) a physician diagnosed not more than 36 months before the policy commenced, or (b) for which medical advice or treatment was recommended or received from a physician not more than 36 months before it commenced. The look-back used to be 48 months, and older documents, including some policy wordings filed in 2022, still show that figure. The 2024 Regulations came into force from 1 April 2024, so they are the current rule.

How long the wait can be

The Regulations say the waiting period for a PED disclosed by the person to be insured shall be at most 36 months of continuous coverage. Insurers may endeavour to offer less. A policy that starts on 1 April 2026 with the full 36-month wait would therefore cover the disclosed condition from 1 April 2029, provided it is renewed without a break. A break happens when the premium is not paid by the due date plus the grace period, which is 30 days for annual payment and 15 days for monthly payment.

• Portability and migration transfer the waiting period already served, up to the previous sum insured. If you served 24 months and the new policy has a 36-month wait, 12 months remain.
• A higher sum insured attracts a fresh waiting period for the added amount only, as IRDAI's Customer Information Sheet format states.
• A different product or add-on may carry a shorter PED wait. IRDAI requires insurers to make products, add-ons and riders available for pre-existing and chronic conditions and to let customers customise them, but the terms are each insurer's own.

What to get in writing before you buy

• The PED waiting period in months, stated in the policy schedule, and whether it differs by condition.
• Whether complications of the condition fall under the same wait.
• Any premium loading or special condition from underwriting, and whether it can be reviewed at renewal. The Regulations let an insurer recognise an improved risk profile by removing a loading at renewal, but they do not make it compulsory.
• For an add-on that shortens the wait: the exact list of conditions it covers, since it will not apply to a condition that is not named.
• Permanent exclusions. IRDAI's format says that after the moratorium a policy cannot be contested except for proven fraud and permanent exclusions in the contract.

Do not compare insurers on marketing pages, because add-on names, waiting periods and loadings change. Compare the policy wording and the Customer Information Sheet, which every insurer must give with the policy and which lists waiting periods, sub-limits and deductibles in one place. Our diabetes-specific policy comparison and best health insurance guide help with shortlisting.

Disclosure and the 60-month moratorium

The waiting period decides when the condition becomes payable. The moratorium is a separate protection. After 60 continuous months of cover, including months credited through portability and migration, no policy or claim can be contested on grounds of non-disclosure or misrepresentation, except established fraud. It applies to the sum insured of the first policy, and any increase starts its own 60 months from the date of the increase. So the moratorium on a policy bought on 1 April 2026 would begin on 1 April 2031.

If your cover comes from an employer

The Regulations require general and health insurers to allow portability of indemnity policies, group or individual, subject to the insurer's Board-approved underwriting policy. A move from group to individual cover therefore is not automatically a reset, but it is also not automatic acceptance: the new insurer can underwrite you. For migration within the same insurer, the Regulations allow underwriting if you have not been continuously covered for 36 months. Start the process before the group cover ends, and see our guides on portability after job loss and the portability process.