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What is the Moratorium Period in Health Insurance?

Moratorium period in health insurance refers to a fixed duration after which a health insurance company cannot reject claims on the basis of non-disclosure or misrepresentation of medical information, as long as there is no proven fraud.

As per the latest IRDAI guidelines, this period is set at 5 years (60 continuous months). Once a policyholder completes this uninterrupted period of coverage, the insurer cannot contest any claims arising from inaccuracies or omissions in the information provided at the time the policy was purchased.

The only exception is if the insurer can establish that the policyholder deliberately committed fraud. This rule protects people who keep their health insurance active for many years. It helps ensure that small mistakes or missed details from the past do not lead to claim rejection later, when the policyholder genuinely needs support.

Understanding the moratorium period helps policyholders feel secure about their future claims and encourages responsible disclosure at policy issuance.

Understanding Moratorium Period in Health Insurance

What is a Moratorium Period in Health Insurance?

The moratorium period is a fixed time after which claims cannot be denied for non-disclosure, unless fraud is proven. In 2024, IRDAI reduced this period from 96 to 60 months. So, if you have held a health insurance policy for 5 continuous years, your insurer cannot reject claims for non-disclosure unless there is clear evidence of fraud or misrepresentation. It also includes migrated or ported policies, provided there are no coverage gaps.

Purpose of Moratorium Period in Health Insurance

A moratorium period in health insurance acts as a safety net for policyholders and also encourages honesty when applying for a policy. It protects you from claim rejections after a certain number of years. Policyholders are also more likely to disclose their medical history during the policy application process. This transparency helps insurers and policyholders assess risk accurately and select suitable health insurance policies. The moratorium period is especially helpful for people with pre-existing conditions such as diabetes or high blood pressure. It reduces the risk of disputes and delays in claims.

What is Fraud in Insurance?

According to section 17 of the Indian Contract Act of 1872, fraud encompasses several fraudulent acts perpetrated by a party to a contract, or by their representatives, or with their cooperation, with the aim of misleading another party or persuading them to enter into a contract. These acts include-

Making a promise without any intention of following through with it.
Making a misleading suggestion as reality by someone who does not think it is true.
Actively hiding a truth by someone who knows or regards it to be true.
Any omission or act that the law declares to be fraudulent.
Any other act focused on deceiving.

Why Does the Moratorium Period Matter?

When You Are Purchasing an Insurance Policy

Ensure you disclose any and all information you know about pre-existing conditions. Use email or extra paper to add any additional information, and ensure to keep records of all confirmations.

When You Already Have an Insurance Policy

If you know about any non-disclosure, inform the insurance provider promptly. Holding onto a health insurance policy with undisclosed information can be detrimental because your insurance claims may be questioned.

How the Health Insurance Moratorium Period Works

Continuous Coverage Required

Policyholders must maintain continuous coverage for 5 years under their health insurance policy by renewing it on time. You may also port your policy to another insurer or switch to a different plan with the same insurer. As long as there is no break in coverage, the time counts toward the moratorium period, helping you reach the five-year mark smoothly.

When Does the Moratorium Period Start?

The moratorium period starts on the day your health insurance policy is issued for the first time. The date remains the same even if you renew the policy, upgrade your plan, or move to another insurer through portability. However, if you miss a renewal and the policy lapses, the moratorium period starts again from the beginning.

What Changes After Moratorium Expires

After the moratorium period ends, the insurer cannot reject claims for past non-disclosures in most situations. Claims can be denied only when there is strong proof of fraud or intentional wrongdoing. After completion of the moratorium period, valid claims are processed without revisiting old medical details.

How Moratorium Applies to Pre-Existing Conditions

The moratorium period is set for a 5-year timeframe, after which claims related to pre-existing conditions cannot be rejected for non-disclosure. Once this period is completed, the insurer is expected to honour valid claims, subject to policy terms. Read the policy document for the duration and conditions of the moratorium.

What Happens if Your Policy Lapses?

If your policy lapses, the moratorium period resets and previous years of coverage will not be counted. It means you must start the five years again. A break in continuity can delay your protection against claim rejections. To avoid this, renew your policy before the due date or at least within the grace period.

Documents and Proof Required After Moratorium Ends

After the moratorium period ends, insurers may still ask for basic medical records to process a claim. These usually include:

Hospital discharge summary
Doctor prescriptions
Diagnostic and test reports
Treatment and consultation records
Hospital bills and payment receipts
Previous medical records, if requested

Please note: Claims may face delays if documents are incomplete, unclear, or inconsistent with earlier medical records.

IRDAI New Rules for Moratorium Period in Health Insurance Claim Settlement

IRDAI has reduced the moratorium period in health insurance from 8 years to 5 years. Once the moratorium period of an active health insurance policy ends, the insurance company cannot deny any claim covered by the health policy, except in the case of fraud.

The IRDAI states that after a health insurance plan has had coverage for a continuous 5 years (including migration and portability), the insurance provider cannot contest the policy and any claim on the grounds of misrepresentation and non-disclosure; however, it can on the grounds of fraud.

How the Health Insurance Moratorium Period Affects Policyholders

Short-Term Impact during Policy Years 1–5

During the first five years of a health insurance policy, the moratorium period places certain responsibilities on the policyholder. Insurers may examine claims more closely and refer back to the original disclosures made at the time of purchase. If any health condition was not mentioned, claims related to that condition could be questioned or denied, unless the omission was unintentional and without fraud.

Long-Term Benefits after the Period Ends

After five years, the policy begins to offer stronger protection. If the policy has stayed active without any break, claims are no longer questioned for past non-disclosure, unless fraud is clearly proven. It reduces claim-related stress for policyholders. It also helps build trust with the insurer and makes the claim process smoother and more predictable over time.

Benefits of Completing the Moratorium Period

Improved Claim Certainty

After the moratorium period ends, claim processing becomes more predictable. Insurers stop reviewing past disclosures, which allows policyholders to plan future healthcare expenses with greater clarity and fewer unexpected issues during claims.

Better Coverage for Pre-Existing Conditions

Once the moratorium period ends, claims related to pre-existing conditions become easier to process. Policyholders do not face repeated scrutiny of their medical history, which makes claim approvals easier.

Stronger Transparency With Insurer

After the moratorium period, the relationship between the insurer and policyholder becomes more transparent. With reduced contestability, claims involve fewer disputes and less documentation related to past health details.

Confidence During Medical Emergencies

As claims will not be questioned for past disclosures, it brings relief during medical emergencies. Policyholders can focus fully on recovery without the added worry of whether their claim will be rejected.

Greater Policy Stability Over Time

Completing the moratorium period adds stability to long-term health insurance coverage. It reassures policyholders that their policy will continue to support them reliably as their healthcare needs grow.

Tips to Navigate The Moratorium Period In Health Insurance

Maintain Continuous Renewals Without Gaps

Renew your policy on time every year to avoid any break in coverage. Even a short lapse can reset important timelines and delay the completion of the moratorium period.

Disclose Medical History Honestly at Time of Purchase

Share complete and accurate health details when buying the policy. Honest disclosure reduces the risk of claim issues and supports smoother approvals once the moratorium period is completed.

Keep Clear Medical Records and Reports

Maintain organised medical documents such as prescriptions, test reports, and discharge summaries. Clear records help insurers verify claims quickly and reduce back-and-forth during claim assessment.

Understand Policy Terms and Updates

Read policy documents carefully and stay informed about updates shared by the insurer. Awareness of terms helps prevent misunderstandings during claims related to waiting periods or disclosures.

How Do I Ensure Coverage with IndusInd General Insurance?

Health insurance works by the insurance provider evaluating your risks and the chances of you making an insurance claim. They depend on information you provide, such as your medical history, lifestyle, age, etc., to determine how much insurance premium you will be charged for your coverage. You provide these details through -

1. The application form, when you buy our Health Insurance.

2. During interactions with your insurer or with their representatives (when you speak with someone in their customer support team).

Since we at IndusInd General Insurance base our decisions on the information you provide, it is essential to be honest and accurate in your declarations. This ensures you get the right pricing and health insurance coverage for your needs.

If you provide incorrect information in your health policy, it might lead to denied claims or a cancelled policy.

In the past, insurance providers could cancel your health insurance policy or reject insurance claims even after years of renewing it, leading to uncertainty for customers. To address such cases, the IRDAI launched the “Moratorium Period in health insurance” to ensure coverage.

Key Takeaways

The moratorium period protects long-term policyholders by limiting claim rejection for past non-disclosure after 5 years of continuous coverage. It brings clarity, fairness, and confidence to health insurance claims while encouraging honest disclosures at the time of purchase.

At IndusInd General Insurance, health plans are designed to support customers throughout this journey. Our approach focuses on transparency, continuity, and clear communication so policyholders understand how the moratorium period works and how it benefits them over time. We help customers track policy timelines and avoid lapses that could reset important coverage milestones.

To make policy management easier, we offer practical tools and ongoing support. Customers can use online dashboards, renewal reminders, and the IndusInd Insurance app to monitor policies, documents, and claims. Dedicated claim support teams are available to guide customers at every stage.

For claims related to pre-existing conditions, we provide specialised assistance. Our teams help with documentation, explain requirements clearly, and ensure claims are processed smoothly once the moratorium period is completed.

Authors - Location -Health

IndusInd General Insurance

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IndusInd General Insurance is one of the leading general insurance companies in India. The Company offers a well-rounded and comprehensive bouquet of products including Motor Insurance, Health Insurance, and Travel Insurance, and offers customised solutions to meet the protection needs of each customer.

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Ritik

Noida

Value for money

Buying a Health policy through the platform ofReliance General Insurance (now IndusInd General Insurance) was straightforward and quick.

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West Midnapore

4.5

Seamless digital experience

The journey of purchasing Health insurance from Reliance Insurance Company (now IndusInd Insurance Company) felt effortless and user-friendly. It met my requirements well and felt tailored to my needs. I am satisfied with the main policy and don't see a need for extras. I'm happy with how everything went and feel secure with my policy.

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West Godavari

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New Delhi

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Wayanad

Value for money

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Wayanad

Seamless digital experience

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Wayanad

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Warangal

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Wanaparthy

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Visakhapatnam

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Visakhapatnam

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Tiruvallur

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4.5

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Suryapet

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Surat

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Siddipet

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Frequently Asked Questions (FAQs)

Why Insurers Use a Moratorium Period in Health Insurance?

Insurers use a moratorium period to manage financial risk and assess claim patterns. It allows them time to verify information provided by policyholders and ensures transparency. The period also helps keep premiums affordable by reducing the risk of excessive claims, ensuring the system remains stable and sustainable.

What Is Portability in Health Insurance?

The portability option allows a policyholder to shift a health insurance policy from one insurer to another while keeping existing benefits. It helps people access better coverage, improved service, or a wider hospital network. The good part is that you do not lose continuity when you port your health insurance policy to IndusInd General Insurance from another insurer.

How to Port a Health Insurance Policy to IndusInd from Another Insurer?

Check portability eligibility at least 45 days before your policy renewal date. Visit IndusInd General Insurance and choose a plan that better suits your coverage needs. Submit the portability request within the allowed timeframe before renewal. Share complete previous policy details and accurate medical history. Respond promptly if the new insurer asks for additional information. Complete payment only after approval to ensure uninterrupted coverage.

Can the Moratorium Period Be Reduced or Waived?

No, the moratorium period cannot be reduced or waived. The IRDAI mandates a continuous five-year period from the start of your policy. This rule applies to all health insurance policies, and insurers are required to follow it. No endorsements, riders, or premium payments can shorten this mandatory period.

What Is Claim Contestability in Health Insurance?

Claim contestability is the period when an insurer can review a claim more closely. During this time, the insurer may check whether important health details were correctly shared when the policy was purchased. This review is limited to a fixed number of policy years and does not continue indefinitely.

How Portability Affects the Moratorium Period?

When a policy is ported correctly, the years of continuous coverage already completed are carried forward to the new insurer. It means the moratorium period continues from where it left off and does not restart. Proper documentation ensures that past coverage is recognised without interruption.

Does Moratorium Apply to All Health Insurance Plans?

Yes, the moratorium applies to all health insurance plans regulated by IRDAI. It covers individual, family floater, and group health insurance policies. The rule applies to policies issued or renewed under the IRDAI Health Insurance Regulations. After 5 continuous years, insurers cannot reject claims except in proven fraud cases.