Your Guide to Pre-Policy Medical Check-Ups in Health Insurance


Health insurance policies help a lot when it comes to combating the financial burden of long hospital bills. The costs for medical care are rising each day and so people become hesitant to take proper medical treatment. However, with an adequate health plan, you can enjoy quality medical care without having to pay much. Some insurance companies even conduct pre-policy medical checkups. It is a medical test that is requested by the insurance providers before they offer you with the coverage. The reason behind this examination is to minimize the insurance company’s risk.

About Pre-Policy Medical Checkup

Before the health insurance company accepts the policy, they conduct a checkup or pre-policy medical examination. You will need to give the tests only if you’re above a 45 years age of age. This is for the insurance provider to know about your current health, and especially to check if you have any pre-existing medical conditions.

Apart from this, there could be another reason for the pre-policy checkup, i.e. if the sum assured by you is more than the average amount. Due to this, the insurer’s risk increases.

Importance of Pre-Medical Test

Some companies make this their strategy to attract customers and even pay for the medical examinations conducted. Initially, the customer needs to pay for the medical test. If the proposal is accepted, customers receive compensation for medical test expenses. By doing this, the insurer can learn about your health, which will help them in the future. The tests are conducted to check if you have any pre-existing medical conditions. These tests bring your illnesses, if any, to light and the insurer can then make a decision and provide you with appropriate cover.

Pre-policy medical checkups are necessary when raising claims. When you file a claim, the insurance provider will have the power to prove that the medical condition is caused due to a pre-existing condition that you did not disclose earlier. This can lead to claim rejection. If you think about it, pre-policy tests are beneficial for both the parties, i.e. the general insurance company and yourself. If you have the report of your medical tests filed, the claims process becomes easier.

What happens after the pre-policy tests are conducted?

After the tests are conducted and the results arrive, it is the insurance company who decides whether or not they will provide you with the coverage. In case any medical condition is detected, the insurer can choose the action they want to take from the following:

  1. The insurance company might issue the policy but have the illness or medical condition which is detected removed from the cover. In simple words, you won’t receive coverage for that particular condition, especially if the illness is risky to be covered.
  2. Another option for the insurance company would be to simply increase the premium amount. They can issue the policy to you at a higher rate so the expenses of the condition detected are covered. The rate at which premiums will increase depends on how severe the illness is.
  3. But if the condition detected needs frequent checkups, i.e. it is a high-risk illness, the insurer can reject the policy.

Looking after your health must be your top-most priority and everything else follows. Life can get stressful at times and you don’t want to add to it. Health insurance works as a perfect shield and helps reduce tension. At times, people don’t know how to make good use of a medical plan and end up making mistakes such as hiding their medical history from the insurance company. Later, they are the ones who suffer at the time of filing an insurance claim and not the insurance provider. Therefore, majority of the companies conduct pre-medical tests for their clients and it is only wise to get it done.


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