Permanent Exclusions In Health Insurance
  • What Are Permanent Exclusions?
  • Explore Permanent Exclusions
  • IRDAI List of Permanent Exclusions
Permanent Exclusions In Health Insurance
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Permanent Exclusions In Health Insurance

If you had a dollar for each time you clicked on 'I agree' without reading the terms and conditions for any app download or software update on your devices, you would be a millionaire!

It is not a surprise that 97% of people between the age group of 18 to 37 years do not read the legal terms and conditions. The data was provided by Deloitte after a study was conducted on 2,000 consumers in the USA. Well! this data does not surprise me.

A similar story is witnessed during claim grievances, wherein a lot of us miss out on important information regarding permanent exclusions in health insurance. This article explores permanent exclusions in health insurance in detail.

Scroll further to learn more about the topic and how you can benefit from understanding this term thoroughly.

What Are Permanent Exclusions?

Health insurance is a contract between you and the insurance provider. Under a health insurance plan, you are covered for hospitalisation and medical treatments, ICU charges, ambulance expenses, OPD, etc. This offers you a strong financial backup when an emergency hits.

It is important to note that with a plethora of inclusions, certain permanent exclusions are attached to your health insurance policy. Permanent exclusions mentioned in a health insurance policy will not be covered in case you are injured or hospitalised.

8 Permanent Exclusions You Must Know About

We promise this is more important than the terms and conditions you ignore, take a look at 8 important exclusions you must know about before investing in any health insurance:

  • Cosmetic Surgeries

    Any medical procedure done to enhance body parts is mostly not covered under a health insurance plan. If you wish to undergo cosmetic surgery it will be an out-of-pocket expense. Cosmetic surgeries are expensive and are generally not covered by health insurance plans making it a part of permanent exclusions.

    However, in case of extreme accidental disfigurement, some health insurance plans might cover corrective cosmetic surgeries.
  • Adventure Sports

    If you are an adrenaline junkie, you must know that injuries caused due to adventure sports are included in permanent exclusions.

    Injuries caused due to participation in adventure sports like rock climbing, bungee jumping, motor racing, sky diving, scuba diving, or other listed sports are not covered by health insurance.
  • Treatments For Gender Change

    Individuals who wish to undergo any medical treatment for gender change will have to arrange for the funds out of pocket as health insurance plans consider it as a permanent exclusion.
  • Self-Harm or Injuries

    Health insurance plans consider self-inflicted injuries, or attempts to suicide as a permanent exclusion and will not cover hospitalisation or treatment costs for the same.
  • Sterility and Fertility Treatments

    With advancements in medical technology, a consistent uprise in successful sterility and fertility treatments can be witnessed in modern-day couples. But, these treatments are expensive and are not covered by most health insurance plans.

    Cover for contraception, sterilization, assisted reproductive treatments, and surrogacy are usually mentioned under permanent exclusions in most health insurance policies.
  • Illegal and Unlawful Activities

    Injuries or hospitalisation due to involvement in illegal or unlawful activities with criminal intent are considered as permanent exclusions under any health insurance policy.
  • Injuries Due To Natural Calamities Or Disasters

    The permanent exclusions include injuries caused due to natural calamities such as earthquakes, tsunamis, and disasters like civil war, etc.
  • STDs (Sexually Transmitted Diseases)

    Any sexually transmitted diseases are permanent exclusions and will not be covered by a health insurance plan that you invest in.

Why You Should Know About Permanent Exclusions In Health Insurance?

When purchasing a health insurance plan, you pay so much attention to the inclusions and features that are offered, oftentimes permanent exclusions are overlooked.

Many claims are rejected due to the customer's misinformation regarding inclusions and exclusions. To avoid claim rejections, you must be well-versed in permanent exclusions of your health insurance.

The Final Verdict

It is common knowledge that terms and conditions are usually ignored across the globe. However, when it comes to health insurance policies, make sure to read the permanent exclusions carefully to understand what is included and what is not included in the policy.

To further understand permanent exclusions in health insurance, connect with our insurance experts at PolicyX.

Permanent Exclusions In Health Insurance: FAQ's

1. What are permanent exclusions in health insurance?

Permanent exclusions in health insurance are the medical conditions that are not covered by your health insurance plan. A list of permanent exclusions is issued by IRDAI which all health insurers across India have to adhere to.

2. What are the common permanent exclusions in health insurance?

The common permanent exclusions of health insurance are cosmetic surgeries, treatments for gender change, STDs, self-inflicted injuries, adventure sports, etc.

3. What are the common exclusions in health insurance?

Some common exclusions in health insurance are listed below

  • Pre-existing diseases
  • Maternity related expenses
  • Mental Illness
  • Dental Treatments, etc.

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Simran Kaur Vij

Written By: Simran Kaur Vij

Simran is an insurance expert with more than 3 years of experience in the industry. She may have all the answers to your insurance queries. With a background in Banking, she proactively helps her readers to stay on par with all the latest Insurance industry developments.