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Waiting period not completed

A waiting-period rejection means the policy was active, but not for long enough for this particular condition or procedure to be covered yet.

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Drapto is not an insurance advisor, broker or agent, and is not registered with IRDAI in any such capacity. This page provides general information about the claims and grievance process and about published Insurance Ombudsman decisions. It is not advice on your specific claim. For advice on your policy, contact your insurer or a licensed advisor.
In short

A waiting-period rejection means the policy was active, but not for long enough for this particular condition or procedure to be covered yet.

What this ground actually means.

Three clocks usually run on a new policy: an initial period of about thirty days for most illnesses, a longer period for named conditions and procedures, and a longer one still for pre-existing disease.

How this ground is actually applied

The policy was in force, but not long enough. Health policies usually carry several distinct waiting periods running at once: an initial one covering everything but accidents, a longer list for named conditions and procedures, one for pre-existing conditions, and often a separate one for maternity.

What it turns on

Which waiting period the insurer applied, and whether the clock restarted — a lapse and revival can reset it, while a clean port usually does not.

Three things people get wrong about it

“There is one waiting period.”

There are several, running concurrently and with different lengths. Check which one was actually cited.

“Porting to a new insurer starts everything again.”

Continuous cover is generally intended to carry across on a port. If the new insurer has reset it, that is a specific thing to raise.

“A gap in premium payment does not matter if I paid later.”

A lapse and revival can restart the clock. The dates on your premium receipts matter here.

What to check in your own documents

  • Which specific waiting period the letter names.
  • The original policy inception date, not the current renewal date.
  • Every premium payment date, looking for a gap.
  • Whether the condition is on the named-conditions list at all.
  • Any portability documentation showing continuous prior cover.

Two sections are missing from this page. The standard policy wording for this ground, and what the Insurance Ombudsman has actually held in published awards. Both are being compiled from the Council for Insurance Ombudsmen’s own reports. Neither will appear here until it can be cited, because a page that invented an award reference would be worse than a page that admits the gap.

The escalation process and deadlines

  1. The insurer's grievance officer. Response due within 15 days.
  2. IRDAI Bima Bharosa — bimabharosa.irdai.gov.in — if the insurer does not resolve it.
  3. The Insurance Ombudsman. Free, no lawyer required, and the award binds the insurer up to the prescribed limit.
  4. Consumer forum, if you choose to go further.

Ask about your rejection letter

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Related grounds

Sources

  • Council for Insurance Ombudsmen — published awards and annual reports, cioins.co.in
  • IRDAI annual report and Bima Bharosa, irdai.gov.in
  • Insurance Ombudsman Rules 2017

You do not have to work this out alone.

Sahayak explains the grounds your insurer gave and the official escalation path. It is an information service, not an insurance advisor.