Moratorium Period in Health Insurance

Quick Overview

The moratorium period is an IRDAI rule in health insurance. If your policy stays active for 5 continuous years, the insurer cannot reject a claim only because you missed disclosing something or made a mistake in the proposal form. The main exceptions are proven fraud and permanent exclusions. This 5-year count carries forward if you port or migrate your policy. If you increase your sum insured later, the moratorium period starts again for the extra cover. Treat moratorium as a backup, and always disclose your full medical history.

Imagine paying health insurance premiums for years, and then a claim gets questioned because you forgot to mention an old health issue while buying the policy. The moratorium period is meant to prevent this situation.

In this article, we explain what the moratorium period is, how it works, and the key IRDAI rules you should know.

What is the Moratorium Period in Health Insurance?

Here’s the exact IRDAI wording for the moratorium period, from the master circular:

In simple terms, if you keep your health policy active for 5 continuous years, the insurer cannot go back to your old proposal form details and reject a claim only because you missed disclosing something or made a mistake. They can still reject or contest a claim in cases of proven fraud and for permanent exclusions written in the policy.

You will also find the definition mentioned in your respective policy wording. Below is an example from HDFC ERGO Optima Secure’s policy wordings.

How Does the Moratorium Period Work?

Check out this video by our experts to learn more about how a moratorium period works:

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Difference Between Moratorium and Waiting Period

Basis	Moratorium Period	Waiting Period
Meaning	Protects claims from rejection due to old non-disclosure agreements	Certain conditions are not covered for a fixed time
Duration	5 years of continuous coverage	Usually 30 days for everything except accidents, 2 years for listed specific illnesses, and 3 years for pre-existing conditions, but it can vary by policy
Purpose	Stops insurers from “looking back” after a point	Reduces early claims for known/high-risk conditions
After It Ends	No contesting for non-disclosure, except for fraud and permanent exclusions	Covered conditions become payable as per policy terms

Moratorium Period and Claim Rejection

Even after the moratorium period is over, a claim can still be rejected in two situations:

Proven Fraud

This is when the insurer can show there was an intentional attempt to cheat, like submitting forged documents, fake hospital records, or inflated bills. In such cases, the moratorium protection does not apply.

Permanent Exclusions

These are exclusions written into the policy contract that are never covered, for example, hospitalization due to substance abuse, or any cosmetic surgeries. So even after the moratorium ends, claims falling under permanent exclusions are denied.

Key IRDAI Rules on Moratorium Period

Continuous Renewals

The moratorium applies only after 5 years of continuous coverage. If coverage is not continuous, it does not apply.

Renewal Lapse

If the policy is not renewed on time and the coverage breaks, the moratorium clock can reset because continuity is lost.

Portability Credit

If a policy is ported or migrated, the moratorium period gets carried forward from the earlier policy and does not reset.

Sum Insured Hike

If the sum insured is increased later, the 5-year moratorium clock starts again only for the extra cover, from the date the increase is added.

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Ditto’s Take on Moratorium Period

The moratorium period is a useful safety net, but it should not change how you fill your proposal form. Our view is simple: disclose everything you know, even if it feels minor.

Why? Because the moratorium helps only after years of continuous coverage, and even then, insurers can deny claims for proven fraud and for permanent exclusions written in the policy. Plus, many claim disputes happen in the first few years, when the moratorium is not yet available.

So, treat moratorium as a backup and avoid claim settlement troubles with honest disclosures.

Frequently Asked Questions

Does the moratorium period apply to all health insurance plans in India?

Yes, it applies to all health insurance policies sold by IRDAI-regulated insurers. After the moratorium ends, the insurer cannot contest a claim only due to non-disclosure or misrepresentation, except for proven fraud.

If someone ports to another insurer, does the moratorium period continue?

Yes. The moratorium period gets carried forward when a policy is ported or migrated. But the insurer will still ask for fresh disclosures at the time of porting or migration. So it is important to disclose the full medical history again. If new facts come up later, they can still create claim issues.

Do pre-existing diseases get covered after a moratorium if they were not disclosed?

After 5 years, the insurer cannot reject a claim only because the condition was not disclosed, unless they prove fraud. However, the claim can still be denied if it falls under permanent exclusions in the policy.

Is the moratorium period a 100% guarantee that claims cannot be rejected after 5 years?

Not always. After 5 years, insurers cannot reject a claim only for non-disclosure or misrepresentation, except in proven fraud cases. The tricky part is that what you see as an honest mistake can be argued by the insurer as an attempt to mislead, which is why it is best to disclose your full medical history upfront.

Last updated on: 29 Jan, 2026