Claim rejected because the waiting period “wasn't over”? Check whether it really applies.
A rejection on this ground is often challengeable — here's why, and exactly how to fight it, free.
Reviewed by the BimaHaq Insurance Grievance Desk — BimaHaq's in-house insurance-grievance team — specialists in IRDAI grievance redressal, the Insurance Ombudsman process, and policyholder rights in India. · Last reviewed 2026-07-11
Health policies carry waiting periods — an initial 30-day period, specific-disease periods, and a pre-existing-disease period — and about one in six rejections cites an incomplete one. But the insurer must apply the correct waiting period to the correct condition, and give you credit for continuous prior cover when a policy is ported.
Why insurers reject on this ground
The insurer refuses because it says the treatment fell within a waiting period that had not yet expired — for the specific ailment, for a pre-existing condition, or within the initial 30 days.
When you can challenge it
The rejection fails if the insurer applied the wrong waiting period, treated an unrelated ailment as the one under a specific-disease waiting period, or ignored the continuity credit you had earned by continuously renewing (including on a ported policy). Waiting periods must be clearly disclosed in the policy, and an illness that first arose after the applicable period ended cannot be shut out by it.
How to fight this rejection
Identify the exact waiting period the insurer relied on
From the rejection letter and policy schedule, pin down which waiting period is cited — initial, specific-disease, or pre-existing-disease — and its length.
Establish your continuous-coverage timeline
Assemble proof of unbroken renewals (and porting history), so any continuity credit that shortens or removes the waiting period is on record.
Show when the illness actually arose
Use medical records to show the condition began after the applicable waiting period, or is not the ailment the specific-disease waiting period covers.
Raise a written grievance with the insurer's GRO
Send a dated grievance to the insurer's Grievance Redressal Officer setting out why the rejection is wrong. The insurer must acknowledge it immediately and resolve it within 14 days.
Escalate to IRDAI on Bima Bharosa
If it isn't resolved in time or the reply is unsatisfactory, register the complaint on IRDAI's Bima Bharosa portal.
Take it to the Insurance Ombudsman
Free, binding on the insurer, and open to claims up to ₹50 lakh — file within one year of the insurer's rejection or final reply.
Common questions
Can a claim be rejected during the waiting period?
Yes, but only for the treatments the waiting period actually covers. If the insurer applies the wrong waiting period, or an unrelated illness, or ignores continuity credit from continuous renewals, the rejection can be challenged.
Do waiting periods reset when I port my health insurance?
No. On porting, you carry forward the credit for the waiting period already served with the previous insurer, so continuous coverage should not be wiped out by a switch.
See the full escalation ladder for a rejected claim, or use a free complaint-letter template.
This guide is general information about the insurance-grievance process in India, not legal advice, and figures (timelines, monetary limits, jurisdiction) can change — verify against the official sources linked above before you rely on them.