Can my claim be rejected after 5 years of having a health policy?

Only if the insurer proves intentional fraud. For honest mistakes or forgotten medical history, they cannot reject claims after 5 continuous years.

What happens to my moratorium period if I port my health insurance?

It carries forward. If you spent 3 years with your old insurer, you only need 2 more with the new one to be protected.

Does increasing my sum insured reset the 5-year clock?

Yes, but only for the increased amount. Your original base cover remains protected by the time you have already completed.

Is the moratorium period the same as a waiting period?

No. Waiting periods are for specific diseases to be covered. The moratorium period protects you from rejections based on past non-disclosures.

What if my policy has a break in renewal?

A break resets the clock. You lose the moratorium benefit and must complete a fresh 5 years of continuous coverage for protection.

Does the 5-year rule apply to family floater plans?

Yes. However, for any new member added later, their individual 5-year clock starts from the day they were added to the policy.

Can Insurers Reject 10-Year-Old Policies? 5-Year Moratorium Rule

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Can an Insurer reject a 10-year-old policy? Exploring the Moratorium Period rules

Your old health policy is now a legal shield. Learn how the 2024 IRDAI rules protect you from unfair claim rejections after five years.

4 min read

OneAssure Team

April 05, 2026

Need advice tailored to you?

Looking for the right plan? You don't have to guess. Let us compare the fine print for you and give you an unbiased recommendation.

Need advice tailored to you?

Looking for the right plan? You don't have to guess. Let us compare the fine print for you and give you an unbiased recommendation.

You have been paying your health insurance premiums for ten years. Every year, you get that renewal SMS, and you pay immediately. You feel safe. Then, a sudden surgery happens. You file a claim for ₹4 lakhs. Two weeks later, you get a letter: Claim Rejected. Why? Because you didn't mention a minor knee surgery from twelve years ago in your original proposal form.This is every Indian policyholder's nightmare. But here is the good news. Since 2024, this nightmare has a legal ending. You are protected. The IRDAI has made it much harder for insurers to dig up old mistakes to avoid paying your bills.

The Five Year Shield

In April 2024, the IRDAI changed the game. They reduced the moratorium period from eight years to five years. Think of this as a 'look-back' limit. Once your policy completes 60 continuous months, it becomes almost impossible for the company to reject your claim based on what you forgot to tell them at the start. It is a massive win. You are safe. Your years of loyalty now translate into legal immunity.

Mistake vs. Fraud

Let us be clear. Honest mistakes are protected. Suppose you forgot to mention that you had a brief bout of jaundice in 2012. After five years of your policy being active, the insurer cannot use that 'non-disclosure' to reject a current claim for a heart ailment. They missed their chance to investigate. The clock has run out for them.However, proven fraud is the only exception. If you actively cheated the system, the five-year rule won't save you. For instance, if someone was already diagnosed with a terminal illness and purposely hid medical reports while buying the plan, that is fraud. Insurance companies can still challenge a decade-old policy if they can prove you intentionally deceived them. But for most of us who just made a clerical error or forgot a minor past detail, the 60-month mark is our safety net.

Upgrading Your Sum Insured

What happens if you increase your cover? Let us say you had a ₹5 lakh plan for six years. Now, you realize medical costs in cities like Mumbai or Bangalore are sky-high. You upgrade to a ₹15 lakh plan. Does the five-year clock reset for everything? No. It only resets for the extra ₹10 lakh you added. Your original ₹5 lakh cover remains protected by the moratorium rule. The new portion starts its own 60-month countdown. It is a fair split.

Porting to a New Company

Many young Indians switch insurers to get better features or lower premiums. You might worry that switching will 'reset' your protection clock. It won't. If you port your health insurance correctly without any breaks, your moratorium period benefits carry forward. If you spent three years with Insurer A and moved to Insurer B, you only need two more years with Insurer B to reach the five-year safety mark. Your seniority is preserved.

Life vs. Health: The Rule Gap

Do not confuse your life insurance with your health plan. They follow different clocks. For life insurance, Section 45 of the Insurance Act sets a three-year rule. After 36 months, a life insurance policy becomes 'incontestable' for almost any reason, including fraud. Health insurance is stricter. It gives the insurer five years (60 months) to find issues. This difference exists because health claims are frequent, while life insurance is a one-time payout.

The Continuity Trap

The biggest mistake you can make is letting your policy lapse. If you miss your renewal and the 'grace period' ends, your moratorium clock resets to zero. You lose all your 'seniority.' Even if you had a policy for seven years, a single break means you are back to day one. Always set auto-pay. It saves your rights. Also, keep in mind that permanent exclusions (like cosmetic surgery or self-inflicted injuries) stay excluded forever. The moratorium period does not magically start covering things the policy never promised to cover.

What to do if Rejected?

If your 10-year-old policy gets a rejection letter for 'non-disclosure,' do not panic. First, check the reason. If it is not about proven fraud, they are likely in the wrong. You can write to the insurer’s Grievance Redressal Officer. Mention the 2024 IRDAI Master Circular. If they don't budge, the Insurance Ombudsman is your next stop. They are very strict about the moratorium rules. Most cases for long-term policies are settled in favor of the customer today.At OneAssure, we often see that clarity on these fine-print rules is what makes the difference between a stressful hospital stay and a smooth recovery. Your protection is earned through your premiums. Make sure you know when that protection becomes absolute.As a final tip for your budget, remember that individual health insurance premiums are expected to become 18% cheaper soon. The GST Council has proposed removing the 18% tax starting September 22, 2025. This makes keeping your policy active even more affordable. Stay covered. Stay protected.