A health declaration form is a form wherein you will declare your current state of health, previous sicknesses, treatment, medication, operations, and other medical history as required by the insurer. In the case of health insurance, the health declaration form is used by the insurer to estimate risk and determine whether to issue the policy.
What information does a health declaration form ask for?
There are different types of information required in a health declaration form. However, the following is common information that is usually asked for.
| Information asked | What you may need to declare | Why it matters |
|---|---|---|
| Personal details | Name, age, gender, contact details, ID details, nominee or emergency contact where relevant | Connects the declaration to the correct person and file |
| Current symptoms | Fever, cough, breathlessness, chest pain, dizziness, recent injury, or any symptom specifically listed on the form | Helps identify immediate health or safety risk |
| Past illnesses | Diabetes, hypertension, asthma, heart disease, kidney disease, cancer, thyroid disorder, stroke, mental health conditions, or other diagnosed illnesses | Helps assess known medical risk and continuity of care |
| Hospitalisation and surgery | Admission dates, reason for admission, surgery name, hospital name, discharge status, complications if any | Shows severity and recurrence risk of a medical condition |
| Medicines and treatment | Daily medicines, injections, oxygen support, dialysis, physiotherapy, chemotherapy, psychiatric treatment, or other ongoing care | Shows whether a condition is active, controlled, or still under treatment |
| Diagnostic reports | Blood tests, ECG, scans, biopsy reports, discharge summaries, prescriptions, or recent consultation notes | Gives evidence for the answers stated in the form |
| Lifestyle habits | Smoking, tobacco use, alcohol intake, recreational drug use, occupation-related risks, adventure sports where asked | Can affect risk assessment, premium, exclusions, or eligibility |
| Pregnancy or reproductive health | Current pregnancy, complications, fertility treatment, caesarean history, or maternity-related details where relevant | Helps assess medical support needs and policy conditions |
| Family medical history | Family history of diabetes, heart disease, cancer, hereditary disorder, or early death where asked | May indicate higher future medical risk for some products |
Why is a health declaration form important?
A health declaration form gives the insurer more information on your health status before making a decision. In the context of health insurance, the form will help the insurer understand the risks and assess whether the policy can be issued under the standard terms or whether additional conditions can be imposed.
A signed health declaration form is a record of the information that you have provided. That is why it is essential to fill out the form honestly. Insurance proposal forms and health declarations are highly sensitive, as insurance operates on the principle of disclosure of material information.
Health declaration form vs medical test: What is the difference?
A health declaration form and a medical test provide different types of health information, as shown in the table below.
| Point of difference | Health Declaration Form | Medical test |
|---|---|---|
| Who provides the information? | You provide the answers. | A doctor, diagnostic centre, or hospital provides the report. |
| What does it record? | Known history, symptoms, medicines, surgeries, habits, and declarations. | Measured health data such as blood sugar, ECG findings, imaging results, or examination findings. |
| When is it used? | Usually before acceptance, entry, travel, employment, or participation. | When the organisation needs proof, clarification, or updated medical evidence. |
| Can it replace a medical test? | No, not where a test is specifically required. | Yes, only for the medical evidence requested by the organisation. |
| Can both be required? | Yes. | Yes. |
Read more about Pre-Policy Medical Check-Up in health insurance coverage.
How to fill a health declaration form correctly
Filling a health declaration form correctly means providing clear, accurate and complete information wherever it is requested. Below are some tips on how to complete the form.
Examine the scope of each question
Ensure you understand each question on the form before responding. Look at the form to see whether it is asking about lifetime history, recent history, current symptoms, etc.
Responding with facts and no guesswork
Ensure you mention all your diagnosed diseases, past operations, admissions, medication, allergies and lifestyle as per your case.
Adding dates and timelines
Use the exact date wherever possible in your response; it could be the month and year of diagnosis, operation date, admission date or last consultation.
Supporting documentation
Provide any prescription, discharge report, test report, vaccination record or doctor's report if required by the form.
Final check
Look through all the responses before signing the form. A signed health declaration form usually indicates that the information stated therein is true to your best knowledge.
What happens after you submit a health declaration form?
The follow-up steps would depend on the details you have provided and the reason you need to fill out the health declaration form.
Sometimes you might be asked to provide medical documents; in other situations, the insurance company may request medical tests if it needs more information about your health. If you are applying for health insurance, the insurance company may offer the policy on standard terms, with specific terms (such as waiting periods and exclusions), or decline your application, depending on its assessment.
The guidelines for health insurance by IRDAI recognise waiting periods and pre-existing diseases in health insurance policy terms, so disclosing a known illness can be relevant to how an insurer assesses the proposal and subsequent claims.
Health declaration form example: What does a complete declaration look like?
A useful health declaration should provide sufficient information for the insurer to get an idea about your medical background. In addition to a one-word answer, provide proper details.
For instance:
Diabetes: Do not write only “yes” but provide information about the type of diabetes, date of diagnosis, current medications, test results (if any), and hospitalisations, if any, due to diabetes.
Previous surgeries: Provide information about the type of surgery, time and place of its performance, as well as complications (if any).
Regular medications: Name the medicine, dosage, disease for which it is prescribed, and the time you started using the medication.
Tobacco use: Provide information about the type of tobacco product and frequency of smoking, and not just write something vague, such as "sometimes".
Key Takeaways
The health declaration form is your self-declaration of your current health, any past diseases, any medical treatments you are currently undergoing, the medications you are taking, any surgeries you have had, and your lifestyle details.
The health declaration form will help the health insurance company evaluate your risks and affect the underwriting, waiting periods, exclusions, and claims processes.
The health declaration form is not a medical test, as it documents what you declare yourself, whereas a medical test documents the results of the test conducted by the doctor.
The information on the health declaration form must include the date, the name of the disease, the name of the medication, the dose, the last report, hospitalisation, and any complications.
Frequently asked questions
No. Submitting a Health Declaration Form is not required for every procedure, but it is generally needed for health insurance. If the company wants you to fill out this form, you must provide it before proceeding.
Yes. A health insurance company can request further medical tests if the health declaration form indicates any age-related risks, previous illness, treatment, symptoms, or a level of sum insured that requires additional underwriting.
Pre-existing disease is any medical condition that existed prior to the policy's inception. If your health declaration form contains questions about diagnosis, treatment, symptoms, medication, or admission, you must disclose the disease.
If you do not remember the exact date, give the closest accurate month or year. For instance, “Thyroid disease was diagnosed in 2021”.
Yes, because the insurer may consider the health declaration when evaluating the claim if the claim is related to a condition, treatment, or a situation which ought to have been previously declared by you. The inconsistency does not necessarily mean that each claim will be rejected, but it may cause further inquiries, investigations, and/or consequences depending on particular circumstances.
Yes. If you find out that there is an error in the health declaration form you submitted, then it is necessary to notify the insurer immediately about it and clarify how this mistake can be rectified. If a health insurance policy has already been issued, the insurer may update this information in accordance with its procedures.
About the authors
Neviya Laishram
Written by · Senior Editor – Health, Life and Group Health Insurance Content at ACKOWith a journalism background, she brings 9 years of experience in strategising and editing health, life, and group health insurance content. Having written for magazines and digital publications, she combines research and editorial expertise to create credible, useful content for readers.
Dr Nitin Kumar Gupta
Reviewed by · SVP – Health Underwriting & Claims at ACKO General InsuranceWith 20+ years of experience in digital transformation and growth, he is a leader specialising in health, life, accident, and disability insurance. Backed by an MBBS degree and insurance designations (FLMI, FALU, FLHC, ACS, ARA), he combines expertise with leadership.
