A health policy comes with various benefits such as providing financial security in the face of a medical emergency, tax rebates, extensive coverage, cashless claim, and more. But, did you know about health insurance portability? This feature allows you to switch your policy to a new user without losing the existing benefits. Interesting, right? Read on to know all about it.
portability of health insurance would lead to the loss of certain benefits such as the waiting period for covering "Pre-existing Diseases". However, as per the latest Insurance Regulatory and Development Authority of India (IRDAI) rule, as a policyholder, you can port an existing policy to any insurer of your choice and the new insurer must give you the benefits that you had accumulated in the policy. These benefits are applicable even when you switch your policy with the same insurer. There are certain conditions attached to the portability process, one of which is that you must renew the policy on time without any breaks. You may have your own reasons such as insufficient coverage amount or the high cost of the policy premium for switching from one insurer to another, but note that the policy terms and conditions will vary between different insurers. Therefore, consider your decision carefully and go through the rules related to portability mentioned on the IRDAI website before porting your policy.
What is Health Insurance Portability?
Health insurance portability in India was introduced by the IRDAI in 2011. Basically, it means switching from your existing insurer to a new insurer without losing the benefits of your health policy. You are free to port your policy to any insurer of your choice, provided that there was no break in the renewal of the policy since you bought it.
Reasons for Porting Your Health Insurance
You may choose
health insurance portability online or offline if you are not satisfied with the benefits provided by your existing insurer. There could be several reasons for switching to another insurer. Some of them are:
- An upper limit on room rent
If your existing insurer has put an upper limit on hospital room rents, you can switch over to get a higher cover for room rents.
- Insufficient coverage or sum insured (SI)
It may happen that the total coverage amount for your
family floater plan is not sufficient for all members of your family. In this case, you can switch to another insurer who provides more coverage at the same premium.
- Additional benefits offered by insurers
You can switch to another insurer if they offer attractive discounts on premiums, No Claim Bonus, and free annual health check-ups and if these benefits are not offered by your present insurer.
If your current insurer does not provide adequate coverage or provides very limited coverage for daycare or domiciliary (at home) treatment, then you may choose to switch over to a different insurer.
Rights of Every Policyholder
While filling up your
health insurance portability form, you should be aware of your rights as a policyholder. As per the IRDAI, you are entitled to the following:
- You can port your policy from any general insurance provider to a specialised health insurance company and vice versa.
- You can port individual or family policies as per your requirement.
- Your new insurer is bound to provide you with the accumulated benefits; for example, the credit relating to the waiting period for pre-existing conditions that you have gained with the old insurer.
- Your new insurer has to provide a sum insured amount which would be at least equal to the sum insured provided by your previous insurer
- The previous and new insurers have to complete the porting as per the timelines prescribed in the IRDAI (Protection of Policyholders' Interests) Regulations and guidelines.
Health Insurance Policy Portability Guidelines
The IRDAI has set certain guidelines regarding porting of a policy. Also, the IRDAI has a web-based facility to view and maintain data about health insurance policies issued by various insurance companies. In case of portability, the database can be accessed by the new insurer to whom you would like to port your policy. The conditions specified by the IRDAI are:
- You can port your individual policy, family floater or group insurance as per the terms and conditions mentioned in the policy.
- Portability is possible from a group insurance policy to a family floater or individual health policy.
- You can transfer the No Claim Bonus and sum insured from the previous policy.
- The residual or unexpired waiting period for pre-existing diseases would be applicable when you migrate to a new insurer.
- For transfer of individual policies without any break-in, there would be no involvement of an underwriter.
- For the transfer of group insurance policies to individual policies, there would be compulsory underwriting.
- The new insurer will not levy any transfer or portability charges on the previous insurer.
Grounds for Possible Rejection of Portability Applications
According to the IRDAI, insurers have the right to reject an application for portability based on the following grounds:
- If you fail to submit the required documents on time. You have to keep up with the timelines of the new insurer otherwise, your portability application would be rejected.
- Non-disclosure of correct information such as pre-existing diseases, claims made etc.
- You have a poor claim history.
- There were break-ins in policy renewals. It depends on the insurer whether he would consider your portability application or not.
- If your medical condition has some underwriting risk.
- If you are very aged, more than 70 years, your policy may get rejected.
How to Apply for Health Insurance Portability
Your inability to match certain requirements may lead to your portability application getting rejected. While applying for portability, you have to follow certain rules:
- You can port the policy only at the time of renewal, so the new policy term would be with a different insurer.
- You may have to fill the IRDAI portability form as the first step.
- Write to your existing insurer at least 45 days before your renewal is due and request for a transfer.
- Specify the name of the insurer where you want to transfer the policy.
- Renew the policy on time so that there is no break-in. You may get a 30 days grace period if the porting process has been initiated.
- You have to send an application to the new insurer at least 30 days before the renewal date of your existing policy.
- You have to be aware of the updated guidelines.
- After you have submitted the necessary forms, the new insurer will contact your previous insurer for getting your medical records and other related information. They may also go through your claim history.
- The new insurer will decide whether to port your policy or not based on underwriting. Here, an underwriter will analyse the data related to you and consider your risk profile. The new insurer has to confirm their decision to you within 15 days.
The documents that you must submit for policy portability include:
- Identity Proof - Passport, Aadhaar Card, PAN Card etc.
- Address Proof – The electricity bill, bank a/c statement, ration card etc.
- The IRDAI portability form
- Proposal Form
- Insurance Policy
- Claim History if required
- Declaration of no claims, if the new insurer asks for it
- Documents related to medical history issued by an authorised medical practitioner
Health insurance portability is a convenient process through which you can switch from your existing insurer to a new insurer due to various reasons. You can also enjoy accumulated benefits such as a No Claim Bonus, waiting period for pre-existing diseases, etc. on your previous policy. The IRDAI has some specific guidelines for the insurer and policyholder which you must go through before moving ahead with porting the policy. Once you are satisfied with the terms and conditions of the new insurer, you should initiate the process at least 45 days before your next renewal. Keep the necessary documents handy, so that your application does not get rejected due to lack of proof.