Things you need to know about Health Insurance portability in India

With the growing demand for health insurance, there has also been an upsurge in the number of insurance companies in India. However, if you are not satisfied with the plans that you had opted for and want to switch health insurance providers, health policy portability allows you to choose a differ rent insurer without losing out on the benefits accrued from the current insurer.

Health Insurance Portability in India- What you need to know:

The concept of health insurance portability was introduced by the Insurance Regulatory Development Authority of India (IRDAI) in 2011. Herein, an individual policyholder is granted the right to switch health insurance from one company to another or from one plan to another within the same insurance company. However, in the case of group health insurance portability, you can’t switch and can only port health insurance within the same insurance company.

Reasons you may choose to port your health insurance:

• The current health insurance company offers you inadequate service.
• The current plan you have is insufficient to cover certain specific diseases.
• You have had a complex claim settlement history with the current health insurance company.
• You faced untimely or delayed reimbursement of medical bills.
• You are facing increased premium charges or hidden co-payment charges in the event of a claim.
• There is a better product available in the market that is competitively priced and offers better benefits than your existing health insurance.

Rights every policyholder should know of:

There are a lot of finer details that come into play while porting your health plan but here are some things every policyholder should know about

• You are eligible to port your new insurance policy from and to a specialised/general health insurance company.
• You have the eligibility to port individual or family health insurance plan.
• The new insurer must cover you up to the sum assured of the previous policy.
• The new insurer is liable to give you credit relating to the waiting period for existing conditions that you had earned with the previous insurance company.

Health insurance policy portability guidelines

According to the IRDAI guidelines, moving to a new health insurance company does not deprive you of benefits such as the lesser waiting period for covering the already existing disorders as stated under the older health insurance plan. You will be eligible for all benefits that were accumulated in your previous policy. However, the two insurers must complete the porting process within the given timelines prescribed by the IRDAI.

Here are the Health insurance policy portability guidelines-

1. 45 days prior notice is mandatory

To ensure smooth health policy portability to a new insurer, you must communicate your intent to the new insurer at least 45 days before (not more than 60 days) the next policy renewal. Otherwise, the insurer can reject your application requesting for portability.

2. Non-eligibility for porting in case of a break in existing policy

According to the IRDA, for a policyholder to be eligible for porting, he/she must not skip the premium dues, and there must not be any break in the existing policy.

3. New insurance company’s liability to respond within 15 days

On the submission of the application form with all necessary documents, the new insurer is liable to respond within 15 days. Otherwise, they lose the right to reject it after 15 days. In other words, the new company has to accept your application if they don’t reject it within 15 days.

Waiting period clause for health insurance portability

According to the waiting period clause, the policyholders can switch over to the benefits availed by the new insurance company without having to go through the initial cycle of waiting periods all over again. The years from the waiting period already served by the policyholder get reduced.

Grounds for possible rejection of portability applications -

IRDAI has permitted insurers to reject a portability application on the following grounds:

• Inadequate information about the applicant
• Poor claim history such as in the case of multiple health claims
• Non-availability of previous (at least three years) policy documents of the applicant
• Delays in meeting deadlines in document submission
• Break in policy renewal
• If the applicant is a senior citizen

How to switch health insurance policy?

You can apply for portability only when your current policy is due for renewal. You must file an application to the insurance company seeking portability. The new insurance company will then send you a portability form, a proposal form, and details and plans offered through various products.

Once the new insurance company collects the forms submitted by the applicant, it will retrieve the claim history and medical history from the existing insurer. Your current insurer must provide all the required details with IRDA’s web portal within 7 working days. It is a violation of IRDA rules if the data is not submitted within seven days.

Only when the new insurer receives all the relevant details, it will begin the process to underwrite the existing policy within 15 days and must inform the insurer about its decision during this period. If it fails, it is forced to accept the application.

Documents required for health insurance portability -

• Current health insurance policy document stating last renewal notice
• Portability Application Form
• Policy certificates of the previous years
• Self-declaration by insured about no-claims made in the last year (if there are no claims)
• Copies of the discharge summary, investigation and follow-up report in case of a claim made

Porting is a convenient option for any insurance customer, as it offers the choice to switch to a better product. Among the benefits of health insurance portability include better service expectations from the new insurance company. You, as a policyholder, can get a competitive price and better features on the plans. Besides, you will be able to customise a policy based on your future requirements. Portability, hence, helps in bridging the gap between the coverage offered by the current plan and others available in the market.