What is Health Insurance Portability?

What is Health Insurance Portability?

Health insurance portability is the right given to an insurance policy holder to transfer the credit gained by the insured (for no claim bonus, time bound exclusions and pre-existing conditions) if the insured member wishes to switch his/her insurer. For this, the previous policy would have to be held without a break. But firstly, let us break down what health insurance itself is:

A health insurance plan can protect your family’s savings from an unforeseen medical emergency. As a health insurance policyholder, you must be aware of the various features of your policy. One such key feature is health insurance portability. In 2011, the Insurance Regulatory and Development Authority of India (IRDAI) introduced health insurance portability in the country. According to IRDAI guidelines, you can port your existing health insurance plans from one insurance company to another, without losing accumulated benefits, like No-Claims Bonus (NCB), cumulative bonus and avail benefits of the waiting period waiver due to ongoing policy term.

When to Port your Existing Health Insurance Policy?

You can consider availing the feature of health insurance portability in the following cases:

1. Not being satisfied with the features of your existing policy

There can be a situation, where you are not satisfied with the benefits of your existing policy, or the services of your current insurer. Maybe the existing plan provides limited coverage, or it entails high health insurance premiums. If you find that the existing plan is not well-suited for your health insurance portfolio, you can always consider porting it to another insurer.

2. Choosing to select a better plan

While buying a health insurance policy, group health insurance policy you must always compare health insurance plans, and zero in on the policy, which fits your requirements. However, if you find that there are better and more affordable plans by other insurers, you can choose to port your existing plan.

Things to remember while availing Health Insurance Portability:

1. You can opt for portability only in the case of individual health insurance plans and family health insurance plans . Remember, in the case of group health insurance plans, this feature is not available, and you have to continue with the existing insurance company. Remember, only retail policyholders with non-life insurance companies can apply for porting the existing health insurance plan.

2. Along with yourself, you can port all currently insured family-members, the existing sum insured, the accumulated cumulative bonus, NCB and your pre-existing and specific disease waiting period.

How to port your existing Health Insurance Plan?

You can port your existing  health insurance policy, and opt for a healthier plan in four simple steps. Remember, as per IRDAI guidelines the stipulated time-period as listed below has to be completely adhered to: 

Step 1: You have to duly fill the portability form, and send the application to the new insurance company, 45 days before the date of renewal.

Step 2: The new insurance company - as per the guidelines of IRDAI - will seek you medical and claims history from the previous insurer within 7 days of receiving the portability form.

Step 3: Your previous insurer then has to furnish the details within 7 working days.

Step 4: Once the new insurance company receives the requisite information, it has to communicate its decision - either approval or rejection - within 15 days.

Rights of a policyholder while availing Health Insurance Portability:

1. Every policyholder has the right to port both individual and family health insurance plans from one specialized/general insurance company to another.

2. The new insurance company must provide for the same sum insured or higher if the insured is eligible to receive the same as per insurance company’s internal underwriting policy.

3. The new insurer has to provide all continuity benefits, like cumulative bonus, waiting period benefits and NCB.

4. According to IRDAI guidelines, it is the responsibility of both previous and new insurers to ensure that the health insurance plan has been successfully transferred.

Can the request for Health Insurance Portability be rejected?

Yes, as per IRDAI guidelines, your application for portability can be rejected in the following cases:

• If there is inadequate information available about the policyholder.
• If the policyholder has made multiple claims, resulting in a poor claim history.
• If proper documents are not submitted within the stipulated time. You need to submit at least three years of policy documents from the previous insurer.
• The portability application can also be rejected, if your previous policy has lapsed, or there is a break in policy renewal.
• The portability application can also be rejected, if the applicant is a senior citizen.

Conclusion:

With rising hospital expenses, it becomes a must for every individual to avail the best health insurance policy. There are manifold benefits of health insurance plans, like quick cashless claim settlement, comprehensive coverage, financial protection, high-value sum insured, and so on. Alongside you can also opt for add-ons, like critical illness insurance and personal accident insurance, to enhance the coverage of your health insurance plan. After the introduction of the feature of health insurance portability, you can now easily shift to a healthier plan, having better features and competitive health insurance premiums. You must, however, exercise due diligence and consider all the associated factors before opting for portability. It is always advisable to choose a trusted and reliable insurance company before making your move.