How Beneficial is Health Insurance Portability? MessyMob

Last Updated on 21/02/2019 by Deepak Singla

Is your current health insurer falling short of your expectations? Do you want to switch to another health insurer? You already have the permission from IRDA! Yes, according to IRDA, you can switch to a new insurer without affecting your current health plan and its benefits. This facility is known as Health Insurance portability. It’s no different from the familiar concept of mobile number portability. All you need to do is select your new insurer and submit them a form before 90-45 days of your current policy renewal deadline with a request for portability. And you’re done! After that you just have to wait for 15 days for the confirmation of your policy from your new insurer. So simple, isn’t it?

Who should opt for health insurance portability?

Health insurance portability is very helpful if you are not pleased with your current insurer. In this case, you can choose a new insurance company and get a health insurance plan of your choice while also retaining the benefits of your previous policy. Moreover, the sum insured amount of your new health insurance plan will be equal to or more than the sum insured of your existing policy.

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IRDAI’s guidelines

The circular from IRDAI dated 10/02/2011 lays down the guidelines for “Portability of Health Insurance Policies” and is issued in exercise of powers conferred upon the Authority under section 14(1) of the IRDA Act, 1999 to protect the interests of the policyholders and to regulate, promote and ensure the orderly growth of the insurance industry.

Rights of the policyholder:

You can port your policy from and to any general insurance company or specialized health insurance company
You can port any individual/family policies
Your new insurer has to give you the credit relating to waiting period for pre-existing conditions that you have gained with the old insurer
Your new insurer has to insure you at least up to the sum insured under the old policy
The two insurers should complete the porting as per the timelines prescribed in the IRDA (Protection of Policyholders’ Interests) Regulations and guidelines

Conditions

You can port the policy only at the juncture of renewal. That is, the new insurance period will be with the new insurance company
Apart from the waiting period credit, all other terms of the new policy including the premium are at the discretion of the new insurance company

At least 45 days before your renewal is due you have to write to your old insurance company requesting a shift
Specify company to which you want to shift the policy
Renew your policy without a break (there is a 30 day grace period if porting is under process)

All insurers issuing health insurance policies shall allow for credit gained by the insured for pre existing condition(s) in terms of waiting period when he/she switches from one insurer to another or from one plan to another, provided the previous policy has been maintained without break.

This credit (in terms of waiting period) would be limited to the sum assured (including bonus) under the previous policy.

The insurers shall strictly comply with Regulation 4(6) of IRDA (Protection of policyholders’ interests) Regulations, 2002 in accepting the proposals when the policyholder is switching from one insurer to other.

If the policy results into discontinuance because of any delay by the insurer in accepting the proposal, the insurer shall not treat the policy as discontinuance and shall allow portability.

Insurers have the right to get the policyholder’s attention to the policy contract and the various promotional materials like prospectus, and sales literature.

Are all health insurance policies portable?

Yes, all health insurance policies are portable. As a policyholder, you should approach another insurer for portability in advance of the renewal date so that you don’t suffer any pause in the policy coverage that can happen if the new insurer delays the confirmation of your proposal. All insurers are responsible to ensure that the entire database including the claim details of the policies which the policyholders want to be considered for portability, be shared with their counterparts, whenever requested by the counterpart within 7 working days of such request by the counterpart.

All applications for the portability shall be acknowledged by the insurers within three working days. This shall be applicable for all existing contracts and new contracts with effect from 1^st July 2011.

How do you go about the process of portability in Health Insurance?

Once you decide to port your health insurance policy, compare from various insurance plans
Browse websites to study various policies and find the one that fits your needs
Analyse thoroughly the waiting periods, capping process, co-payment schedules & exclusionary clauses as dictated by the insurer
Approach your new insurer at least 45 days prior to your current policy’s termination date
Consult an authorized representative for all the information
Don’t leave any field empty while filling the proposal form and portability form.
Enter valid and correct information as asked
Submit your proposal form to your new insurer
Your new insurer may enquire for certain information from your previous insurer on the IRDA portal
After evaluating the received information from your previous insurer, the new insurer will inform about their decision to you within working 15 days
If you agree with the new insurer’s proposed terms & conditions, you will be required to pay the premium without any delay
Once your new insurer receives the premium, your policy will become active and dispatched to you
Last but not the least, kindly verify all the details in the policy’s schedule