What is Health insurance Portability?

By Vamsee Dr. in Health Insurance in India

May 26

Mr. Kapil Sharma is 40 years old and has been renewing his health insurance with a premier general insurance company in India past 8 years. Due to the advent of standalone health insurers in the market and offering the competitive products, Mr. Sharma decided to switch to such new product of a stand-alone health policy.

The old policy of Mr. Sharma gave him the credit of Pre-existing diseases (PED) credit to 3 years and also he has not claimed during the term of the policy. Now Mr. Sharma is worried that he may lose his PED credit with the new insurer and also the no claim bonus, but the old policy is very expensive for him.

He was ever wondering that is it possible for him to buy a new policy without losing existing policy benefits with the old insurer ceded to a new insurer under the new policy.

He contacted the mymedpolicy.com for assistance in buying a new policy without losing the previous policy benefits.

Now the Health Insurance Coach of mymedpolicy explained to him the HEALTH INSURANCE PORTABILITY concept in health insurance.

 

Health insurance portability was introduced by the IRDAI in the year 2011. IRDAI has issued a circular in this regard Ref: IRDA/HLT/MISC/CIR/030/02/2011 dated 10-02-2011.

Portability benefits the policyholder in transferring the credit gained for pre-existing conditions and time-bound exclusions when switching from one plan to another of the same insurance company, or from one insurance company to another insurance company.

The policyholder will also be entitled to all continuity benefits, like the no-claims bonus and free medical check-ups, which were accumulated during the previous policy.

Every policyholder has the right of portability on the condition that the previous policy is in force without any breaks.

Rights of the Policyholder

  1. The policyholder can port from general insurer to stand alone health insurance company and vice versa
  2. The policyholder can port any individual/ family policies
  3. The new insurance company has to give you the credit relating to previous policy (relating to the waiting period for pre-existing conditions that you have gained with the old insurer)
  4. The Policyholder’s new insurer has to ensure at least up to the sum insured under the old policy
  5. The two insurers should complete the porting as per the timelines prescribed in the IRDA (Protection of Policyholders’ Interests) Regulations and guidelines

Conditions

  1. The policyholder can port the policy only at the time of renewal.
  2. Except for the waiting period term, all other terms and conditions are at the discretion of the new insurance company.
  3. 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)

 

Benefits for the Policyholder

  1. The policyholder can take the benefit of credits of the previous policy with the company.
  2. Instead of purchasing a new policy, the policyholder can switch to other policy without losing the benefits.
  3. The portability helps the policyholder in containing the premium by exercising the Pre-existing conditions and other benefits of the earlier policy.
  4. It is easier and hassles free for the policyholder.

Things to keep in mind

  1. The policy with the new insurer will be treated as any new policy by the new insurer. And other conditions are subject to the Underwriting policy of the insurer.
  2. The policy can be portable only before 45 days of renewal of the policy.
  3. The policyholder cannot take the sum assured less than the previous policy.
  4. With regarding waiting period for pre-existing diseases, if the new insurer proposes a waiting period more than the old insurer, the policyholder is bound to accept such a waiting period.
  5. The new insurer can reject the proposal if it’s deemed unfavorable. In that case, the policyholder will have no other option but to continue with the existing insurer.
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