You can port your health insurance policy from one insurer to another without losing the accumulated no-claim bonus and other benefits
Shantanu, a 40-year-old professional, is suffering from asthma. He listed this health issue as a pre-existing condition while buying a health insurance policy After two years, when the insurance provider raised the premium, Shantanu decided to shift to a new insurance provider. However, he was worried that the new insurer might treat him as a new policyholder and impose a waiting period for the pre-existing condition.
At this situation, the Insurance Regulatory and Development Authority of India (IRDAI) and its health insurance portability scheme came to Shantanu’s rescue. The guidelines on the portability of health insurance policy enabled Shantanu to shift to a new insurance provider without losing the benefits accumulated with the present insurer.
What is Health Insurance Portability?
The IRDAI introduced health insurance portability in 2011. Through portability, a policyholder can carry forward the credit accrued for pre-existing conditions along with time-bound exclusions while switching from one insurance provider to another, or from one health insurance plan to another. The policyholder also qualifies for getting all continuity benefits, like free medical check-ups and no-claim bonus, which were acquired during the previous insurance policy.
Rights of the policyholder for porting a Health Insurance
Under the health insurance portability scheme, the IRDAI gives policyholder the right to port a policy (individual or family) from a general insurance provider to a specialised health insurance provider, and vice versa. The new insurer is liable to provide him or her a health policy of at least the sum insured under the previous policy.
Moreover, the new insurer is also liable to provide the credit rating associated with the pre-existing conditions that the policyholder had already accrued with the previous insurer. Both the previous insurer and the new insurer are liable to complete the process of porting within the stipulated timeline prescribed under the regulatory guidelines of the IRDAI (Protection of Policyholders’ Interests).
Conditions for porting a Health Insurance Policy
A policyholder can apply for porting a health insurance policy only at the time of renewal, which ensures that the new period of insurance will be effective with the new insurer. Any policyholder can apply for the portability of his/her existing health policy only if it is maintained without any breaks.
To port an insurance policy, the policyholder has to submit a written application to its present insurance company to shift the policy to a new insurer. The application should be made at least 45 days prior to the policy renewal date, mentioning the name of the insurance company to which the policyholder wants to switch his/her policy.
Process of porting a Health Insurance Policy
Once the insurance company receives the insurance portability application, it provides the policyholder with a proposal form and a portability form. The present insurer then shares the details of the insured person with the new insurer via a common IRDAI portal for sharing customer data. Once the new insurance company gets all the details, it has to take a decision about underwriting the insurance policy within 15 days. Failing to respond within 15 days will force the insurer to accept the portability application.
Documents required for Porting a Health Insurance Policy
- Policy certificates of previous years
- Latest notice of renewal mentioning coverage continuity and other details
- The policyholder’s self-declaration in cases of no-claim
- Investigation report, discharge summary and other equivalent documents in cases of claims
- Filled in proposal form and portability form
Grounds of Rejection of Portability Requests
In case a policyholder fails to submit the above-mentioned documents on time, the IRDAI has given the insurers the right to reject a health insurance portability application. A portability request may also get rejected due to inadequate information, poor claim history and breaks in the renewal of policy.
Another major factor that may lead to the rejection of health insurance portability is higher age of the policyholder. While people in the age group of 60-70 have some chances of portability, the applications from people above the age of 70 have high chances of rejection. When it comes to portability requests from senior citizens, insurance companies apply severe underwriting rules, charge higher premiums, and may even introduce a co-pay clause.
Thus, it is advisable to furnish all the necessary details to the insurer and keep the required documents ready before submitting the application for the portability of a health insurance policy. This will prevent your application from getting rejected and hence, will make the process smooth and hassle-free.
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