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Insurance Article

All You Need to Know About Health Insurance Portability

December 02 2016
Health Insurance Portability

Everything you must know about health insurance portability

Most policyholders often complain about the services offered to them and at times are dissatisfied with their policies. In order to preserve the interests of policyholders, the Insurance Regulatory and Development Authority of India (IRDAI) introduced the concept of Health Insurance Portability.

What Is Health Insurance Portability?

In the past, moving your health insurance policy from one insurer to another resulted in the loss of accumulated benefits like waiting period for pre-existing diseases. But now IRDAI has given rights to policyholders to port their health insurance policies without losing the accumulated benefits.

As per the latest guidelines by the IRDAI, the new insurer will allow for the credit gained by the policyholder for pre-existing conditions in terms of waiting period. The portability is not only applicable when you move an existing policy from one insurer to another but also when you move from one plan to another with the same insurer.

What Are The Rights Of A Policyholder?

Under the Health Insurance Portability scheme, as a policyholder, you have the following rights:

  • Option to transfer your policy to and from any health insurance or general insurance company
  • You can transfer any health insurance policy be it individual or family
  • Your new insurer must provide you with the benefits accumulated relating to the waiting period for a pre-existing condition with your previous insurer
  • Your new insurer must insure you at least up to the sum insured by the previous insurer
  • The porting must be done by both the insurers as per the IRDAI guidelines

What Are The Terms And Conditions Of Portability?

Here are the terms and conditions of the scheme which must be looked into before porting your existing policy:

  • You can port your existing policy only when it reaches its renewal, which means that the new insurance term will be with the new insurer
  • All other terms and conditions of the new policy except for the waiting period will be at the discretion of your new insurer
  • You need to notify your old insurer regarding the shift with the name of insurer in written, at least 45 days prior to your renewal so that the policy gets renewed without a break

Things To Watch Out

Here are a few things which you need to watch out before switching your policy:

  • Certain health insurance policies have an age restriction for renewal, you must renew such policies at the maximum renewable age possible
  • Every policy has certain exclusions and you must check whether those are covered in the one you are switching to
  • Transfer of credits from group insurance policies to individual policies needs further discussion

Impact Of Portability On The Insurance Sector

IRDAI has created a web-based platform for maintaining data related to health insurance policies that is accessible to insurance companies. This data allows the new insurer to retrieve data on health history of the policyholder. This will bring transparency in the portability system and also allow easy claim settlement with lesser disputes.

Related Article:

Closing the Gap in Health Insurance
Give Your Health Insurance the Booster Advantage

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