You must have felt cheated when you have put your medical bills to your insurer. There may be many reasons like copay, deductible fee, not fully paid the amount, waiting period, not timely processing the claim, etc. You must have thought of having better health insurance with better features or affordability. But, you must have thought of a health insurance portability option like a mobile network.
In the past, switching health insurance could mean losing accumulated benefits like waiting periods. Thankfully, the Insurance Regulatory and Development Authority of India (IRDAI) has introduced health insurance portability to help out policyholders. This post unfolds everything you need to know about switching health insurance providers in India.
What is Health Insurance Portability?
Health insurance portability allows you to seamlessly transfer your existing health insurance policy to a new insurance provider while retaining the previous benefits. This means you won’t lose out on critical aspects like No Claim Bonus (NCB): Discounts on premiums earned for claim-free years, Free Medical Check-ups: Certain policies offer annual check-ups as a preventive measure.
Read more: How to choose Health Insurance for You and Your family
Why you need health insurance portability
There might be a few reasons which may vary person to person and its need. As per my opinion, you need to change insurer for health insurance as
- More features are now offered by many insurance companies.
- No room limit and 100% copay feature which were not available in earlier insurance plans
- Affordability and price factors
- Fast claim process required with less riders or terms and conditions.
- Dissatisfied with the service of the current insurer can switch to an insurer with better service quality.
What will you get Health Insurance Portability
1. You can port your policy from and to any general insurance company or specialized health insurance company
2. You can port any individual/ family policies
3. 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
4. Your new insurer has to insure you 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
Process and Procedure for Portability
Here’s a step-by-step guide on how to port your health insurance policy in India:
Initiate the Process: You need to apply at least 45 days before your existing policy renewal date, inform your desired new insurer about your intent to port your policy. Clearly specify the 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).
Proposal and Portability Forms: The new insurer (whose insurance plan you want to buy) will provide you with proposal and portability application forms. Fill them accurately and submit them along with supporting documents like photo, identity proof, reasons, etc.
Information Retrieval: The new insurer will contact your existing provider to retrieve your policy details and claim history (done electronically through IRDAI’s portal). This can take up to 7 working days.
Decision on Portability: Based on the information received and your proposal, the new insurer will decide to accept or reject your portability request within 15 days. They are legally obligated to make a decision within this timeframe.
Policy Issuance: If your request is accepted, the new insurer will issue your new health insurance policy with the ported benefits reflected.
Documents Required for Portability
- Existing health insurance policy document
- Photo identity proof
- Address proof
- Contact details (phone number and email)
- Medical history documents (if applicable)
Important Aspects
Portability Window: You can only port your policy during the renewal period, not mid-term.
Sum Insured: The new insurer might require you to maintain a minimum sum insured equivalent to your old policy. However, you can always opt for a higher sum insured for better coverage and bargain for better features and add-ons.
Pre-existing Conditions: Disclose any pre-existing conditions accurately to avoid claim rejections in the future policy.
IRDAI Changes Portability Rules 2024
I have already posted the detailed article on IRDAI changes in the Health insurance sold in India and empowering users or policyholders (Read here). There is a big change portability rules, if you are willing to port from one health insurance to another. The Rules states that –
- You have the freedom to switch your existing health insurance policy to another insurer while retaining benefits you’ve earned, such as NCB and completed waiting periods. This empowers you to choose the plan that best suits your current needs.
- A Policyholder has the choice to port his/ her policies from one Insurer to another. The Acquiring and the Existing Insurers shall jointly, ensure that the entire underwriting details and claim history of the Policyholders are seamlessly transferred.
- The existing insurer shall provide the information sought by the Acquiring insurer immediately but not more than 72 hours of receipt of request through Insurance Information Bureau of India (IIB)–https://iib.gov.in/ portal.
- The Acquiring insurer shall decide and communicate on the proposal immediately but not more than 5 days of receipt of information from Existing insurer.
With these new rules, the policy switch will become seamless and will also force your policy provider to provide better services else you have the option to port your health insurance policy.
You have to just buy new policy with giving details that you want to port and everything will be taken care by the acquiring insurer and will get all information from your existing insurer.
Making an Informed Decision
I have posted an article on Health insurance and how to make an informed and well researched choice (Click here to read). Health insurance is the most important aspect in one’s life which can help one to avoid any financial burden during a medical emergency. Before porting your health insurance, carefully compare plans offered by different insurers. Consider factors like:
Network Hospitals: Check the list of empaneled hospitals and the nearby hospitals where you stay.
Coverage Details: Compare the extent of coverage offered for hospitalization, Room limit, Co-pay feature, and sub limit on critical illnesses, if any.
Claim Settlement Ratio: Research the claim settlement ratio of the new insurer to evaluate their claim processing efficiency. This will help you in making a decision and in future also, your medical claim might get processed within specified time limit.
Premium Costs: Always compare the premium cost and no claim bonus and discount on premiums before buying a new plan.
Conclusion
Health insurance portability is a game-changer that gives you greater control and flexibility in managing your healthcare needs. By understanding the process and considering all aspects, you can make an informed and well-researched decision when switching insurers. Remember, the goal is to choose a better plan that best suits your medical needs and ensures protection against any financial liability that can arise in a medical emergency.
