Health insurance portability: Know when and how to initiate

This was during the pandemic when 32-year-old Sonakshi realised for the first time how critical the right health insurance can be. Her policy covered the hefty 15-day hospital bill when both she and her husband were admitted for treatment. While she continued with the same coverage, a few years later, she noticed her premiums steadily increasing. To make matters worse, her friend's insurer seemed to be offering some very attractive new-age value-added services.

Sonakshi knew about health insurance portability, but she wasn't sure if that would be the right approach. With no claims in the last two years, she worried about losing the benefits she had accrued. Little she knew, Sonakshi was bombarded with queries related to premiums, waiting periods, and other details.

Does this sound familiar? Have you been having similar concerns about your health insurance policy? Do you want to port your health insurance policy to a more appealing insurance provider? If yes, you are at the right place.

Health insurance portability, approved by the IRDAI, could be the solution you need. Read on to learn more about health insurance portability rules, and how this feature empowers you and prevents health insurance providers from controlling your options.

What is health insurance portability?

Let us begin with what health insurance portability is. Introduced in 2011 by the Insurance Regulatory and Development Authority of India (IRDAI), health insurance portability allows you to switch from one insurance provider to another without losing out on the benefits that you may have accumulated. Some of these benefits include no claim bonus, free medical check-ups, cumulative bonus, and the waiting period that has been served.

IRDAI allows you to transfer your health insurance, both individual and family floater, where the new insurer must offer coverage that matches at least the sum insured under your previous health plan.

Apart from this, it is mandated that the new insurer honours the credit for pre-existing condition waiting periods that have already served with the former insurer. Another health insurance portability rules states that both insurers, the old and the new, are equally responsible for ensuring that the policy transfer is completed within the time frame set by the IRDAI's Protection of Policyholders' Interests Regulations and guidelines.

Keep in mind that these portability rules apply not only when you are moving from one insurer to the other but also when you are changing your health plan with the same insurance company.

When to consider switching health insurance plans?

Now, let's understand when you can or should consider porting your health plan. One or more of the following reasons may require a health plan porting:

• If you are not satisfied with the services being provided by your insurance provider
• If you come to know lately that your health insurance company plan does not cover health issues as per your needs
• The claim settlement is very slow and inconvenient
• Reimbursement claims take very long
• Your health insurance plan premium is becoming very high
• If sub-limits appearing as unnecessary burden
• When are getting better options from another health insurance company

How to switch health insurance plans?

So, if you have made up your mind about health insurance porting, you should understand how to go about this switch. Please keep in mind that you need to follow the stipulated time period as specified by the IRDAI.

1. Step 1: Initiate the portability request
Start the process by intimating the insurance company you want to port to and request for health insurance portability forms. On receiving portability request, the insurance provider will prove the necessary forms along with the various available plan options.

2. Step 2: Submission of the Application
Remember that your application has to reach the new insurance provider at least 45 days before the expiry date of your health insurance policy.

3. Step 3: The Validation of the Application
Once the new insurer receives your application, they will ask for your medical and claims history from the previous insurer. This has to be done within 7 days.

4. Step 4: Policy Update
Once the new insurance company authenticates your details, it will inform you of its decision to approve/reject your porting request within 15 days. If your application is accepted, you can pay the insurance premium and start the new coverage.

Can health insurance portability requests be rejected?

It is important to understand that while health insurance is your right, you have certain responsibilities. Your portability application may be rejected in case you are not eligible for it. Read on to understand.

• You are allowed to port your policy only at the time of policy renewal.
• When opting for a new policy, remember that the policy cannot be completely different.
• In case you have a group health plan, you cannot port your health insurance policy.
• You need to inform your existing insurer in writing about your wish to port to the new company. This has to be done with a 45-day period of notice.
• The health insurance company has to acknowledge your request within 3 working days. In case of delay from the insurer's side, portability will continue.

Before You Take Off

As a health insurance plan owner, you would know that it is one of the most important things to do in today's world. Soaring healthcare costs can make it challenging to afford good quality treatment for yourself and your loved ones. Thus, being under the umbrella of health insurance coverage is essential. However, if you feel the need, you have the right to port your current health insurance.

While IRDAI has clear guidelines regarding health insurance portability, you need to analyse if this switch is the best thing for you and the other insured members. Make sure you understand the pros and cons of this feature, analyse your health insurance needs and then make a well-informed decision.

Disclaimers:

1. The above information is for reference purposes only: Policy Assurance and Claims at the underwriter's discretion.
2. All plan features, benefits, coverage, and claims underwriting are subject to policy terms and conditions. Kindly refer to the brochure, sales prospectus, and policy documents carefully.