Health insurance portability enables policyholders to switch their existing health insurance plan to a different insurer without losing key benefits like waiting period credits, No Claim Bonus (NCB), and free medical check-ups.
This feature ensures individuals can move to a more suitable policy if they are dissatisfied with their current provider. To qualify for portability, the existing policy must be renewed promptly without any lapses.
Keep reading to understand the common reasons for switching insurers and the steps involved in the porting process.
How does Health Insurance Portability Work?
The Insurance Regulatory and Development Authority of India (IRDAI) introduced health insurance portability in 2011, allowing policyholders to transfer their health insurance plans to another insurer while retaining key benefits.
However, before opting for portability, it is important to be aware of the following rules:
? Policy Type: Portability is only allowed for a similar type of policy, meaning the coverage and plan structure cannot be entirely changed.
? Notifying the Insurer: A portability request must be made at least 45 days before the existing policy's expiration, and switching can only occur at the renewal time.
? Insurance Company Type: Policies can be ported only between similar insurance providers, such as from one general insurer to another.
? Grace Period: A grace period of 30 days is provided during the porting process. In some cases, the current policy may be extended for a short duration on a pro-rata premium basis.
? Porting Fees: There are no additional charges for transferring a health insurance policy to a new insurer.--ubmitted
? Bonuses and Premiums: The new insurer can determine the bonuses, premiums, and other policy terms. The premium may be higher for individuals classified as high-risk.
? Waiting Period: The waiting period generally remains unchanged unless new coverages are added to the ported policy.
? Acknowledgement: Insurers must acknowledge portability requests within three working days. The existing policy should not be cancelled until the new insurer approves the application.
Documents Required for Porting
To successfully port a health insurance plan, the following documents need to be submitted:
? Address proof
? A valid government-issued identity proof
Here are the documents required from the previous insurer:
? Copies of past policy certificates
? Self-declaration confirming no claims (if applicable)
? Latest renewal notice confirming continuous coverage
? Relevant medical documents, such as investigation reports and discharge summaries, if any claims were made
Here are the documents required from the new insurer:
? Portability request form
? Duly filled proposal form
Having these documents ready ensures a smooth transition while switching to a new health insurance provider.
What is the Process of Health Insurance portability?
Follow these steps to switch your health insurance plan seamlessly:
? Step 1: Submit a portability request to the new insurer at least 45 days before your current policy renewal date.
? Step 2: Upon receiving the request, the new insurer will provide a proposal, portability forms, and details of available health plans.
? Step 3: Choose the desired health plan and submit your duly completed portability and proposal forms to the new provider.
? Step 4: The new insurer will then request medical records, claim history, and other details from your current insurer or retrieve them from IRDAI’s data-sharing portal.
? Step 5: Your existing insurer must share the requested information within 7 working days. Any delay may result in the new insurer putting your porting request on hold.
? Step 6: After receiving all necessary details, the new insurer will evaluate your request and communicate its decision within 15 days. If no decision is made within this period, the insurer must approve the portability request.
Reasons and Benefits of Porting
Switching health insurance policies offers several advantages, including:
Retention of No Claim Bonus (NCB)
Policyholders can transfer their accumulated NCB when porting their health insurance. For instance, if a policyholder has earned a 20% NCB under the existing policy, the same benefit will be applied to the new policy.
Continuation of Waiting Period Credit
The waiting period served under your current policy is carried forward to your new plan. For instance, if the existing policy has a two-year waiting period for pre-existing diseases and the new policy has a three-year waiting period, you will only need to serve one year after porting.
Potential for Lower Premiums
Health insurance portability lets policyholders switch to a plan with similar coverage at a lower premium, which is beneficial if the existing insurer raises premiums after a claim.
Improved Services
If a policyholder is dissatisfied with their current insurer’s services—such as a complex claim process or poor customer support—they can switch to a provider with better service and a more efficient claims process.
Factors to Consider Before Porting
Before switching your health insurance policy to a new provider, it is essential to evaluate the following aspects to ensure a smooth transition and optimal benefits:
? Assess Your Healthcare Needs: Review your medical requirements, including pre-existing conditions and future healthcare needs, to ensure the new policy offers adequate coverage.
? Check Network Hospitals: Verify if the new insurer has a broad network of hospitals, particularly those near your residence or preferred healthcare facilities, for cashless treatment convenience.
? Compare Premiums and Features: Analyse the cost of premiums and the benefits provided by different insurers to ensure you receive better coverage at a reasonable price.
? Review Claim Settlement History: Research the claim settlement ratio of the new insurer to assess their reliability in processing claims efficiently and without unnecessary delays.
? Analyse Plan Benefits: Ensure that the new health insurance plan provides superior coverage, including additional riders or benefits, compared to your existing policy.
? Understand Policy Terms and Conditions: Carefully read the fine print to learn about the new policy's exclusions, sub-limits, co-payment clauses, and waiting periods.
? Check the Insurer’s Reputation: To avoid future inconvenience, research the new insurance provider's service ratings, customer reviews, and responsiveness.
? Ensure Affordability: While opting for a new policy, make sure the premium remains within your budget while offering comprehensive coverage and essential benefits.
Reasons for Health Insurance Portability Rejections
Although IRDAI grants policyholders the right to port health insurance, it also allows insurers to reject portability applications based on specific criteria. Each request is treated as a fresh application and undergoes thorough evaluation by the underwriter.
When an insurer receives a portability request, they assess the associated risks and determine an appropriate premium. If the request does not meet their risk criteria, they may decline it, leaving the policyholder with no choice but to continue with their current insurer.
Below are some of the key reasons why portability requests may be rejected:
? Incomplete or Incorrect Information: Providing incomplete personal or policy details can lead to rejection. Accurate and complete information is essential for the insurer to evaluate the application correctly.
? Issues with Documentation: Delays in submitting required documents or providing incorrect paperwork can disrupt the portability process. Ensuring accurate and prompt documentation is crucial for approval.
? High-Risk Underwriting Factors: If a policyholder has a history of pre-existing health conditions, multiple claims, or significant differences between the old and new policy coverage, the new insurer may perceive the application as too risky and reject it.
? Lapsed Policy: A gap in renewing the existing policy can adversely impact the portability request. Most insurers prefer continuous coverage without lapses, indicating responsible policy management.
? Age Restrictions: Older applicants may face difficulties in porting their policies, as some insurers have age limits or stricter terms for senior policyholders, making approval less likely.
Health insurance portability allows policyholders to change insurers while retaining their accrued benefits. However, the process is subject to strict evaluation, and requests can be rejected for several reasons.
Policyholders should carefully assess their new insurer’s requirements, submit accurate documentation, and maintain continuous coverage to ensure a hassle-free transition. Individuals can secure better coverage, services, or premium benefits by making informed decisions.