How health insurance portability works

How to switch to new health insurer

From October 1, your health insurance policy has become portable. Switching to a new insurer can be easy if you follow some simple steps.

From October 1, your health insurance policy has become portable. Switching to a new insurer can be easy if you follow some simple steps -

What's Portable...
Portability allows customers to carry forward continuity benefits accrued on their previous policy. These benefits are gained by being under continuous coverage for a certain period. This is essential for getting coverage for pre-existing diseases. Earlier, policyholders had to stick to a policy only to retain the waiting period benefit.

Those covered under employer group health insurance policies or family floater policies can also port to an individual health cover .

However, they will first have to switch to a plan offered by their existing insurer and will be allowed to switch to the insurer of their choice only after a year.

The Procedure...

  • The application to port your health insurance policy should reach the new insurer 45 days prior to the last date of renewal of your existing policy.
  • On receiving your request, the new insurance company will provide you a proposal form and a portability form along with details of various products offered by it.
  • Choose the product which suits your requirement, fill up the proposal and portability forms and submit them to the new insurer.
  • Once the insurance company receives both these forms, it will approach your existing insurer seeking details such as medical records and claim history .
  • The data will be received through a common data sharing portal developed by Irda for all insurers. The existing insurer will have to furnish all the details within seven working days.
  • After the new insurer has the requisite information, it has to take a decision on underwriting your policy within 15 days. If it fails to take a view within this time frame, it will be bound to accept your application.
What you can lose...
The premium may not stay the same even for a similar coverage as insurers are free to levy premiums according to their underwriting norms. This means that people in the 'high-risk' category may have to pay a higher premium after switching. If you have accumulated no-claims bonus, it will be lost in transition.

Though you can carry forward your enhanced coverage, you will not get a discount on the premium and will have to pay the full amount. The terms and conditions of the policy will differ from insurer to insurer. Therefore, know the inclusions and exclusions before switching.

Things to remember

The 45-day criterion
File your request to switch insurer at least 45 days before the expiry of your existing health policy to ensure that the application is accepted. Though the health insurance company is free to consider a proposal even if the policyholder fails to approach it 45 days before the renewal date of the current policy, it is not legally bound to offer portability if this criterion is not met. So, there is a chance your application will be rejected.

Policy Continuity
Portability may be denied if there is a break in the policy. So, ensure that you port the policy before the existing cover expires. In case the decision of acceptance is still pending on the last date of renewal of your existing policy, you can request your present insurer to extend the coverage for a month or more. You will have to pay a pro rata premium for this extended coverage. It can remain till the procedure is completed.

Maintaining Records
Maintain proper documentation such as previous policy certificates, renewal notices clearly stating continuity of coverage, etc., so that it is easier for the new insurance company to evaluate your proposal and underwrite the policy accordingly.