Health Insurance Portability in India

Sanjay Mishra, 47 had thyroid problems since long. He had this issue listed as a pre-existing condition in his health insurance plan. A couple of years down the line, when his insurer increased the premium substantially, he decided to port his health insurance. However, Mishra was worried about the fact that his new insurance provider would treat him as a fresh policyholder and impose a waiting period for the pre-existing disease.

However, Insurance Regulatory and Development Authority of India (IRDAI)’s guidelines on health insurance portability ensured that Mishra is able to switch to a new insurer without losing out on the benefits of his previous health insurance policy.

What is Insurance Portability?

Introduced by the IRDAI in 2011, the process of portability allows a policyholder to transfer the credit gained for pre-existing conditions and time-bound exclusions when switching from one plan to another of the same insurer or from one insurer to another. The policyholder will also be entitled to all benefits like no-claims bonus and free medical check ups, which are accumulated during the previous policy.

Every policyholder is entitled to insurance portability provided he maintained the previous policy without any breaks. In order to avail this facility, the policyholder has to apply to the insurance company, where he wishes to port his or her policy, at least 45 days before the premium renewal date of the existing policy. If the policyholder fails to do so, it is up to the insurer to decide whether it will at all consider the application for portability.

Should you consider porting your insurance policy? When asked this question, Shreeraj Deshpande, Principal Officer and CEO (Officiating), Future Generali India Insurance said, 

“Yes you can consider porting your health insurance policy. Generally policy holders port their health policies in case of any issues regarding service, product, pricing or any other reason.”

On the other hand, Shanai Ghosh, Chief Marketing Officer, Strategy and Commercial at Edelweiss General Insurance added 

“Porting is a good option for the customer, as it offers him or her the choice of switching to a better product.

It should be considered if there is a gap between the coverage offered by the current product and others available in the market or if there is a deficiency in service by the current insurer.”

Portability Process  

A person can apply for insurance portability when his or her existing policy is due for renewal. When the insurance company receives an application from a policyholder seeking portability, they are provided with proposal form and a portability form including details of various products offered by it. After the insurance company receives all the filled in forms, it will obtain the medical records and clam history from the existing insurer.

The insurer must furnish details within seven working days through a common data-sharing portal developed by IRDAI. Once the insurer obtains all the details, it will have to take a decision about underwriting the policy within 15 days. In case it fails to do so, it will be bound to accept the application.

Things to Consider

Do not forget take into consideration inclusions and exclusions in health insurance portability. Terms and conditions differ from insurer to insurer. As a policyholder, do remember to weigh in the factors before switching. People in high-risk category may also end up paying more premiums during the process.

If done in a proper manner, health insurance portability can help a policyholder in a lot of ways.