Medical Insurance Portability was introduced in India in 2011 by The Insurance Regulatory and Development Authority of India (IRDAI). Health Insurance Policy Portability refers to the right given to a policyholder of a Health Insurance policy, whether it be an individual cover or family cover, to apply for a Health Insurance plan of another Health Insurance company, or even a different plan of the existing Health Insurance company, keeping intact all the accumulated benefits in terms of exclusions based on time and that on pre-existing conditions. Let us take a detailed look at this concept, and how it can benefit you.
What is Health Insurance Portability?
Health Insurance Portability is a phrase or concept you may have heard of. What is it all about? Let us understand the idea of Health Insurance Policy Porting with an example.
Priyanka is a 35-year-old professional with a Health Insurance policy from Insurer A, which she purchased 10 years ago. She has been suffering from High Blood Pressure (BP) ever since she was 20 years old. While applying for her Health Insurance policy from Insurer A, she had declared her High Blood Pressure as a Pre pre-existing disease and the policy was issued with a waiting period of 36 months. Now her Health Insurance Policy will cover her treatment for ailments related to High Blood Pressure.
Unfortunately, Priyanka was subject to extremely bad service from her existing Health Insurance company A. She wants to shift to a different Health Insurance company immediately. However, as she is suffering from a Pre Existing Disease – High Blood Pressure, she will have to once again face a Waiting Period of 36 months when she purchases her new Health Insurance policy. This is risky for her.
Fortunately, in India, a customer like Priyanka has another option. She may apply for Porting of Health Insurance to a Health Insurance company of her choice. Once she is able to successfully Port Health Insurance, she will retain the benefits of her existing policy, which, in this example, means that the Waiting Period of 36 months for her Pre pre-existing disease will not be applicable again to Priyanka.
So, when you apply for a Port Health Insurance Policy, you retain the accumulated benefits due to you on renewal, including your No Claim Bonus and the time elapsed on the Waiting Period for your Pre Existing Diseases.
What are the Health Insurance Portability Rules?
IRDAI has introduced Health Insurance Portability Rules to ensure that individual Health Insurance policyholders are protected. The rules for Mediclaim Policy Portability are as follows:
- You may apply to Port Medical Insurance only during the renewal
- You need to apply for the Port Mediclaim Policy at least 45 days before the renewal of your Health Insurance Policy is due, but not more than 60 days prior
- You need to inform your existing Health Insurance Company in writing, or online, of your intention to apply for Health Policy Portability and mention which insurer or policy of your existing insurer you wish to port to
- You need to renew your policy within the timelines. A 30-day grace period is provided in case you miss the renewal date
- The Health Insurance company has to acknowledge your application to Port Health Insurance Policy Online, or offline within 3 days
- The new Health Insurance company you have chosen has 15 days after getting your request and details to take a decision on your request. In case of a delay beyond 15 days, the Health Insurance company is bound to accept your Insurance Portability request
Advantages of Health Insurance Portability
Health Insurance Portability Benefits are as below:
Wider Choice
You may move your Health Insurance Policy from any General Insurance to a specialised Health Insurance Company and vice versa depending on the benefits you are getting.
Continuity of Benefits
By deciding to Port Health Insurance you will continue to enjoy the benefits that have accrued to you in your existing policy. If you have already completed the Waiting Period for Pre Existing Diseases in your existing policy, then you will not have to wait any more for PED coverage.
Better Coverage
When you decide to Port Health Insurance, you get an opportunity to reassess your Health Insurance coverage. If your healthcare requirements have changed you may apply for a Health Insurance policy that caters to your current requirements. You may also add new members to your Health Insurance Policy.
Better Services
In case you are not satisfied with your existing Health Insurance provider, you may switch to a Health Insurance company which provides better service, all the while keeping your existing benefits intact.
No Claim Bonus
Porting of Health Insurance ensures that your No Claim Bonus remains intact and that you continue to enjoy the credit for the same.
Time Schedule Fixed by IRDA
IRDA has defined a strict time schedule for the health insurance companies to adhere to in cases of Health Insurance Policy Portability. The insurer has to acknowledge your application to Port Health Insurance within 3 days. If you have applied physically, then this responsibility lies with your existing insurer. If you have applied to Port Health Insurance Policy Online, then the responsibility of acknowledging your application lies with the new insurer.
The new Health Insurance policy provider has 15 days after they receive your application to decide whether they wish to underwrite your policy. They may access your data and your Health Insurance history from the web-based facility created by IRDA. In case the insurer fails to get back to you within this stipulated period of 15 days, they will be forced to unconditionally accept your application for Health Insurance Portability.
Disadvantages of Health Insurance Portability
Those of us who wish to Port Health Insurance Policy do so with the aim of reducing premium or accessing better facilities at the same premium. However, the process of Medical Insurance Portability, as it stands now, has some disadvantages:
Rules
You can only apply for Mediclaim Portability during the process of renewal of your Health Insurance policy. This makes the window for application narrow and often inconvenient for you.
Senior Citizens
Senior Citizens, especially those in the age bracket above 70 years are subject to very strict and severe rules from the underwriters of the new Health Insurance issuing company. Senior Citizens may be burdened with higher premiums and a higher percentage of co-pay in case of claims.
Reduced Coverage
The insurer providing your Health Insurance policy may reduce the coverage against lower premiums. This negates the main objective of the Porting of Health Insurance.
Higher Premiums
The new Health Insurance company may decide to charge you higher premiums depending on your age, the current status of your health, the city where you are domiciled or extra add-on covers you may decide to apply for.
Documents Required for Health Insurance Portability
Following is a list of documents required to apply for your Medical Insurance Portability:
- ID Proof
- Address Proof
- Previous Health Insurance Policy
- Latest Renewal Notice
- Proposal Form
- Portability form from IRDAI
- Medical History Documents
- Self-Declaration for No Claims
Note: Your Existing Health Insurance Company will provide you with the formats and the list of documents you need to come up with after you submit a written application to them stating your intention of going forward with Mediclaim Portability.
You may apply for Health Insurance Portability Online too by entering your details on the website of the Health Insurance company you wish to port your policy too. However, note that you may still be required to submit the formats and documents physically.
CARE Health Insurance has a number of Health Insurance Policies you may consider porting to. Some of them are as below:
- CARE Advantage
- CARE Classic
- CARE Senior Citizen
- CARE Supreme
- CARE Freedom
Reasons for Rejection of Porting of Health Insurance
There are several reasons why the new Health Insurance company may reject your request for Porting of Health Insurance. Most of the reasons are in your control and may easily be avoided by following the rules.
The major reasons for the rejection of an application for Medical Insurance Portability are as:
1. Policy Holder Failing to Submit Documents in Time: You need to ensure that you submit all the documents and fully filled-up formats to your Health Insurance company within the given time. As Health Insurance companies have to follow timelines as defined by IRDA, they will not give you any extra time.
2. Inadequate Information: If you have held back material information and have not submitted details of your existing illness or any such illness you are suffering from after you applied for your original Health Insurance policy, your request to Port Health Insurance may be rejected.
3. Break in Policy: If you have not paid your renewal premium even after the grace period of 30 days, it is considered to be a break in policy and will result in your application getting rejected.
4. Poor Claim History and Underwriting Risk: If you have frequent claims, you are categorised as a high-risk customer. If you have a pre-existing disease or a health condition that is beyond the underwriter’s risk threshold, or the policy of the Health Insurance company is not to allow requests for Health Insurance Portability above a defined age limit, your application may be rejected.
Wrapping Up!
While IRDA has allowed for Health Insurance Portability, you need to be very careful while choosing your newHealth Insurance company from the point of view of their thresholds on various parameters, as well as on the features available. Do not initiate the process of Porting of Health Insurance before carefully studying everything. The option to Port Health Insurance is often better than applying for a new Health Insurance policy, but you need to be well informed in your choices and decisions.
>> Also Read: How to Port Health Insurance Plan?
Disclaimers: 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.
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