What is Portability Of Health Insurance: Rules, Documents, Pros & Cons
Health insurance portability is an option that allows the policyholder to change the current insurance company or choose a better insurance plan. Introduced in 2011, these guidelines let policyholders transfer their benefits gained for pre-existing conditions and other time-bound exclusions to the new policy.
Health Insurance portability also provides continuity benefits like no-claims bonuses and free medical check-ups accumulated in the previous policy. It offers the flexibility for insured people to not stay bound to their current insurer. This also ensures that insurance companies do not take their customers for granted.
How to Port Current Health Insurance Policy?
Follow the given steps to switch your existing health plan:
- Get in touch with the new insurance company and tell them that you want to port your existing health insurance.
- They will send you some documents, including a health insurance portability form and a proposal form. They may also send you some documents detailing their various insurance products.
- Once you have filled out all the required forms, submit them to your new insurer. Also, submit any documents they have asked for.
- The new insurer will reach out to your existing one to get medical records and other relevant information.
- They will underwrite the proposal for the new policy and inform you about it within 15 days.
Documents Required for Porting Health Insurance
Here’s a list of documents you need for porting your health insurance:
1. From Previous Insurer
- Latest insurance renewal certificate.
- Previous years policy certificate.
- Insurance claim documents like discharge summary, diagnostics and investigation report, etc.
- In case of no-claim, a self-declaration document.
2. From New Insurer
- Duly filled portability form.
- Duly filled proposal form.
Health Insurance Portability and Accountability Act
Health Insurance Portability and Accountability Act give every policyholder of individual/family floater plans the right to get their credit gained for time-bound exclusions transferred when they change the insurer/plan.
Here is a list of the rights provided by the IRDA portability guidelines:
- You can port a policy from and to any general insurance company or specialised health insurance company.
- The new insurer needs to provide a sum insured equal to or more than the previous policy.
- The new insurer will have to give you credit related to the waiting period for pre-existing conditions.
- Both your current and the new insurer are responsible for completing the porting process within the timelines set by IRDA.
Rules Regarding Health Insurance Portability
- You should have maintained the previous health plan without a break.
- A policyholder needs to apply to the existing insurer for porting their policy at least 45 days before the premium renewal date of the current policy.
- You have to write to the existing insurer requesting a shift and mention the new company’s name.
- He/she will also need to apply to the new insurer for the porting at least 45 days before the premium renewal date.
- Policyholders will be provided a 30-day grace period for the porting process.
- If you require more time, you can request to extend the current policy for a short period. In that case, you will have to pay the premium on a prorated basis.
- Premium, bonuses and other terms of the new policy will be decided by the new insurer.
- Your current insurer has to acknowledge your application for portability within 3 working days. You should not cancel the existing policy until receiving a confirmed policy from the new insurer or make a specific request.
Why Port Your Existing Health Insurance Policy?
1. Better Terms
With intense competition, many insurers are trying their best to offer better value for your money. As such, you could take advantage of better deals instead of continuing with your current one.
2. Poor Service
If your current insurer has not been providing quality services for some time, you may want to move on. Similarly, if they were not fair in their claim settlement, you can consider making a switch.
3. Insufficient Coverage
Your existing insurance provider may not provide coverage for specific health issues which could concern you. In this case, you may want to consider switching your health insurance provider to get coverage for new ailments.
4. Hidden Clause
If you discovered a hidden clause well after purchasing a policy, you might consider a more transparent insurance provider. When it comes to making claims, such hidden conditions can wreak havoc during moments of crisis.
If you are paying an exorbitant premium for your current policy, consider switching to Navi. It offers a very simple and paperless claims process that takes only 20 minutes to get approved. Download the Navi app to purchase a health plan from a company with an industry-leading claim settlement ratio.
Also Read: What Is a Top-up Health Insurance Policy? Why Is It Beneficial?
Also Read: Cashless Health Insurance Policy: All You Need To Know
Reasons Insurance Porting Request can Get Rejected
Here are the reasons your health insurance porting request can get rejected:
1. Distorted Medical Information
Misinformation about health conditions can lead to health insurance porting requests. Differences in the claimed health problems and health check-up reports are one of the primary reasons for the rejection of health insurance portation.
2. Underwriting Risk
The new insurer can reject your request for health insurance portation if the medical conditions do not align with the insurer’s underwriting risk, also known as risk acceptance.
3. Documents and Technicalities
The required documents need to be duly filled out and submitted to the new insurer’s office. Failing can lead to rejection. Also, not being available for medical check-ups can lead to health insurance portation rejection.
4. Age
If the policy holder’s age is above 70 years, there’s a high probability that the health insurance portability request to get rejected.
Pros & Cons of Health Insurance Portability
| Pros | Cons |
| To gain a competitive advantage, insurance companies provide existing benefits at lower premiums. | You can only port when the renewal date is near. |
| The existing amount is clubbed with a no-claim bonus to calculate the new sum insured. | Higher premiums for additional benefits. |
| All the benefits of the current plan remain effective. | Can only opt for similar products. |
| You may customize your plan. | Moving from a group plan to an individual plan can lead to the loss of certain benefits. |
Things to Consider Before Porting Health Insurance
- Check the network hospitals of the new insurer.
- Check the limits, sub-limits, terms and conditions of the new insurer.
- Check the restrictions based on disease, age, etc.
- While porting your health insurance, know that you will not be able to port the features of your old health insurance policy. However, you may port the bonus credits and waiting period.
- If the new insurer is providing insurance at a low premium, check their documentation to see the coverage they are providing.
- File a portability request 45 days prior to the renewal date.
Final Word
Health insurance portability lets you switch to a new insurer without losing some of the benefits accumulated with the old insurer. With this rule, you can easily opt-out of your current health plan without losing benefits.
FAQs
Ans: Insurance companies have a certain waiting period for pre-existing diseases like diabetes, thyroid, asthma, depression etc. Policyholders need to wait till the end of this period to get their claims accepted.
Ans: IRDA has a web-based facility that obtains data about all issued health policies. Whenever a policyholder makes an application for porting their medical insurance, the new company can access data from this site.
Ans: IRDA has given insurers the right to reject any port-in requests. Any requests for portability are treated as new and get examined by the insurer’s underwriters. If the policyholder is deemed to be risky, they may reject the request.
Ans: Firstly, policyholders cannot change the health insurance plan when porting. They may also need to pay a higher premium for additional coverage and lose some benefits.
Ans: It is unlikely. You may have to serve half of the waiting period under the new plan. However, this can change depending on the terms and conditions of the new insurer.
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Disclaimer: This article has been prepared on the basis of internal data, publicly available information and other sources believed to be reliable. The information contained in this article is for general purposes only and not a complete disclosure of every material fact. It should not be construed as investment advice to any party. The article does not warrant the completeness or accuracy of the information, and disclaims all liabilities, losses and damages arising out of the use of this information. Readers shall be fully liable/responsible for any decision taken on the basis of this article.
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