What is Portability Of Health Insurance: Rules, Documents, Pros & Cons

Portability of health insurance refers to the transfer of your current health insurance from one company to another or one plan to another. The current IRDAI  (Insurance and Regulatory Development Authority) guidelines protect the right of the insured individual(s) to port their insurance without losing on certain benefits. Especially for pre-existing conditions. 

Want to know your rights, rules and how to port your health insurance from one to another? Keep reading!

What is Health Insurance Portability?

Medical 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.  

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. 

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?

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.

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.

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. 

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 on Android or iOS 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?

How to Port Your Current Health Insurance Policy?

Follow the given steps to switch your existing health plan:

1. Get in touch with the new insurance company and tell them that you want to port your existing health insurance.
2. 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.
3. Once you have filled out all the required forms, submit them to your new insurer. Also, submit any documents they have asked for.
4. The new insurer will reach out to your existing one to get medical records and other relevant information.
5. They will underwrite the proposal for the new policy and inform you about it within 15 days. 

Also Read: Cashless Health Insurance Policy: All You Need To Know

Documents Required for Porting Health Insurance

Here’s a list of documents you need for porting your health insurance:

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. 

From New Insurer

• Duly filled portability form.
• Duly filled proposal form. 

Reasons Insurance Porting Request can Get Rejected

Here are the reasons your health insurance porting request can get rejected:

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.

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. 

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.

Age

If the policy holder’s age is above 70 years, there’s a high probability that the health insurance portation request to get rejected. 

Pros & Cons of Porting Health Insurance 

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 on Portability Of Health Insurance

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