All You Need to Know About Health Insurance Portability

Health insurance is one of the most important investments you’ll make in your life. It’s also something you’ll have to live with for as long as you live. Given the length of this partnership, there’s a good chance that disagreements may arise between you and the insurance provider.

Earlier, there weren’t any options that let you switch to a new insurer; today, the Insurance Regulatory and Development Authority (IRDA) of India’s(IRDAI) introduction of health insurance portability has changed all that.

This concept means that you won’t have to stick with an insurer if you are dissatisfied with their services—you can simply switch to another one. When you switch (or ‘port’) your insurance policy from one company to another, you get to retain the terms and benefits you had agreed upon when you first signed off on the policy.

Reading on, you’ll learn about the basics of the health insurance portability process, and how you can switch from one insurance organisation to another.

The 45-Day Notice Period

If you are applying for a port, you’ll need to do so at least 45 days before the policy renewal is due. Usually, all the insurance policy providers stick to this rule, but IRDAI has made it a little more flexible.

They’ve ruled that an application can be accepted even if it is submitted after the 45-days-from-date mark.

For insurance holders under 45 years of age, medical tests are waived off as a non-medical-test policy. Under such cases, the new insurer usually accepts new proposals 21 days before the due date.

Period of Acceptance

When you apply to a new provider, you will get their decision in 15 days. Once this is done, they will need to take you in as a client within the next 15 days.

In case they (the new provider) fail to do so, they’ll need to ask your old insurance company to extend their coverage for a short period of time (usually 30 days). When this happens, the new insurer will have to pay a suitable premium to the old insurer in your stead.

The Waiting Period Clause

As you make the switch to a new insurance provider, the waiting period you had accrued with your previous insurer gets carried over.  Let’s say your new policy has a 2-year waiting period to get coverage on specific health conditions like kidney stones, or diabetes. If you’ve already served one year with your previous provider, you will only need to wait one more year to get coverage. Also, if you’ve had continuous coverage without claims for over 4 years, you can claim for treatments on all conditions without serving the waiting periods.

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The Underwriting Process

The new insurer processes your proposal according to its own underwriting process. While the company can accept the proposal with a standard premium, it might also charge an additional premium on any previous surgeries or illnesses. The new company can also reject your application if your proposal doesn’t meet its underwriting conditions.

A Step-by-Step Guide to Switching Insurance Providers

#Step 1: Finding the Right Insurance Policy

Guidelines on insurance policies vary from provider to provider. Before going ahead with the porting, consider all the aspects of the policy—like no-claim bonuses, claim procedure, and sub limits.

Get details of a few policies from different insurers and pit them against each other. Once you’ve figured out the policy that offers the best benefits, go ahead with it.

#Step 2: Putting Together the Documents You’ll Need

Insurance portability depends a lot on the paperwork; any missing documents can actually get your proposal declined. Make sure you have all the documentation you’ll need.

To make things easier, here’s a list of documents you will need.

Old Insurer Documents:

  • Self-declaration by the customer for claims cases
  • All policy documents from the previous policy
  • Renewal notice sent by the old insurer
  • Discharge summaries, if any claims have been made

New Insurer Documents:

  • Filled-in insurance form
  • Portability form

Some Basic FAQs

  • Will I need to undergo further medical check-ups?

Yes. According to the underwriting guidelines set by the new insurer.

  • Can I get a higher sum insured on the policy?

Yes. You can get a higher sum insured when you port your policy. However, you will need to complete a waiting period before the new sum can come into effect.

  • Will insurance premiums remain the same?

Not necessarily. The premiums usually depend on the plan you choose from the new insurer.

  • Do I have to pay up to complete the porting procedure?

No. According to IRDAI rules, insurance providers can’t charge an extra amount to complete the portability process. You will only need to pay the premiums for the plan you have chosen.

  • What types of policies can I port?

You can port only like-to-like policies. For example, you can only port your basic policy to another basic policy from a new insurer.

  • Will I get the same sum insured as the old policy?

Yes. Once the new insurer accepts your proposal, you will get the same sum insured.

There you have it; not only can a policy provider switch reduce your monetary burden when an illness strikes, it can also guarantee good health care facilities. Do your own research, and proceed cautiously before signing off on a health insurance portability deal.

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