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HEALTH INSURANCE

How to Port a Health Insurance Policy: Making the Switch Count!

Neha Gadoo Neha Gadoo 01 February 2017
4.2 (15 votes)

There can be several reasons for switching from one insurance policy to another. Know all about portability before you actually apply for it.

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Yesterday, I was left outside the hospital with a half-good leg, waiting for the app-booked cab. And after a 25 minutes wait, I was cheesed off enough to want to order from another app. You could call it fickle-mindedness, but it was just plain bad service lacking accountability! So, if you have been stuck with a health insurer, wanting to change to another for whatever may be your reasons (bad service, lack of options in the current one, strict and non-flexible guidelines), feel better to know that you’re not at the wit’s end of your last straw!

What is Portability Of Your Health Insurance Policy?

Portability is that which allows you to switch between insurers without having to worry about losing benefit (like no-claim-bonus) or sit out a waiting period that you may have already completed with your previous insurer. I specify on health insurance because regulations allow portability only for health policies by non-life insurers. This feature is what will allow you to move to an individual policy or a family floater, if you’ve been covered under a group policy until now and decide to change jobs. Let’s call it the best of having both worlds!

Some Important Portability Guidelines For You

As you’ve probably heard enough already, health insurance is a long term decision. So, a decision as calculative as choosing the right policy and then switching to a different insurer comes with the responsibility of some guidelines.

The 45-day notice period: Your application for portability should be made 45 days before your existing policy expires. You should know that portability is not guaranteed. The new insurers may decline the proposal if the risk is not acceptable as per its underwriting policy.

The new-insurer’s acceptance period: It’s not all rules for us after all; it applies to the insurer too! The new insurer is expected to respond to a portability request within 15 days of receipt of the proposal. If there is a delay in the processing of the proposal and you’re due to renew the old policy, then the onus lies on the new insurer to request your current insurance company to provide you insurance for a short period of up to 30 days from the due date. The premium paid by you to the existing insurer for this short period will be calculated on a pro-rata basis.

Underwriting process: The new insurer may accept your proposal only if it is in line with their underwriting norms. If you’ve clean slate for pre-existing illnesses and have maintained a claim-free policy, the company would love you for it and charge the nominal premium. But in the event of any of these two, they could charge additional premium. Or they could go one step ahead on the nasty scale and refuse you a policy altogether, if you do not fall under their underwriting guidelines.

Though you can always go back to your old insurer in the mid-way process of porting, as we’ve always emphasized, don’t allow premiums to be the sole reason to choose the right health decision.

Waiting period clause: The most advantageous feature of policy portability, this clause allows you to switch over to the new insurer without having to wait out entire waiting periods all over again. Sounds twisted? Let me explain. Say, in your current policy, you have waiting period of 2 years for diabetes or hernia or kidney stones and you’ve completed one year already. The new insurer, on the condition of proposal acceptance, will expect you to wait out only the remaining one year and not the entire period. If, for the mentioned or other specific ailments, the new insurer has a 3 year waiting period, then you might be expected to wait out 2 years. On a different note, if you’ve completed the 4 years of waiting with your current insurer for your pre-existing ailments, then you’d be covered immediately by the new insurance folks without having to wait any longer.

Policy continuity: Policy will be denied if there is a break in the policy. Meaning: it is important that you port your policy before your existing one expires. You could earn brownie points with the insurer you’re applying to by being prudent and maintaining a clean record of all documents like renewal notices and policy certificates which certifies your continuity of coverage.

Benefits of Porting a Health Insurance Plan

One of the primary benefits of porting health insurance plans is that of continuity. This implies that a policyholder can switch between insurers without having to give up on the financial benefits accumulated on the previous health insurance plan. For instance, if the waiting period for a certain disease is 3 years under the old policy, and the waiting period of 2 years is already completed for the same disease under the old plan, then for the new policy, the policyholder will be given the advantage of serving only a year’s waiting period after porting his/her health insurance plan.

However, since waiting periods are minimized or completely waived off for new insurers, their liability also starts earlier than usual.

Health insurance companies are usually open to offering this benefit to young policyholders than senior citizens. Health plans for senior citizens may not offer this benefit. Also, policyholders who suffer from chronic illness or have undergone major hospitalization have a lesser chance of availing the portability option.

Reasons Why You Should Consider Porting Your Health Insurance Policy

  • Retain the features and benefits of the existing health plan that you want to keep, give up on the benefits that do not serve your purpose anymore, and opt for features that will be more suitable for your changing needs.
  • Portability offers policyholders the flexibility to customize their health insurance plan as per their unique needs. Features and benefits offered in the existing policy can be modified to suit changing requirements due to increasing age by adding a new nominee, opting for additional benefits, etc.
  • Sudden steep increase in premiums is one of the factors why health insurance policyholders should opt for porting to another policy.

There is usually a hike in the premiums with increase in age of the policyholder. However, a sharp hike is the reason enough for you to switch to another plan.

  • If a policyholder has experienced a slow and hassled claim settlement process with the existing insurer, it is advisable that he/she opts for portability to an insurance company with a better claim settlement process and incurred claim settlement ratio. This ratio implies that they have a high chance of the claims getting settled quickly and in a hassle-free manner, in case such a situation arises. This would serve the purpose of investing in a health plan.
  • Cashless benefits have made payments during hospitalization easy and hassle-free. If the existing insurer does not offer the same benefit, it is time to make a switch. Most modern insurance companies have a list of network hospitals that are authorized to offer cashless benefits to policyholders. Select an insurance company that does not only offer cashless facilities, but has an extensive list of network hospitals – preferably the ones that are easily accessible to you or those that you visit.

What You May Lose Out On, In Portability

  • There is no standardization of policy wordings in the industry. If you’ve been holding a 1 lakh policy and the new insurer you are shifting to doesn’t offer coverage below 2 lakhs, then you could end up paying a higher premium.
  • Also, you may lose out on the accumulated no-claim-bonus. You may be able to carry out your NCB to the new policy, but your premium will be calculated on the enhanced cover. Say you have been paying a premium of Rs.1000 for a one lakh cover. And, because you haven’t made any claims, NCB enhanced your sum assured to 1.3 lakhs for the same premium of Rs.1000. When you switch your insurer, the coverage will be calculated at 1.3 lakhs and you may have to pay up a higher premium (may be Rs.1300) as your premium, thus losing out on the discounted premium.

Portability Of Health Insurance In 6 Simple Steps

  • Step 1: Like mentioned earlier, apply to the new insurer 45 days before the existing policy runs out.

  • Step 2: On receiving the application, the new insurer will expect you to fill out your portability and proposal forms. Fill ‘em right up! And submit!

  • Step 3: The new insurer will have to check your details (like medical and claim history) with the existing policy’s insurer and they would do it within a 7 days period.

  • Step 4: The insurance company will now pass on the required information through IRDA’s portal in the format prescribed by the regulator for shifting the policy.

  • Step 5: When the new insurer receives the required information, they will frame the proposal in accordance to their underwriting norms.

  • Step 6: The new insurer will process and give you their proposal in 15 days. But wait, there is a sunny side to this! If this is not done within this 15 days period, despite receiving all the required information, they will be bound to accept the policy-porting.

When You Should Consider Porting Your Policy

You might be unsatisfied with your current insurer that’s prompting you to look at other options. But before you make the call make sure you consider all aspects such as sub-limits, no-claim-bonuses, ease of claims procedure etc. Young people are unlikely to have made much claims and can switch easily as they would come under the non-medical category. Their policy would be ported immediately.

Even if you’re over 45 years with a clean medical history, it’s advisable to get a thorough medical test done before applying to port your policy. Because if an abnormality is then detected, you could stick to their old policy instead of having to face rejection or an increased premium with the new insurer. And since you’ve already completed any or all of your mandatory waiting period, you can just take additional cover for any ailments that have come up – you’re assured of getting claims from your old insurer who is aware of your health history.

Documents Required For Porting Health Insurance Policy

  • Policy documents of the insurer that you want to switch from.
  • Details about policy renewal, clearly specifying continuity of coverage.
  • Self-declaration by policyholders in case of no claims made on the previous insurer. In case of claim settlements, investigation report, discharge summary, etc. have to be submitted as proof

Problems Faced While Porting Health Insurance Policies

Not Being Aware Of The Features Of The New Health Plan: Does the new policy offer the same features as your old policy? Does it offer any limits on hospital room rent, day care facilities, etc. that you are not comfortable with? Make sure that you are switching over to a plan that meets your unique needs.

Capping on Maximum Maturity Age: A health plan that covers the policyholder for a lifetime is a more preferable option that one that offers coverage only up to a specific maturity age.

Lack of Cashless Benefits: It is highly recommended that policyholders opt for health plans that offer cashless facilities at their network hospitals. Leading insurance companies have network with a list of hospitals that are authorized to offer cashless hospitalization benefits to policyholders. Even if the previous insurer did not extend this benefit, it is best that you choose an insurance company that does.

Increased Premium Payments: Some insurance companies charge extra premiums for claimed years. In certain cases, there are limits on hospital room rent, certain treatments, co-payments, etc. Look for an insurance company that does not have any such restrictions.

Recommended Read: Health Insurance Portability: All you wanted to know

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4.2 (15 votes)
Neha Gadoo
Written by Neha Gadoo
Daring and Bold, Neha loves philosophy, trekking and walking bare feet in the rain. Loves talking and can stare out of a car window for hours continuously.
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