Health Insurance Portability

What is Portability under Health Insurance?

Given medical inflation and rising health issues, better healthcare coverage becomes crucial. As a policyholder, you can use the portability feature to switch your current health insurance for a better plan that offers extra coverage options and value-added benefits. 

Under health insurance portability, you can modify your current policy by increasing the coverage and sum insured while retaining the waiting periods from your previous policy. Keep reading to understand the key features of health insurance portability when you port your current plan.

• Transfer of Benefits: Porting your current health insurance allows you to retain your served waiting period on the current coverage amount (including your base sum insured and accumulated bonuses), so you would not have to serve the waiting period again with the new insurer.
• No Loss on Waiting Period due to Pre-existing Conditions: If you have already served the waiting period for pre-existing diseases in your current plan and are deciding to port your health plan, you can avail of continued coverage with your new insurer.
• Continued Coverage: Porting your current plan to a new insurer before its expiry ensures your policy is ported on time and that you remain under comprehensive coverage.
• Upgraded Coverage at Optimum Premium: Upon porting your insurance plan, the new insurer may offer better benefits, wider networks and coverage at the same or an affordable premium.b

Why Should You Port Your Health Insurance?

Porting your current health plan to a new insurer allows you to get better coverage and services at a cost-effective premium. Below are the common reasons to switch your current policy to a new one.

• If you are Seeking Better Coverage: Porting your current health insurance policy is necessary if you are looking for extensive coverage that is not otherwise available under your current plan.
• Need for a Better Cashless Network: If your current plan has limited cashless healthcare providers near you, it is time to port your policy to a better cashless network.
• Need for Higher Sum Insured: As your family grows, the need for a comprehensive health insurance policy with a higher sum insured increases. Here, porting and upgrading your health plan can be helpful. However, you must also look for the benefits offered before porting your current coverage.
• If You Find a Cost-Effective Plan: If you find a cost-effective health insurance plan that offers similar or better coverage, porting your health insurance is a viable option. However, you should remember that the new plan must be comprehensive and provide coverage when needed.

Portability Guidelines as per the IRDAI

The Insurance Regulatory & Development Authority of India (IRDAI) has granted certain portability rights, subject to conditions, to protect a policyholder's well-being.

Rights

1. Policyholders can port their existing indemnity Individual/ Family Health Insurance Policy from any general/ specialised health insurance company.

2. The new insurer must provide continuity benefits on waiting periods due to pre-existing conditions.

3. The new insurer must insure the policyholder for the same sum insured as the current policy.

4. The old and new insurers must complete the porting procedure in accordance with the timelines and porting guidelines prescribed by the IRDAI.

Conditions

1. Portability of a health insurance plan shall only be possible at the time of renewal.

2. The insurer is liable for providing the waiting period credit. Apart from this, coverage, including the premium and terms and conditions, shall be in accordance with the filed policy terms and conditions.

3. When considering portability, the policyholder must notify the old insurer about the port at least 45 days before the policy renewal date. The policyholder must also specify the new insurer to which they wish to port to ensure coverage without a break during the porting process.

Did you know? There’s a 30-day grace period if portability is still in process after the policy expiry date. For instance, if your current health insurance plan expires before the portability process is completed, your accumulated bonuses are carried forward.

The IRDAI's portability guidelines have been regulated with the best interests of policyholders in mind. Let's examine a few examples to understand how portability works.

How Does Portability Work?

Before porting your health insurance policy, it is important to understand how it works to avoid technical hassles later. Below are a few aspects that you must understand about health insurance portability.

Health Insurance Portability and Its Impact on Waiting Period

Let’s understand how porting impacts the waiting period with an example:

Suppose you had health insurance with 7 lakh coverage for 2 years, and you decide to port the policy to 10 lakh coverage in the 3rd year. Then, the impact on the waiting period can be explained below:

Health Insurance Portability and Its Impact on Bonuses

Suppose you were insured under health insurance for 3 years with a sum insured of 10 Lakh, and then port your policy to Care Supreme. Upon renewing your policy for consecutive years, you gain the Cumulative Bonus and Cumulative Bonus Super in your coverage. Let’s understand how it affects the claim under various scenarios.

Sum Insured Before Porting = ₹10 Lakh

(Continuity benefit on waiting period applicable up to SI ₹10 Lakh)

Sum Insured After Porting = ₹10 Lakh

Then the accumulated bonuses and impact on the claim shall be explained as per the table below.

In conclusion, a fresh waiting period shall apply to claims arising from the Cumulative Bonus Super until the insured serves a three-year waiting period for the accumulated bonus. Whereas, the insured can claim coverage under the base sum insured, as they have already served a waiting period under their old insurer.

Port Your Existing Health Insurance to Get Better Care!

Porting your existing health plan with Care Health Insurance offers rewarding, more convenient benefits, such as a wide range of sum insured options, new-age coverage benefits, and a vast network of healthcare providers. Below are some reasons why switching to Care Health Insurance will be your best decision in planning your healthcare finances: 

#We offer optional benefits, such as Cumulative Bonus Super under our Care Supreme health insurance plan, which boosts coverage by 100% of the sum insured upon each renewal, maximum up to 5 consecutive renewals, whether or not you file a claim.

The plan also offers new-age benefits such as Be-fit benefit, Claim Shield, Cumulative Bonus Booster, etc., that offer the best coverage and rewards for staying fit!

How to Port Health Insurance Online in 4 Easy Steps?

Care Health Insurance is your one-stop solution if you're looking for a hassle-free port and a seamless health security option. Our in-house support ensures that you are guided at every step of porting your policy through these four easy steps:

1) Inform us Before Policy Renewal

Submit a portability request to our team before your existing policy's expiry date. Fill out the portability form, including all the asked details.

2) Submit the Portability Form. 

Please submit the duly filled-out portability form and self-attested copies of the previous year's policy schedule to our operations team. You must disclose all the medical history and ensure submission of the previous claim history, whether or not the claim was approved with the previous insurer.

3) Fill in the Proposal Form. 

Fill out the proposal form with complete details. Also, disclose your medical history and undergo pre-policy medical checks if the underwriter asks you to do so.

4) Complete Payment

Once your portability request is approved, you should pay the new health insurance plan’s premium through online payment methods. 

Documents Required for Porting Health Insurance

Below are the documents you need while porting the insurance policy:

Documents required from the existing policy-

• Previous year's policy certificates,
• Medical Reports, and the doctor’s certification for PED, if any,
• Renewal notice

Documents required at the new insurer

• Duly filled portability form
• Duly filled proposal form

Reasons Why Your Portability Request Might Get Rejected 

 We understand your need to protect your family from medical contingencies. However, specific rules from the IRDAI may cause the rejection of your portability request. The rules that are to be abided by are as follows:

 1) Porting an Expired Policy

The new insurer may reject your portability request if your current policy’s renewal date has expired. 

2) Porting After Policy Renewal

If you have already paid the current policy's renewal premium, you must wait for the next renewal before raising a portability request again.

 3) Health Risks Involved

The new insurer might consider the health risks before porting your insurance policy if you have critical pre-existing comorbidities and a complex medical and claim history.

4) Claim History

Your claim history can be another reason for a portability request rejection. Multiple claim rejections due to incomplete information at your previous insurer may result in rejection of your portability request.

Things to Consider Before Porting Your Medical Insurance

Keep in mind the following factors for effortless medical insurance portability:

• Check the Policy Terms & Conditions: The terms and conditions of the health policy may vary among insurers. Thus, it is crucial to understand the policy terms before finalising.
• Understand the Portability Process: Portability requests are scrutinised by underwriters. They follow the prescribed guidelines to assess risks and determine premium costs. Insurers consider higher age and health issues as factors for rejecting portability requests. In the event of acceptance, insurers may apply certain clauses and restrictions that policyholders must carefully review.
• Disclose Correct Information: You must always provide complete and correct information about your medical and claim history. Remember, a poor claims history is another reason for rejection of health insurance portability requests.
• Ensure Optimum Coverage: Lower premiums are among the foremost factors encouraging policyholders to port policies. However, this may lead to the insurer reducing their coverage amount, and policyholders might spend more. Hence, premium and policy coverage are critical factors when porting policies.