Health Insurance Portability – Know Health Insurance Portability Rules, Meaning and Benefits etc.

Let’s evaluate the various features and benefits of Health Insurance Portability, starting with its meaning.

What do you mean by Health Insurance Portability?

Portability in health insurance is the right given to a policy owner to shift or switch the existing policy to another insurance provider without losing the benefits accumulated in the current policy. The various benefits that are accrued in a policy, such as No Claim Bonus (NCB), free medical check-ups, credit of waiting period etc., can be transferred from the existing policy to the new policy provider with the help of Portability in medical insurance.

Thus, Health Insurance Portability allows policy owners to migrate his/her policy to a better company if the person is not happy with the existing provider. However, to enjoy Health Insurance Portability, it is important to renew your policy every year without a break. If you have missed renewing your medical insurance in the past, you cannot enjoy the portability feature. Also, to port to another insurance company, you have to apply 45 days prior to the renewal date of your current policy.

Common reasons of Health Insurance Portability

• If the insured is not happy with the quality of the insurer.
• If the cover offered for a particular health condition is insufficient.
• If the process of claim settlement is slow and complex.
• If you are receiving your reimbursements late.
• If the insurer hikes the premium rate
• If there is lack of transparency in terms of hidden charges levied on you.
• If there are complex clauses of co-payment.
• If you receive a good deal from another insurance provider.

Rules of Health Insurance Portability and Accountability Act

There are many rules entrusted by IRDAI regarding the portability in insurance. These rules are expected to be followed by both policyholders and the insurance providers.

Below are the different rules laid down by IRDAI:

• Category – Type of policies allowed to port under health insurance portability.
• Rule – Only the same type of health policies are permitted to port in case of both family and individual policies.

• Category – Company type allowed to port.
• Rule – Can port from one general or specialized company to other general or specialized company.

• Category – Time required to port a policy.
• Rule – Portability is allowed just before the renewal time of the current policy and not during any other period.

• Category – Renewal of existing policy
• Rule – For using the benefit of portability, the insured person must renew the policy continuously without any break. If you have not renewed the policy in the past, you cannot claim the feature.

• Category – Intimidation about Portability
• Rule – Insured person must notify their insurance provider in writing with a 45 days’ notice period prior to the renewal date of your policy.

• Category – Acknowledgment
• Rule – Your insurance company is expected to accept and acknowledge the application within 3 working days

• Category – Charges
• Rule – No porting charge is levied on the insured

• Category – Premiums
• Rule – Premium might change even for similar policies. Elderly people might have to pay more after porting to new company.

• Category – Grace period
• Rule – 30-days grace period for renewal is allowed to the insured person in case they are willing to port and waiting for the new company’s approval.

• Category – Sum Insured
• Rule – It is the discretion of the policy owner if they want to increase the amount insured. But sum insured should be equal to the original amount insured in the previous policy.

• Category – Waiting period for existing diseases
• Rule – If the new policy has more waiting period as compared to the earlier policy, then the insured person has to complete the additional period of waiting. So, if you have served 3 years of waiting period in the old policy and the new policy has 4 years of waiting period, then you have to serve one year of the waiting period before you could enjoy the benefits of the new policy.

Health Insurance Portability Benefits

• You can safeguard your continuity reimbursements by using Health Insurance Portability.
• You can continue or preserve your credit for the waiting period.
• You can switch to a policy provider offering lower premium.
• You can port to an insurance company offering better services.

Health Insurance Portability Process

• You must apply 45 days prior to the due date of the existing policy renewal.
• You will receive a portability form from the new insurer once your portability request is received.
• The form will have details of different health policies.
• Choose the best one suiting your needs. Now fill the form accordingly and submit it to the new insurance provider.
• Once the form reaches the new company, they will approach your existing policy provider or go to the IRDAI portal to check various details.
• The new insurance company will take 7 work days to furnish and proceed with the details.
• Finally, the new insurance company will decide within 15 days whether to accept or reject your application.

Documents required for Health Insurance Portability  

 From the old insurance company:

• Policy certificates of the past year
• Renewal notice with details of coverage continuity
• Policy owner self-declaration on no-claim
• Important documents like investigation report, summery of discharge, etc.

From the new insurance company:

• Proposal form with details
• Portability form with details

Reasons for rejection of Health Insurance Portability  

At times the portability application might get rejected. Here are the reasons for the same:

• Insufficient information
• Delay in submitting the details
• Poor history of claims
• Non-availability of details of the previous documents
• Higher age factor
• Gap in policy renewal
• Adverse history of health