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All You Needed to Know About Health Insurance Plan Portability

By Admin
16 May 2022, 5:58 PM
all you need to know about health insurance portability

Are you happy with your existing health insurance plan? Or do you have some issues regarding the same, which could be service or claim-related? If yes, then the Insurance Regulatory and Development Authority of India has introduced a feature called Portability of Health insurance Plans. With portability, the policyholder can port or transfer their existing health insurance plan to another health insurance provider without losing the benefits of existing health insurance plans.

This feature introduced by the IRDA, provides relief to dissatisfied customers and lets them transfer the plan to another health insurance company and avail themselves of better services without losing any accrued benefits.

What is Health Insurance Plan Portability?

The ‘Insurance Regulatory and Development Authority of India (IRDA)’ is an apex institute working towards the welfare and interest protection of the policyholders. The IRDA introduced the concept of health insurance plan portability in the year 2011 as a provision that allows the policyholder to switch and carry forward the existing health insurance plan benefits. Thus, when a policyholder ports a health insurance plan from one provider to the other, the waiting period and other continuity benefits are not lost. 

There are multiple benefits of porting a health insurance plan, which can be summarized as:

Benefits of Health Insurance Plan Portability

  1. Personalization: 
    The health insurance plan portability offers a chance to the policyholder to modify and choose their health insurance plan as per their current need. There could be a change in requirement for the policyholder in terms of health as well as financial requirement. With Health Insurance Portability, there is a facility to upgrade/change the offering as well with the new insurance company. Thus, the policyholder can personalize and customize his health plan at the time of porting the health insurance plan.
  2. Sum Insured: 
    As mentioned above, the policyholder can choose to upgrade and change his coverage requirement also at the time of health insurance portability. However, there would be a medical underwriting for the additional sum insured at the time of porting the plan.
    Thus, the policyholder gets the benefit of enhancing or increasing the coverage with an increase in sum insured along with accrued no claim bonus, along with change or transfer of the policy to the new insurance company.
  3. No additional waiting period: 
    The health insurance plan portability allows the policyholders to enjoy the benefits of their new health insurance plan instantly as there is no additional waiting period provided the sum insured is the same. 
    For example, if a particular policyholder has completed the waiting period under a specific plan and has then exercised the portability option, then under this scenario he would be able to get the coverage immediately.
    However, if a certain amount of waiting period, say 2 more years, is still remaining then the policyholder has to first complete the remaining waiting period(2 years) before enjoying the complete benefits of the plan with the new insurance provider.
    However, the additional sum insured might be accompanied by a fresh waiting period and that is decided by the medical underwriting department of the new insurance company.
  4. Better Customer Service: 
    With the increase in competition in the insurance sector along with the option of health insurance plan portability, it has opened doors for policyholders to choose an insurance provider that offers great customer service.
  5. Transparency: 
    With the health insurance plan portability facility, the customer can now switch their health insurance provider and plan with complete transparency. There are no hidden conditions or clauses in the same.
  6. Happy customers: 
    If any of the policyholders is unhappy with the plan features, benefits, premium, or claim settlement procedure, they can exercise the health insurance plan portability. One can easily switch to another health insurance provider that offers great customer service, a lower premium for similar coverage, or has a speedy health insurance claim settlement procedure.

Whatever be the reason, switching or health insurance portability is definitely a benefit for the policyholders!

Ideal Situations to Exercise the Health Insurance Plan Portability

Health Insurance Plan portability can be exercised by the policyholder depending upon their financial as well as health insurance needs. However, exercising the portability facility is best when the differential benefits offered by the prospective insurance provider best suit the current financial as well as health insurance needs. The following are certain ideal situations where exercising the health insurance plan portability facility has proved advantageous.

  1. Insufficient Sum Insured: 
    In case the existing health insurance plan is not offering adequate health insurance cover for particular health concerns then exercising the switch is advantageous as it allows the policyholder to be substantially insured. 
    Pro Tip: This is especially true if the existing insurer refuses to increase the sum insured of the plan!
  2. Poor Customer Service: 
    Poor customer service and delayed claim settlement process are two main reasons for policyholders shifting their health insurance provider. 
    Pro Tip: If the policyholder experiences a compromised service quality then it is natural to opt for a plan portability facility.
  3. More Economical: 
    In today’s digital world customers can easily explore and avail the features and facilities provided under other health insurance plans or by other health insurance providers. In a situation where the other insurance provider is offering better deals in terms of room rent, co-payment terms, illness coverage, etc. then the portability facility comes to the rescue as the policyholder can then avail better and economical service.

Eligibility Conditions for the Health Insurance Plan Portability

There are no specific eligibility conditions for exercising the health insurance plan portability facility. A policyholder can easily switch the insurance provider for the ‘In Force’ health insurance plan and all due premiums have been paid on time. 
But one must keep the following checkpoints in mind before exercising the portability facility.

Checkpoints for the Health Insurance Plan Portability

  1. The application for porting the health insurance plan to the prospective insurance provider must be made in writing at least 45 days prior to renewal.
  2. A detailed investigation from the underwriter team can be carried out by the prospective insurance provider for claim history, etc.
  3. There are certain scenarios like high age, inadequate/false information, or severe medical condition, porting of the health insurance plan might be rejected as well.
  4. Policyholders can exercise the portability facility for alike health insurance policies i.e. an indemnity health insurance policy can be ported to another indemnity health insurance policy from another insurance provider but a complete change may not be allowed.
  5. Only individual and family health insurance plans can be ported to the same policy type only.

Process of the Health Insurance Plan Portability

The following is the procedure exercised by the insurance provider in the case of the health insurance portability facility.

  1. Step 1: 
    Once a policyholder approaches a prospective insurance provider with a portability request, he/she is provided with a proposal form along with a portability form.
  2. Step 2:
    The policyholder has to fill in all the accurate details and submit the duly filled new proposal form along with the portability form to the new insurance provider along with his KYC documents, as necessary.
  3. Step 3:
    Once all the required documents are received by the new insurance provider, they contact the previous insurance provider and avail historical data related to claim history, medical history, etc. This information request is put through the IRDA’s common data-sharing website.
  4. Step 4:
    Upon receiving the request, the previous insurance provider must furnish and share all the necessary information with the new insurance provider at the earliest.
  5. Step 5:
    Once the new insurance provider receives all the information, they can underwrite the policy for a time frame provided. The new insurance provider must decide within this time frame. If the new insurance provider fails to decide within this time frame then the new insurance provider is obliged to accept the portability application.

Conclusion

This is a complete guide regarding the health insurance plan portability facility as offered by the IRDA. Hope it helps you to make an informed decision if you are contemplating porting your existing health insurance to a new insurer!

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