Health Insurance Portability
span>Share:With the onset of health insurance portability, people now have the freedom to switch from one insurer to another carrying forward all the benefits of their previous health insurance policy. Portability will enable transfer of credit gained by the insured for pre-existing conditions and time bound exclusion if the policyholders choose to switch from one insurer to another or from one plan to another plan of the same insurer provided the previous policy has been maintained without any break. Insurers can be switched to only if the policyholder has held it for one year. Under the new guidelines, a policyholder will have to initiate the portability process 45 days before his policy with the old insurer expires or becomes due for renewal. No-claim bonus can be carried forward to the new insurer. All benefits of the waiting period will get transferred. Cumulative bonus comes under benefit of porting.
1. What is Portability? Is portability applicable for all the health products?
Ans. Under Portability the health insurance customer can switch from one insurer to another insurer, the credit on continuity of the coverage would be passed on from the previous insurance policy to the new insurance policy.
Continuity can be passed on from products with similar risk covered, for e.g Portability can be opted from Hospitalization policies popularly known as mediclaim policies to mediclaim policies
2. What continuity do I get under portability?
Ans. After the UW process if the proposal is accepted continuity would be given for all the waiting periods under the policy, including the waiting period for pre-existing illnesses.
The continuity would also be given on the time bound exclusions, for e.g. most of the policies exclude the joint replacement surgeries for a period of 3-4 years, with portability the continuity would be considered for these conditions also
3. What is the recommended process for portability?
Ans.
Once you have decided to port the policy, look at the various insurance products
Visit the web sites & study the various policies
Understand your requirement & compare the products
Check the waiting periods, capping, co-payments & exclusions under the policy
Select the product which meets your requirements
Approach the insurance company at least 45 days prior to the policy expiry date
Collect all the details from the agent
Fill the proposal form completely without leaving any field blank
Disclose all the information correctly on the proposal form
Submit the proposal form with the insurance company
If any further information is required from the previous insurer the new insurer will request for the same on the IRDA portal
On receipt of data from the previous insurer the new insurer will process the proposal further & inform the decision to the customer within working 15 days.
If you agree with the proposed terms & conditions of the new insurer premium should be paid without any further delay
On receipt of the premium from the client the policy would be issued with continuity & dispatched
Please check for all the details on the policy schedule
Now you are successfully enrolled with the new insurer under portability
4: Will I need to undergo medicals again? After the medicals are conducted by the new insurer, there is a positive finding in the medical reports, what would be the decision of the new insurer?
Ans. This depends on the Underwriting guidelines of the new insurer, if so the insurer will inform you accordingly please ensure the tests are conducted within the given time frame.
The new insurer would take the decision as per the UW guidelines decided by the company, if the proposal is accepted the terms & conditions would be informed to the customer. If the illness is not pre-existing exclusion would not be applicable. However the insurer has the discretion to either accept or reject the proposal
5. If I want to port my policy to your company what documents I need to submit?
Ans. The documents required are
a) Previous policies (The no. of years continuity will be subject to the policies submitted)
b) Claim experience in detail
c) Proposal form
d) Age proof
e) If any positive declarations discharge card, investigation reports, latest prescriptions & the clinical condition
6. What about the Portability with regard to individual floater policy?
Ans. Portability is applicable from Individual Health Guard to Family Floater Health Guard policy & vice versa
7. Can I change my Sum Insured while changing the insurance company?
Ans. Yes you can apply for revised SI with the new insurer, however acceptance would be at the discretion of the new insurer
8. If an insured has an earlier policy from 1-Jan- 11 until 31-Dec-12, Can he port from 1-Mar-11, i.e. can he port midyear?
Ans. Portability can be applied at the renewal only, he cannot apply for portability midterm of the policy
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