subject: What Is Health Insurance Portability? [print this page] Portability means transferring your existing health insurance policy to a new insurer without loosing any of the benefits that your current health insurer provides. Credit Gained that can be transferred from one insurer to another includes waiting periods; waiting period of pre-existing diseases or time bound exclusions. Portability is allowed to all individual and family floater health insurance policies issued by all general insurance & health insurance companies.
Benefits of Health Insurance Portability for policy holders
You can expect good services from all insurers.
Better claim settlements from all companies.
New upgraded health insurance products.
Definitely lower or competitive premiums.
Portability will ensure that accrued benefits (including waiting periods; waiting period of pre-existing diseases or time bound exclusions) are transferred at par to the new insurer at the time of porting and you do not lose on these benefits while switching insurers.
The direction given by IRDA to insurers that it is essential to protect the policyholders against the discontinuity and consequential loss of pre existing disease cover by making the health insurance plans portable across the insurance companies.
Another benefit for pre existing disease is waiting period to be carried forward i.e. if a pre existing disease is being covered by a company is three years and the policyholders is with the company for two years, then for the new insurance company the waiting period will cover the pre existing period within one year. (If New insurance company also cover the same disease in three years).
Earlier there was compulsory waiting period of 30 days to get benefits from the health insurance policy which is gone now in case if you shift the policy.
Cumulative bonus can also be transferred in health insurance portability.
In group health insurance scheme after seeing the medical history & claims the insurer can provide the individual health insurance and this will be available for portability after one year. (Now you dont have to worry much about Should you buy mediclaim even if your employer is covering you)
Process of Health Insurance Portability
You have to apply in new insurance company at least 45 days before the policy renewal date of current insurance policy. (some cos. are saying 30 days).
You have to fill new insurance company proposal form along with portability form.
New health insurance company within 7 Days will ask old health insurance company about the policyholders details that include medical history & claim Benefits.
New Health Insurance Company has the right to reject the proposal of a policyholder seeing the medical history & claim, but if in case of the health insurance company do not reject the proposal within 15 days it means that the proposal has been accepted.
Documents required for portability (differ from company to company)
Copy of the Last year Policy Schedule issued by the previous Insurer OR Renewal Notice.
Self-declaration by customer regarding no claims made.
Question regarding previous and existing health insurance details in the Proposal Form should be mandatorily filled.
If there is a claim in existing policy, then discharge summary, investigation and follow up report copies.
If there is a past medical history, then consultation papers, prescription, investigation, treatment and report copies.
Grey areas in Health Insurance Portability
Features of Health Insurance companies are very different.
There is cooling off period of 1 year.
You can shift to another company only at the time of renewal.
In case you want to shift your group mediclaim you have to compulsorily move it to the same insurance company. After 1 year you can transfer it to any other insurance company.
For the preexisting disease the new company can charge loading on the premiums.
Maternity benefits that are normally available in group health insurance policies may not be available if switched to individual policy.
No clarity regarding top up medical insurance policies.
Loss of no claim bonus will be there for the policyholder who opts for portability as some companies dont provide no claim bonus or cumulative bonus.
What you should do now?
Health Insurance Portability looks a great idea but my suggestion is wait & watch. Dont jump on first day first show I did it in case of mobile portability (reliance to airtel) & my mobile was out of service for 20 days. Let insurance companies work on it & develop smooth process meanwhile you try to choose the best health insurance for you. May be your existing company upgrades their products or reduce the premiums soon.
by: Rajendra Bhatia
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