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Thursday, 12 October 2017

Health Insurance

         Health Insurance Portability

Rajesh was not too happy with his health insurance company, who had canceled his genuine claim last year. Now, the health insurance was up for renewal in some month's time and he was looking at cancelling the policy and purchasing a better one but he was worried about the lost credit of waiting periods and pre-existing exclusions. When I met him on a cup of tea once in a while, he shared his dilemma and when I told him about health insurance portability, I could see a gleam in his eyes and he had all the ears on it.

Rajesh is one of the hundreds or thousands who see the renewal premium notice every year and get in confusion. In this post, let us understand the finer nuances of health insurance portability and how you can make the best use of it.

Meaning of health insurance portability

IRDAI is the regulatory body for insurance in India. As per its guidelines on Standardization of Health Insurance released on February 20, 2013, and as amended on July 03, 2013, portability is defined as: "Portability means transfer by a personal health insurance policyholder (including family cover) of the credit earned for pre-existing conditions and time-bound exclusions if he / she chooses to switch from one insurance to another "

In 2013 itself, the IRDA released a very comprehensive and customer friendly health insurance regulations wherein it was made mandatory that all health insurance policies in India will be portable. Schedule I of the regulations for the detailed process along with timelines to be followed by all parties: insured, existing insurance and new insurance, to carry out the activity According to health insurance regulations, following health insurance policies will qualify for portability:

All individual health insurance policies issued by non-life insurance companies, including family floater policies

Individual members, including the family members covered under group health insurance policy of a non-life insurance company can migrate to the same health insurance policy as the same insurance company and then the right to portability as described above. When a person buys a health insurance policy and is not very happy with it, the biggest concern is the second policy, the loss of credit and the pre-existing related exclusions. So, what does the portability mean? Similar to mobile number portability where you can port (or say shift or transfer) your mobile number to another provider without causing hassle to change in your number, as well as the same as your health insurance policy to another insurer. waiting periods and pre-existing related exclusions

Process of health insurance portability

First and foremost: You can apply for portability of your health insurance planBEFORE 45 days of your renewal due date. If you are breach this timeline, the insurer who wants to pay your policy, may decrease your application. So, once you've decided on porting your insurance policy, new insurer within time frame, the process is as follows:

You have to fill the standard portability application form with the proposal form for the new policy which will be downloaded from new insurance company.

Submit both the forms to the new insurer's branch office.

The new insurer will review the form and seek details of claim history and medical records from your existing insurer (this will be done through the IRDA's web portal)

The existing insurer will provide the requested data to new insurer within 7 working days of receipt (note: if the existing insurance company takes more time, it will be eligible as a violation of the Insurance Act).

On receipt of medical and claim details, new insurer will review the proposal as per its underwriting terms and it is to decide its decision. Note that new insurer has a right to even decline your case, if it does not fit new insurer's underwriting guidelines.

Also, if new insurer doesnt give a decision within 15 days, it can not be canceled.

                  Thanks For Reading
                      Have A Nice Day

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