All that you need to know about Health Insurance Portability

Last Updated: Nov 08, 2011 | 166 Views

Health insurance portability is the right given to a health insurance policyholder to switch from one insurance company to another or from one plan to another. In the process of switching, the credit gained by the insured member for pre-existing diseases and time bound exclusions, no claim bonus etc also gets transferred.

Let us understand this with the help of an example: Kapil has a health insurance policy with ‘A’ company. His Sum Insured is Rs 4 lakhs and has Rs 50,000 as accrued bonus. When he shifts to the new insurance company ‘B’, this company has to offer Kapil a Sum Insured of Rs 4.5 lakhs. In case the company ‘B’ does not have a health policy of Sum Insured Rs 4.5 lakhs, then it must offer a policy of the nearest higher slab say Rs 5 lakhs but the portability would be available only upto Rs 4.5 lakhs. The premium will be charged as per the sum insured offered.  

Here are a few health insurance portability guidelines that you should know:

Ensure that there is no break in the policy. A break in the policy occurs when the premium is not paid on or before the renewal date or within 30 days thereof.

Policyholder must apply for portability at least 45 days before the premium renewal date.

On receipt of application for porting the policy, the insurance company will provide the applicant with

- Portability Form

- Proposal Form

- Relevant product literature on various health insurance policies that can be offered

Policyholder must fill the Portability Form and Proposal Form and submit it to the insurance company

Policyholder must not cancel the existing policy until the confirmation of new policy is received from the insurance company or unless specific request in writing is received from the insurer.

Within 7 days of receiving the Portability Form, the new insurance company will ask the existing insurance company for medical and claim history of the policyholder.

On receipt of the data, the new insurance company may underwrite the policy

If on receipt of the complete information if the insurance company does not communicate it to the policyholder within 15 days, then the company cannot reject the proposal and will have to issue the policy.

If the waiting period on the new policy is longer than that in the old policy for the same disease, then the additional waiting period must be clearly explained in the portability form.

Sameera Bootwala
Sameera Bootwala aggregates news on anything related to insurance in India. Keeps you updated.