Health Insurance Portability Guidelines

On 1st October 2011, the health insurance portability guidelines issued by Insurance Regulatory and Development Authority to bring relief to mediclaim policyholders who wanted to switch from their current insurance service provider to another insurer without breaking its continuity and advantages.

But, the insured person needs to consider some issues before he or she takes a decision to port his or her existing policy. Policyholders need to be aware of some important portability guidelines to make an informed decision.

  • Notice Period

Those who want to port their policies need to apply to a new insurance company in India before 45 days from the expiry date. Due to the flexibility offered by IRDA, the new insurance service provider can accept the proposal even if the application is submitted less than 45 days of renewal date. Generally, insurers insist on health check-up for policyholders who are above 45 years of age.

The application qualifies as a non-medical proposal and therefore, the portability application in such scenarios are accepted up to 21 days before the expiry date. Hence, insured person needs to begin the porting application procedure considering the above deadline.

  • Acceptance Period by New Insurer

After submitting the application with necessary documents to the new insurer, communication about acceptance or proposal status need to be provided to the applicant within 15 days of submission else insurer has to accept the application. The applicant can request his or her current insurer to give short-term health insurance coverage in case delay in processing the proposal and pay a pro-rate premium for it.

  • Internal Evaluation Process of a Policy

This process is also called as underwriting process. All insurers have their standard underwriting procedure based on their terms offered to insured people. Insurance companies in India consider disclosures on health and evaluate the health check-up reports to come at a conclusion. Some insurers accept diabetic or some major critical ailments cases. The applicant has right to accept or reject the new terms.

  • Waiting Period

Each online health insurance policy usually includes 3 categories of waiting period clauses. The first waiting period is of 30 days for fresh plans and the second phase is of 1-2 years for common ailments like kidney stones, hernia, appendicitis etc. The third category of the waiting period is of four years for pre-existing diseases.

If you switch a policy after two years to a new insurer having the same waiting period, then policyholder will be exempted from the 30 days and the two-year waiting periods. So, he will get only second clause waiting period. Those who already completed two years in earlier health insurance plan will have to wait for another two years to claim.

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