Health Insurance Portability in India Explained

Health insurance portability was introduced in 2011 by the Insurance Regulatory and Development Authority of India (IRDAI), allowing individuals to switch their health insurance policy from one insurer to another if they are dissatisfied with the current provider. This gives policyholders greater flexibility to choose an insurance company that suits their needs without losing the benefits they have already accumulated.

IRDA Health Insurance Portability Guidelines

Here are the key guidelines for health insurance portability as set by IRDAI:

1. Permitted Policies: An individual or family can transfer their health insurance policy to a new insurer, but the policy being ported must be of the same type. For example, you cannot port from a critical illness policy to a hospitalization policy.
2. Renewal of the Policy: The portability process can only be initiated at the time of policy renewal. Moreover, your policy must be continuous, with no lapses. If there is a break in the policy, the portability request may be denied.
3. Type of Insurance Company: Porting is allowed only to an insurer of the same type, whether it is a life insurance company or a general insurance company.
4. Intimation Process: Policyholders must inform their current insurer of the intention to port the policy at least 45 days before the policy’s renewal date. Failure to do so could result in the insurer denying the portability request.
5. Fees for Insurance Portability: There are no fees associated with porting your insurance policy to a new insurer.
6. Premiums and Bonus: When transferring the policy, the policyholder can retain the full benefit of any accrued no-claim bonuses. Additionally, premiums with the new insurer may be reduced according to their underwriting guidelines.
7. Waiting Period for Pre-Existing Diseases: The waiting period for pre-existing diseases will need to be fulfilled according to the new insurer’s rules, particularly if there is an increase in the coverage amount.
8. Sum Insured Clause: If the policyholder wishes, they may increase the sum insured when porting the policy.
9. Grace Period: If the porting process is still underway, a grace period of 30 days is provided to complete the renewal.

Rights of Policyholders

The IRDA guidelines offer the following rights to policyholders:

• You are eligible to port your individual or family policy.
• The new insurer must acknowledge the credit for pre-existing conditions from your former insurer.
• The new insurer must provide a sum insured value that is at least equal to or greater than your previous policy.
• Both insurers are required to complete the portability process within a defined time frame, and you have the right to track and understand the status of the process.

Conclusion

Understanding the IRDA health insurance portability guidelines empowers you to make an informed decision about transferring your health insurance to a provider that better meets your needs. For personalized guidance, consulting an insurance expert is recommended.