Health Insurance Portability: Important Clarifications

Health insurance portability is the ideal way to switch to a new insurer without losing accumulated benefits like waiting period credits and no-claim bonuses.

In fact, with a rapid rise in health insurance premiums by nearly 25% for around 52% of the policyholders in recent years, as reported by The Economic Times, choosing a cost-effective policy with better coverage has become more important than ever.

If you are planning to switch to a new policy, continue reading to explore IRDAI's guidelines on portability, how to apply for it, and its limitations.

When is the Right Time for Porting of Health Insurance?

The right time for porting your health insurance is typically 30 to 45 days before your policy renewal date. However, apart from the timeline, you must consider the following circumstances for health insurance portability:

Evolving Medical Needs

With growing age or an increase in family size, people will require a plan with better network hospitals or higher coverage. You may need a higher sum insured, maternity benefits, critical illness cover, or access to a wider network of hospitals.

Dissatisfaction with Current Policy

If you are facing issues settling your insurance claim or have insufficient sum insured, poor customer service or a lack of transparency from your current insurer, it is better to switch as early as possible. However, remember it is always ideal to use online tools to compare different healthcare policies for finding the best policy.

Need for More Cost-Effective Premiums

A health insurance plan with lower premiums and a wide range of coverage benefits is what every policyholder looks for. Therefore, in case your current premium is high compared to similar plans offering better features, health insurance portability will let you secure a better plan with better value for money.

Limited Network Hospitals

Only at the network hospitals can you get the cashless treatment benefits. This is why, with this benefit, you can port a health insurance policy to a provider with a stronger hospital network. In fact, while relocating to a new city where your current insurer has limited service support, switching may offer better convenience.

Better Add-on Benefits Elsewhere

Along with standard coverage, you should also consider add-on benefits, such as maternity coverage or wellness rewards, to obtain a more comprehensive medical assistance. So, if your current provider is not providing these facilities, porting is the best option.

Also Read: What is Comprehensive Health Insurance? Benefits and Coverage

What are the Steps to Port Health Insurance Online?

To smoothly transfer your health insurance policy to another insurer, you have to start by informing your current insurer. The subsequent steps will follow:

Step 1: Submit your portability request to your preferred new insurer. Later on, they will provide you with a proposal and portability forms. Here, you can find details about their available health insurance plans.

Step 2: Choose the health plan you wish to port to. Therefore, submit the duly filled proposal and portability forms to the new insurer.

Step 3: Once your application is submitted, the new insurer will contact your previous insurer to get details, such as your claim history, medical records, etc.

Step 4: Within 7 working days, your current insurer will provide all requested details through the Insurance Regulatory and Development Authority of India's (IRDAI)  common data-sharing portal. If they delay in sharing information, your new insurer can also hold your health insurance portability request.

Step 5: You will get to know about your new insurer’s decision on accepting or rejecting your portability request within 15 days.

Documents Required for Porting a Health Insurance Policy

The section below outlines the list of documents the policyholder, new insurer and current insurer need to submit to ensure health insurance portability:

From the Policyholder 

1. Completely filled out the portability and proposal form

2. Policy documents of the existing health Insurance policy.

3. Identity and address proof, such as Aadhaar, PAN, Passport, etc

4. Medical history records and past prescriptions

5. Details of previous claims.

From New Insurer

1. Provide portability and proposal forms

2. Product details and policy terms

3. Recent Medical examination reports of the policyholder(if required)

From Current Insurer

1. Renewal notice with a mention of continuity in coverage.

2. Self-declaration by the policyholder in case of no claim.

3. Policy certificates of previous years.

4. Medical documents, such as a discharge summary. (if any claims have filed)

What are the Rules of the Health Insurance and Portability Act of IRDAI?

On regulation 17 (iv) and clause 16 of Schedule 1 IRDAI Regulations 2016, guidelines related to health insurance portability have been clearly mentioned.

Read the table below to understand the rules related to the Health Insurance and Portability Act:

Important Tip: If your insurer is not following any of the above-mentioned profitability rules, you have every right to file an official complaint at the IRDAI Bima Bharosa System portal.

Also Read: What is Loading in Health Insurance? Everything You Need to Know

What Benefits Can You Get While Porting a Health Insurance Policy?

With medical inflation in India rising by 12% to 15% annually, porting to a better health insurance plan can help you obtain stronger financial protection.

Now that you understand the steps and regulations, explore its advantages to make a smart decision for your healthcare needs.

Access to Better Coverage

With health insurance portability, you can switch to a policy that offers broader coverage and quality treatment at a wide network of cashless hospitals. This is highly beneficial for growing young families who might require specialised medical facilities such as maternity benefits. 

No loss of  No Claim Bonus

In case you have accumulated no-claim bonuses to increase your sum insured for claim-free years, it will be transferred to your new policy. For instance, if your NCB is 20% under your existing individual health insurance of ₹25 lakh, you will receive the exact 5 lakh NCB bonus to your new policy after portability.

Retention of  Waiting Period

The primary advantage of porting health insurance is that your waiting period would be carried over to the new policy.

For example, imagine your first policy has a waiting period of 4 years for knee replacement surgery. If you port to a new healthcare policy after 3 years, you have to serve only the remaining  1 year of the additional waiting period in the new policy.

Helps in Getting Low Premium

Through the health insurance portability process, you can switch to a similar coverage with a lower premium. Especially if your current policy consists of senior citizens, porting can help you secure better benefits while reducing the premium burden. This way, you can get continued coverage without compromising on essential healthcare needs.

What are the Limitations of Health Insurance Portability?

Health insurance portability generally allows policyholders to switch insurers at a cost-effective premium without much hassle. However, there are also certain limitations of this clause that you must know to make a more informed choice.

1. Similar Policy Requirement: Since porting of health insurance is generally allowed only between similar policy types, the flexibility to choose is less. 

2. Limited to Renewal: Portability is not allowed throughout the policy year means you have to wait till your existing health insurance policy's renewal.

3. Loss of Benefits During Porting: If you decide to port to group insurance policies from individual policies, you may lose their specialised benefits like OPD cover or organ donor cover.

4. Strict Application Timeline: No matter how urgently you want to transfer your policy, it can not be done if you cross the 45-day timeline.

5. Pre-existing Conditions Review: For serious health conditions or frequent claims, you may have to pay higher premiums or get coverage exclusions in the new policy.

Why Should You Port Your Existing Health Insurance to Bajaj General Insurance?

When it comes to trusted protection, porting to Bajaj General Insurance will help you get some incredible benefits, which are as follows.

Fast Claim Process

We focus on making your claim process quick and efficient. Whether you want a cashless claim or a reimbursement claim, with fast verification, you receive the necessary funds without undue stress or delay during your medical emergency.

Specialised Plans for Women

Bajaj General Insurance have designed a specialised health insurance solution under our ‘World of Women’ plan. Under this facility, every woman will get protection for their specific medical conditions, including pregnancy, PCOS, or even for chronic illnesses like breast cancer.

Round-the-Clock Assistance

In case you face any issues or have a query related to your health insurance plans, our 24/7 customer service will provide instant help whenever you need. You can contact us at our toll-free number, 18002095858, or email us at careforyou@bajajgeneral.com.

Wide Range of Products

Our wide range of products and specialised add-ons for health insurance plans will help you get all-around protection. No matter if you want an individual plan or a family floater plan, you will receive an instant insurance quote based on your health care needs. This way, you can choose the best coverage as per your budget.

Over 1800+ Network Hospitals

Under our over 18,400+ network hospitals, you can receive quality treatment from any part of India. With this facility, we wish to decrease your financial burden of upfront payment at the time of need.

Additional Coverage Benefits

We have designed some specialised add-on coverage to help enhance your financial protection with evolving healthcare needs. For instance, our non-medical expense rider will cover the cost of consumable medical items, such as gloves, syringes, and bandages during treatment, up to a specified limit.

Also Read: Claim Adjudication in Health Insurance

Final Words

With the above guidelines, you can understand the timelines, criteria and documentation required for health insurance portability.

In case you are looking for a new insurer with comprehensive healthcare coverage, contact Bajaj General Insurance now! From ambulance cover to domiciliary hospitalisation, our all-round protection will help you fight every unexpected medical crisis without draining your savings.

Frequently Asked Questions

Is portability allowed in a critical illness policy?

Yes, portability is allowed in critical illness policies. However, you can only port between critical illness policies, not to any standard individual or family floater plan.

Can I port my policy with pre-existing diseases?

Yes, you can port your health insurance policy with pre-existing diseases (PED). Nevertheless, the new insurer can increase the premium amount or adjust the sum insured after assessing the health risk of the policyholder.

Is there any chance of rejection of health insurance portability?

Yes, the new insurer can reject your portability application based on their specific policy clause. In most cases, the application can get rejected if the policyholder has high-risk medical conditions, poor claim history, age restrictions, or fails to meet application deadlines.

Is medical insurance portability allowed in offline mode?

Yes, you can initiate medical insurance portability in offline mode. All you have to do is visit your new insurance company's nearest branch office or contact their customer service helpline.

Can I cancel my health insurance portability request after submitting documents?

Yes, you can cancel your health insurance portability request after submitting documents if a new policy has not yet been issued or is still in the free-look period. While withdrawing your application, try to be in touch with your old insurer to ensure there is no break in coverage.

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