Health Insurance Portability Rules: Rules, Steps and The Right Time to Port

Based on the latest health insurance portability rules set by the Insurance Regulatory and Development Authority of India (IRDAI), policyholders must initiate a policy switch within 30 to 60 days of the renewal. According to a report published in the Economic Times, policyholders covered for a longer period experience smoother policy porting. 

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

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.

हेल्थ इंश्योरेंस पोर्टेबिलिटी क्या है?

Health insurance portability is a feature that allows policyholders to switch from one health insurance company to another without losing certain benefits accumulated under their existing policy.

Introduced by the Insurance Regulatory and Development Authority of India (IRDAI), portability allows individuals to switch to a plan that better suits their healthcare needs while retaining continuity benefits, such as waiting period credits and no-claim bonuses, subject to policy terms and conditions.

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. Failing to share the required information may prompt the new insurer to underwrite based solely on the available information, as per regulatory guidelines.

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

इसे भी पढ़ें: Important Rules on Health Policy Portability

When is the Right Time to Port Health Insurance?

If you are wondering, “Can I port my health insurance anytime?” Then, the answer is no. 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

As people age or family sizes increase, they may 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, have insufficient sum insured, or experience poor customer service or a lack of transparency from your current insurer, it is better to switch as early as possible. However, remember that it is always ideal to use online tools to compare different healthcare policies and find the best one.

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, if your current premium is high compared to similar plans with 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. If your current provider does not offer these facilities, porting is the best option.

इसे भी पढ़ें: What is Comprehensive Health Insurance? Benefits and Coverage

Key Things to Know Before Porting Your Health Insurance Policy

Before initiating a portability request, consider the following points:

1. Portability is generally allowed only at the time of policy renewal.

2. The request should typically be submitted between 45 and 30 days before the renewal date.

3. Waiting period benefits already served under the existing policy may be carried forward to the new insurer.

4. No-claim bonus benefits accumulated under the previous policy can also be transferred, subject to applicable rules.

5. The new insurer may conduct an underwriting assessment before approving the request.

6. Premiums, policy features, and coverage benefits may differ from your existing plan.

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. 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 been filed)

Are you looking for good health insurance in India? Then, visit the official website of Bajaj General Insurance or download the Bajaj General App to explore different स्वास्थ्य बीमा योजनाएं. Here you will find details from policy brochures, allowing you to easily compare coverage and premiums before buying.

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 may require specialised medical facilities, such as maternity care.

No loss of No Claim Bonus

If you have accumulated no-claim bonuses to increase your sum insured for claim-free years, they 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 4-year waiting period 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 maintain coverage without compromising 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, which 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 offers the following incredible benefits.

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 funds you need 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.

राउंड-द-क्लॉक असिस्टेंस

If you face any issues or have a query related to your health insurance plans, our 24/7 customer service team will provide instant help whenever you need it. 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. Whether you want an individual plan or a family floater plan, you will receive an instant insurance quote tailored to your health care needs. This way, you can choose the best coverage as per your budget.

Network Hospitals Spread Across Globe

With our network of hospitals spread across the globe, you can receive quality treatment from anywhere in the world. This facility reduces your financial burden by eliminating the upfront payment at the time of need.

Additional Coverage Benefits

We have designed specialised add-on coverage to enhance your financial protection as your healthcare needs evolve. 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.

इसे भी पढ़ें: ग्रुप हेल्थ इंश्योरेंस से इंडिविज़ुअल हेल्थ इंश्योरेंस में पोर्ट कैसे करें?

What are the Health Insurance Portability Rules of IRDAI?

If you are asking, “What are the health insurance portability rules?”, then here is your answer. Under regulation 17 (iv) and clause 16 of Schedule 1 of the IRDAI Regulations 2016, guidelines on health insurance portability have been clearly stated.

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.

अंतिम विचार

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

As per the health insurance portability rules, a policyholder must initiate the porting process between 30 days and 60 days before the renewal.

In case you are looking for a new insurer with comprehensive health insurance 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.

अक्सर पूछे जाने वाले प्रश्न

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 or adjust the sum insured after assessing the policyholder's health risk.

What are the Health Insurance Portability Rules?

As mentioned in an Economic Times report, the latest IRDAI portability rule requires submission of a portability request 30 to 60 days before policy renewal. Policyholders need to compare coverage benefits, waiting periods, exclusions, network hospitals, and premium costs before switching and ensure there is no break in coverage during the portability process.

Is there any chance of rejection of health insurance portability?

Yes, the new insurer can reject your portability application under its 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 I submit the 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.

Can Your Health Insurance Portability Request Be Rejected?

Yes, the new insurer has the right to accept or reject a portability request after evaluating the application. The decision is based on factors such as the applicant's age and health condition, pre-existing diseases and medical history, previous claim records, the new insurer's underwriting guidelines, and so on.

*मानक नियम व शर्तें लागू.

Insurance is the subject matter of solicitation. For complete details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.

डिस्क्लेमर: इस पेज पर मौजूद जानकारी सामान्य है और केवल जानकारी और स्पष्टीकरण के उद्देश्यों के लिए शेयर की गई है. यह इंटरनेट पर मौजूद सामान्य स्रोतों पर आधारित है और इसमें बदलाव हो सकते हैं. कृपया कोई भी निर्णय लेने से पहले एक्सपर्ट से परामर्श करें.

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