When it comes to insurance policies, we often find ourselves lost in the labyrinth of financial jargon and legal terminologies.

While insurance companies have a team of legal advisors and highly experienced salespersons, we have neither.

While they have fine print T&C written at the bottom of the policy papers, we rarely have the understanding to gauge the loopholes designed to safeguard the insurers.

So what do we do?

We approach insurance agents who are relatives or well-known amongst your other family members. But unfortunately, human behavior is unpredictable when it comes to a scope or shot at financial profits.

Let’s say you availed of health insurance coverage from a so-called family ‘friend’ because you think your relationship is a shield against being financially duped. He offers you a seemingly affordable premium that offers extensive coverage. You go on with the premium payments for an estimated 3 years before your first claim.

It’s coronary angioplasty. Say you are relatively well-prepared and approach a partner hospital. You now go under the knife knowing that you are looking at complete cashless financial coverage with a partner hospital. So, no pressure on the family. You have been financially responsible. But have you?

The time for your discharge comes. And your agent receives your call and tells you they will be paying 50% of the billed amount, which is 3 lakhs. And then the teeth and claws (read: finer prints, exclusions, and T&C) start emerging -

  • Room rent is capped at INR 1200/day (but you took up a room that charges INR 2500/day)
  • Disease Wise Sub-limits for cardio illnesses are capped at 3 lakhs.

And then, you find out from the hospital bill desk that you should have received the no-claim bonus for the 3 years and additional taxation benefits (as per Section 80D).

So, what should be your next step?

Other than burning that bridge with your so-called friend, opting for a health insurance portability request would be best.

However, you’ll now be much more cautious with choosing your next insurer, as you should be. You also need to know when and how to go ahead with the portability option, which factors can help you search for the best insurance provider, and more.

Take a look here, and you’ll have all the answers to your questions.

What is Health Insurance Portability?

Health insurance portability means shifting your current Health Insurance policy from one to another Insurance company based on the context of your requirement.

Why Should You Port Your Current Health Insurance Policy?

Health Insurance Cases
Let's say Mowgli has a health insurance plan (yes, even Mowgli has one! If you don't have one yet, read on here to know why you should be availing one ASAP!) Health Insurance Guide He paid his premium of INR 10,000 towards coverage of INR 10 Lakhs. Now, consider the following cases -
CASE Description
CASE 1: He finds inadequate caps on room type and room rents during hospitalization.
CASE 2: There are Disease Wise Sub-limits
CASE 3: There is an extended waiting period for pre-existing illnesses.
CASE 4: He had to undergo surgery in a hospital with no ties with his insurer. He faced delays in the reimbursement of the hospitalization charges.
CASE 5: Irrespective of whether he was admitted to a hospital with a tie-up or one that hasn't, Mowgli undergoes a cumbersome claim settlement process post-hospitalization.
CASE 6: Once a claim is made, there is no option for a swift restoration benefit on the sum insured.
CASE 7: In cases of treatments requiring less than 24 hours of hospitalization, he cannot avail of financial coverage.
CASE 8: After choosing to avail of health insurance coverage, Mowgli thankfully stays healthy for the next 3 years. He continues paying the same premium towards his preset coverage of INR 10 lakhs. However, here is what he missed out on - no claim bonus and a waiting period bonus on the cumulative bonus.
CASE 9: He faces unsuitable co-payment clauses on his existing plan. (What exactly are co-payment clauses? Read this article to know more about this and what should be the suitable clause for your plan.) Co-Payment in Health Insurance
So, if you face either all or any combination of these cases, it’s time you break up with your existing insurer and opt for one that suits your medical and financial requirements. And we can help you choose the perfect plan and steps to port to the new health insurance cover!

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How to Port to a New Health Insurance Policy?

Keeping in mind the convenience factor for policyholders, the IRDAI (Insurance Regulatory and Development Authority of India) offers a very easily accessible option to port your existing health insurance coverage to a new one with lucrative features.

Here, take a look at the steps to port to a new health insurer -

STEP 1: Research your next insurance policy and contact industry experts for relevant advice.
STEP 2: Apply for your health insurance portability to your new insurance provider (the portability application window starts 60 days prior to your policy renewal date).
STEP 3: Fill in the proposal and portability form provided by your new insurer.
STEP 4: Opt for a suitable health insurance plan with the new insurer and submit the aforementioned forms.
STEP 5: Keep certain documents handy (claim declaration or no claim declaration, and last insurance policy copies) and stay prepared to submit them if required to the underwriting team of the new insurers.
STEP 6: The new insurer approaches either the IRDAI website or your existing insurer to verify certain details, like your claim and medical history, with your last insurer.
STEP 7: The new health insurance company either accepts or rejects (based on a couple of factors mentioned below) your portability request within 15 days of applying.
(In case the new insurer can’t arrive at a decision in these 15 days, your portability proposal is automatically accepted.)

While the steps to port a health insurance policy are relatively simple, knowing when to port your cover is equally important. So, when should you port?

When Should You Port Your Health Insurance?

The portability window on your health insurance policy starts 60 days before the renewal date on your insurance plan. The window usually lasts 30 days before the policy renewal date. However, this varies based on the chosen insurance company.

However, make sure to start your research for your next insurance company well before the window for portability starts.

But considering that you have once experienced the issues that you can face with an unsuitable insurer, this time, you will be much more likely to be careful with choosing your next insurance company.

Here are a few tips on choosing your new insurance provider -

How Should You Choose Your Next Health Insurance Plan?

Choosing your next insurance plan becomes far more convenient once you know the features and perks that any premium health insurance company should offer. Here are a few that should help you with choosing your next plan -

  1. Optimum no-claim bonus that is a minimum of 50%
  2. Pre & Post hospitalisation coverage
  3. No caps on room type and room rent
  4. No co-payment clause
  5. Restoration benefits that have a minimum amount of 100%
  6. Shorter waiting periods on pre-existing illnesses.

In case you are looking for the details on the perks mentioned above, take a look at one of our previous blogs -

Health Insurance Guide

What are your Top Choices for your Next Insurance Provider?

As of recent, there has been an increased demand towards opting for health insurance covers considering the spiraling cost of healthcare. More and more people are becoming aware of the mandatory requirement of a financial security net to ensure premium medical attention without putting a dent in one’s savings.

Unfortunately, this also means that there are many more insurance players in the market. This increases the chances of potential policyholders getting more confused over the best plan.

Thus, our industry experts conducted a thorough market analysis to arrive at a few of the top health insurance providers in the market (the details of these companies are available on our blog -Best Health Insurance Companies in India )

Also, when choosing your next insurer, make sure to take into account the following determiners -

  • High claim settlement ratio
  • Network of partner hospitals
  • Extensive product portfolio and historical record of Insurance company
  • Excellent operational efficiency

What are the PROS and CONS of Health Insurance Portability?

PROS

  1. The waiting period is carried forward.
  2. He/she can now add a new nominee or opt for an additional cover on the availed policy.
  3. The waiting period served on the policy is carried forward to the new insurer.
  4. Policy Coverage (Sum Insured) can be increased.
  5. Ability to move to a better insurance company and plan
  6. Chances at a lower premium and a more transparent coverage policy and provider.

CONS

The only con in the case of health insurance portability is that the no-claim bonus earned from your current insurer cannot be carried forward to your next plan/insurance provider. However, you can still carry forward the waiting period bonus on the no-claim bonus amount.

Conclusion

Considering the long queue of pros for the health insurance portability option, policyholders can safely opt for this. However, remember to ask your insurance agent all the relevant questions to help you choose the best insurance company for your next policy. Also,  inform your existing policy provider about your decision to port and keep all the required documents handy.

Frequently Asked Questions

  1. Under what circumstances can an insurer reject the request to port my insurance policy?

    A. No coverage for certain pre-existing illnesses

If the new insurer does not offer coverage for a policyholder’s pre-existing illnesses, the proposal for portability will be rejected.

   B. The BMI of a policyholder

Body Mass Index or BMI is indicative of the current health conditions of the individual and the hospitalization chances of him/her. Thus, insurance companies are particular about the BMI range that is permissible in the case of health insurance portability.

2. What should I avoid while choosing my next insurance plan?

 A. ONLY online research for insurance plans

Just online research for the most suited health insurance coverage might be misleading. Insurance companies often leave out the exceptions and restrictions across the policy to fetch more policyholders.

In fact, it’s better to approach industry experts and unbiased insurance advisors for health insurance covers that are best suited to your financial and medical requirements.

 B. Relying on ‘family friends’ for insurance policies

As has been already established, when it comes to financial decision-making, it’s best to leave it to the experts and not rely on your personal relationships for such cumbersome decisions that might become a financial burden.