Delhi-based Arjun was recently hospitalized for Covid-related health complications. After recovering, he filed for claims with his health insurer. And to his surprise, the claim was rejected on the grounds that the mild covid symptoms didn’t warrant hospitalization. He decided to port to another insurer but was unsure about the process.
What’s the procedure?
Since 2011, consumers are allowed to port their health insurance policy if they are dissatisfied with their services and without any additional cost. It can be done by applying for porting with the new insurer – about 45-60 days before the renewal date of the existing policy. You can port from a family as well as a corporate health policy to another individual or family policy.
Many insurers are not asking for a medical check-up or to fill up forms all over again while resorting to porting. However, you might have to give a declaration of good health and make fresh disclosures on pre-existing health conditions.
Medical underwriting happens on the basis of existing health status. So, ensure you are making honest medical disclosures to avoid rejection of claims later.
On receipt of the porting request, the new insurer approaches your existing insurer to get further details regarding your medical and claims history.
Within 15 days, the new insurer usually communicates whether it accepts or rejects your porting decision. After 15 days, it has to compulsorily accept your request, as per regulations.
How does it work?
A new insurer has to provide a sum assured at least equivalent to the existing policy. However, the insured can ask for a larger sum assured at the time of porting.
Also, the new insurer has to give continuity benefits relating to the waiting period for pre-existing conditions. For instance, if you have bought a health policy for a sum assured of Rs 5 lakh three years back, and pre-existing disease has a waiting period of 4 years, then the waiting period will only be one year for the new policy.
However, if you have gone for a larger sum assured of Rs 8 lakh under the new policy, then the incremental sum assured (of Rs 3 lakh) will kick in only after a waiting period of 4 years.
While the No-Claim Bonus (NCB) of the existing policy gets transferred to the new policy as it is, the premiums need not remain the same. It is entirely at the discretion of the new insurer based on their underwriting risk estimates. For instance, they might ask for a co-pay or loading premium at the time of porting.
When to port your policy?
Lower premiums can help you save a lot over the long term. However, make sure you are comparing apples with apples by going through the fine print. While certain health policies might appear similar, sub-limits and exclusions can make a big difference in pricing.
Better product features
You should port if the new insurance policy’s features are compelling, and include some of the features that are critical for your family. These features can be, a hospital with zero or higher sub-limits on room rents, a wide network of hospitals or one that offers a better restore benefit. Some policies might also provide cover for a certain illness that is relevant to a family member.
You should move towards another insurer if you have poor service experiences, as well as transparency issues like a hidden clause. Ensure the new insurer has superior claim-settlement ratios.
Some insurers might not be willing to underwrite beyond a limit – say Rs 10 lakh of sum assured. Or have reservations for doing so in certain geographical or income brackets, while others might not.
If you have a justifiable reason to port start the application process for porting with the new insurer – at least 45-60 days before the policy due date.