IRDA Guidelines for Health Insurance Portability
May 31, 2021

IRDA Health Insurance Portability Guidelines

Suppose you buy a new health insurance plan and within the next few days, you got sick and had to be hospitalized. When you went to claim for the treatment costs, the insurance company started oscillating you with different terms and conditions of the policy which cost you more time and effort. For such a case, the Insurance Regulatory Development Authority of India (IRDAI) offers policyholders a significant portability medium through which they can switch their insurance policy to some other insurer without losing any benefits. In this post, we will simplify the IRDA health insurance portability guidelines for you so that you can port your policy to a better insurance provider.

Health Insurance Portability in India Explained

Health insurance portability was first introduced in 2011 by the Insurance Regulatory Development Authority of India (IRDAI). According to it, an individual policyholder is entitled to port health insurance policy from one provider to another if the person is unsatisfied with their services or is looking for a better alternative. Portability safeguards the policyholder from being taken for granted by the insurer and provides them with more flexibility to choose the insurer as per their own preferences.

IRDA Health Insurance Portability Guidelines

The following are the IRDA guidelines for health insurance portability:
  1. Permitted Policies: An individual or a family can port their insurance policy to a new insurer. However, the policy can be ported only to a similar medical insurance policy type and no other insurance category.
  1. Renewal of the Policy: The process of portability of the policy can only be carried out at the time of renewal of the policy. Also, portability is only possible if your policy is running without any breaks. Any discontinuity in the policy may result in the rejection of the portability application.
  1. Type of Insurance Company: The policy can only be ported to a similar type of insurance company, whether it is a life insurance company or a general insurance company.
  1. Intimation Process: The IRDA portability guidelines suggest that a user must intimate their current insurer about the portability 45 days prior to the renewal of the policy. Failing this, the company can reject the user’s application.
  1. Fees for Insurance Portability: Fortunately, there is no fee for porting your insurance policy.
  1. Premiums and Bonus: Usually, the users get the full benefit of accrued and no claim bonus when porting the policy. Also, your premiums may be lowered with the new insurer as per their underwriting norms.
  1. Waiting Period for Pre-Existing Diseases: The waiting period for pre-existing diseases needs to be served according to the norms of the new insurer. However, it is only applicable if you are applying for an increase in the coverage amount.
  1. Sum Insured Clause: There can be an increase in the sum insured value at the time of portability if wished by the policyholder.
  1. Grace Period: An applicant is given a grace period of 30 days for renewal of the policy in case the porting of the policy is still in process.

What are your Rights as a Policyholder?

The IRDA portability guidelines give the policyholders some rights, which are as follows:
  • Any individual or family policy can be ported.
  • The new insurance company has to give you the credit that you have gained for pre-existing conditions with your previous insurer.
  • The new insurer must offer the sum insured value as per the previous policy or higher.
  • Both the insurers must complete the porting process within a set time frame, and the policyholder is entitled to question and know the process status.

Frequently Asked Questions (FAQs)

  1. Are the IRDA portability guidelines applicable for all insurance companies?
Yes, the guidelines must be followed by all insurers.
  1. Can we apply for portability for any health insurance product?
You can apply for any product provided the new policy product is of the same nature.
  1. Will I have to undergo all medical tests when porting to a new insurer?
It depends upon the norms of your new insurer. Conclusion Now that you are clear with IRDA health insurance portability guidelines and have complete knowledge of the process, you can opt for portability if you find it worthwhile. For more information, you can consult an insurance expert to discuss your case and get the right advice for more information.

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