Portability Frequently Asked Questions (FAQ's)

What is Portability?
Under Portability the health insurance customer can switch from one insurer to another insurer, the credit on continuity of the coverage would be passed on from the previous insurance policy to the new insurance policy.

Is portability applicable for all the health products?
Continuity can be passed on from products with similar risk covered, for e:g Portability can be opted from Hospitalization policies popularly known as mediclaim policies to mediclaim policies.

Is there any age criterion to be eligible for portability?
The entry age depends on the new policy terms & conditions & guidelines.

What continuity do I get under portability?
After the UW process if the proposal is accepted continuity would be given for all the waiting periods under the policy , including the waiting period for pre-existing illnesses & The continuity would also be given on the time bound exclusions, for e:g most of the policies exclude the joint replacement surgeries for a period of 3-4 years, with portability the continuity would be considered for these conditions also.

Under what conditions I should port my health policy?
1. Study your existing health insurance policy & also the company records
2. If you are not satisfied wither with the services / coverage's, think of porting the policy
3. You will have to initiate the process at least 2 months prior to the policy expiry date.

What is the recommended process for portability?
» Once you have decided to port the policy, look at the various insurance products
» Visit the web sites & study the various policies
» Understand your requirement & compare the products
» Check the waiting periods, capping, co-payments & exclusions under the policy
» Select the product which meets your requirements
» Approach the insurance company at least 45 days prior to the policy expiry date
» Collect all the details from the agent
» Fill the proposal form completely without leaving any field blank
» Disclose all the information correctly on the proposal form
» Submit the proposal form with the insurance company
» If any further information is required from the previous insurer the New insurer will request for the same on the IRDA portal
» On receipt of data from the previous insurer the new insurer will Process the proposal further & inform the decision to the Customer within working 15 days
» If you agree with the proposed terms & conditions of the new Insurer premium should be paid without any further delay
» On receipt of the premium from the client the policy would be Issued with continuity & dispatched
» Please check for all the details on the policy schedule
Now you are successfully enrolled with the new insurer under portability

Will I need to undergo medicals again?
This depends on the Underwriting guidelines of the new insurer, if so the insurer will inform you accordingly Please ensure the tests are conducted within the given time frame.

If I want to port my policy to your company what documents I need to submit?
The documents required are
» Previous policies (The no. of years continuity will be subject to the policies submitted)
» Claim experience in detail
» Proposal form
» Age proof
» If any positive declarations – discharge card, investigation reports, latest prescriptions & the clinical condition.

Will I get Cumulative Bonus under portability?
The cumulative bonus will be clubbed with the SI, & premium has to be paid for the SI + CB. Continuity will be given on SI +CB For E:g: The insured has applied for renewal from XYZ Company with SI 2 lacs & has earned 25% Cumulative Bonus. The Total limit of indemnity under the expiring policy is Bajaj Allianz General Insurance Company Ltd 3 Rs250, 000/- (SI +CB), he can apply for SI 3 lacs with us as the option of SI 2.5 lacs is not available in our products. The premium would be collected for SI 3lacs, if the proposal is accepted the continuity would be given for SI 2.5 lacs only.

After the medicals are conducted by the new insurer, there is a positive finding in the medical reports, what would be the decision of the new insurer?
The new insurer would take the decision as per the UW guidelines decided by the company, if the proposal is accepted the terms & conditions would be informed to the customer. If the illness is not pre-existing exclusion would not be applicable. However the insurer has the discretion to either accept or reject the proposal.

What is the status of cheque bounce cases after acceptance of portability applied after 45 days and do not pay back?
The terms, conditions, guidelines of the new insurer will be applicable. If the new insurer is not providing any discount the same would not be applicable.

Whilst refusing portability, whether detailed reasoning for refusal will have to be Provided?
If any proposal is declined either under portability or for a new customer a proper Justification would be provided.

Why medical test is required at least for proposal with insurance policy of 4yrs and above as we are covering pre-existing diseases after 4 yrs?
This is as per the std UW guidelines decided by our company for portability cases.

Whether any fresh condition /exclusion may be put for proposers with insurance cover of more than 2/ 4 yrs?
This will be decided as per the details of the proposal & medical test reports

Will there be any loading on premium in case of any adverse history?
In an insurance policy, the deductible or excess is the portion of any claim that is not covered by the insurance provider. It is normally quoted as a fixed amount and is a part of most policies covering losses to the policyholder. The deductible must be "met", that is, paid by the insured, before the benefits of the policy can apply.

What does the term Reinsurance mean?
In case of adverse medical history loading may be applied as per std guidelines of the product ( filed with the IRDA).

In case of GMC, how many yrs continuity Cover will be given in case if policies a re not continuously with one insurer? What is going to be modality?
Portability can be given for Own GMC to own retail policies only. Continuity would be given for the period of coverage with our GMC policy.

When portability is given then why medical tests mandatory for age 45 yrs & above? Otherwise what is the meaning of Portability?
Medical tests are recommended to asses the current health status of the client.

What about the Portability with regard to individual floater policy?
Portability is applicable from Individual to Floater policy & vice versa.

What about the Banca products in case of portability?
Portability is applicable for banca products also, circulated in the product guidelines.

If client does not declare the claims in the proposal form which incurred with existing insurer and we get a clean chit from existing insurer. Later when there is claim reported which mentions about the pre-existing illness? What is our stand in such case.
In this case the non-disclosure clause would be applicable, as the policy is issued based on the proposal form declarations, the client has to provide all the details of the illness/ diseases/ injury prior to our policy.

If the insured is covered with Insurer A in GMC for 10 years and now covered with retail policy of Insurer A in 11thyear. a) Will Pre-existing be covered? (PED is covered after 4 years of continuous policy in insurer A retail product)? b) If in the 12th year, he is covered with Insurer B, will pre-existing be covered? (PED is covered after 4 years of continuous policy in insurer B retail product)
a) If the proposal is accepted, continuity would be given for 4 yrs waiting period of pre-existing diseases also b) After 1 year coverage under retail policy of the same insurer , he can approach a new insurer, if the proposal is accepted by the new insurer he will get the continuity of 12 years.

Can I change my Sum Insured while changing the insurance company?

Yes you can apply for revised SI with the new insurer, however acceptance would be at the discretion of the new insurer.

On what base the premium will be calculated, will it depend on the new company's Pricing or it will be same as the existing insurer?
All the terms, conditions, guidelines, definitions, exclusions, premiums, loadings & Waiting periods of the new policy would be applicable.