Health Insurance Portability Preexisting Diseases

Health insurance generally have specific exclusions for preexisting diseases for a specific period of cover during the initial years of insurance. Therefore the insurers were tied down to any particular insurance provider. Else the preexisting diseases [PED] clause will again haunt the policyholder and he will have to wait for some more years, usually three years, to get insurance coverage for preexisting diseases [PED].

To address this concern of the insurers, IRDA has come up with a new set of guidelines (Ref :IRDA/HLT/MISC/CIR/03/02/2011) to allow health insurance portability.

With effect from July 1,2011 all the insurers providing health insurance policies shall allow to carry forward the credit earned by the insured for preexisting disease, in terms of waiting period when he or she switches from one insurance provider to another or from one plan to another of the same insurance provider, provided he or she has maintained the policy without any break. Also, during the waiting period, the sum assured from the previous insurer can only be carried forward for the treatment of preexisting diseases.

Therefore, as a health insurance policyholder you should be aware of the following:

• All health insurance policies are portable
• There might be delays in acceptance of a proposal by a new insurer; so it is wise to approach the new insurer well in advance of the renewal date to avoid any break in the policy coverage due to any technical reason.
• If there is any delay in accepting the proposal for portability by the insurer which results into a discontinuance of the policy, the insurer shall not treat the policy as discontinued and allow for portability of the same.
• All applications for portability should be acknowledged by the insurer within three working days.
• If a policy holder has opted for portability, all claim details about the policy should be shared with the insurer with whom the policy holder will enter into a new insurance contract, within seven working days of getting the request from the new insurer
• The one-time waiting period of around 30 days, will also get waived off in case the policyholder decides to port the policy. Thus, the initial waiting period will now be a one-time exercise
• These guidelines are applicable for all existing and new insurance contracts with effect from July 1, 2011

Health insurance

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