Ref:IRDA/HLT/MISC/CIR/030/02/2011 Date:10-02-2011Portability of Health Insurance PoliciesIn general, health insurance poli...
counterparts, if requested by the counterpart within seven working days of such request bythe counterpart.9. All applicati...
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Portability of health insurance

Published on: Mar 4, 2016
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Transcripts - Portability of health insurance

  • 1. Ref:IRDA/HLT/MISC/CIR/030/02/2011 Date:10-02-2011Portability of Health Insurance PoliciesIn general, health insurance policies have specific exclusions for pre-existing diseasesfor a specified period of cover during the initial years. However, it has been observed that incases where policyholder wishes to switch from one insurer to other, they do not gain anycredit for the period of cover with previous insurer. Consequently the insured is tied to theinsurer which is detrimental to competition. This places in policyholder at a distinctdisadvantage.2. In order to address this, the Authority is satisfied that the following guidelines on theportability of health insurance policies shall be allowed in the manner prescribed in thisguideline. This circular is issued in exercise of powers conferred upon the Authority undersection 14(1) of the IRDA Act, 1999 to protect the interests of the policyholders and toregulate, promote and ensure the orderly growth of the insurance industry.3. All insurers issuing health insurance policies shall allow for credit gained by theinsured for pre existing condition(s) in terms of waiting period when he/she switches fromone insurer to another or from one plan to another, provided the previous policy has beenmaintained without break.For example if under a previous policy, the condition was excluded from coverage for twoyears and under a new plan with a different insurer the exclusion period for the samecondition is three years, the new health insurance policy can only exclude the condition fromcoverage for one extra year.4. This credit (in terms of waiting period) would be limited to the sum assured(including bonus) under the previous policy.5. The insurers shall strictly comply with Regulation 4(6) of IRDA (Protection ofpolicyholders’ interests) Regulations, 2002 in accepting the proposals when the policyholderis switching from one insurer to other.6. If the policy results into discontinuance because of any delay by the insurer inaccepting the proposal, the insurer shall not treat the policy as discontinuance and shall allowportability.7. Insurers shall clearly draw the attention of the policyholder in the policy contract andthe promotional material like prospectus, sales literature etc that:i. all health insurance policies are portable;ii. policyholder should initiate action to approach another insurer, to takeadvantage of portability, well before the renewal date to avoid any break inthe policy coverage due to delays in acceptance of the proposal by the otherinsurer.8. All insurers are hereby directed that the entire database including the claim details ofthe policies, where the policyholders has opted for portability, shall be shared with their
  • 2. counterparts, if requested by the counterpart within seven working days of such request bythe counterpart.9. All applications for the portability shall be acknowledged by the insurers within threeworking days.10. This shall be applicable for all existing contracts and new contracts with effect from1stJuly 2011.sd/-(J. Hari Narayan)ChairmanAll Copy Rights Reserved. 2010 IRDA

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