Is a health insurance policy taken by an individual from a health insurer 'A' transferrable to another health insurer 'B'? Discuss the modalities of such a transfer if it were to be possible.
CS Professional · Insurance - Law & Practice · PYQS · December 2020
Is a health insurance policy taken by an individual from a health insurer 'A' transferrable to another health insurer 'B'? Discuss the modalities of such a transfer if it were to be possible.
Answer & Explanation:
Portability is the right accorded to the Policyholder to transfer the credit gained for pre-existing conditions and time-bound exclusions from one insurer to another insurer or from one plan to another plan of the same insurer. In simple words, it is the right conferred on a Policyholder who decides to move from one General or Health insurer to another or to another plan of the same General or Health insurer. Portability is not applicable to fixed benefits payable under Health insurance policies issued by a Life insurer. The advantage of portability is the carry forward of the credits accrued on account of having a Policy with the previous Insurer. Portability form shall be submitted to the old insurer who shall send it through a portal to the new Insurer. New insurer may request the claims history and other details from the previous insurer who shall submit the required details within a period of 7 days from the date of receipt of request. An insurer may reject the request for portability if the Policyholder approaches 60 days before or within 45 days of the date of expiry of the insurance policy. However, an insurer may at their option consider the request for renewal even outside the above period. New insurer is under obligation to accept or reject within a period of 15 days from the date of receipt of the Portability form. If the New insurer does not convey any decision with the aforesaid 15 days, the New insurer is deemed to have accepted the request for portability. No charges for portability can be levied either by the Previous insurer or the New insurer. No commission shall be paid to any Agent or Intermediary for the policy which is ported from one insurer to another insurer. The insurance regulator added the terms portability and migration in its health insurance guidelines. By doing this, the Insurance Regulatory and Development Authority of India (IRDAI) has given clarity with regards to transfer of credit gained for pre-existing conditions (PED) and time-bound exclusions, from one insurer to another insurer, while migrating or porting policies. It also added the definition of migration specifically. These changes were included in the guidelines on standardisation in health insurance released by IRDAI on January 1, 2020, with respect to the Standard Definitions for 42 commonly used terms in health insurance policies as defined under Guidelines on Standardization in Health Insurance. IRDAI said, 'The definition of 'Portability' and 'Migration' shall be applicable in respect of all health insurance products (both Individual and Group) filed immediately. Break in policy clause 'occurs when the premium due on a given policy is not paid on or before the premium renewal date or within 30 days thereof' as per the earlier guidelines. Here is the latest definition: 'Portability' means, the right accorded to individual health insurance policyholders (including all members under family cover), to transfer the credit gained for pre-existing conditions and time-bound exclusions, from one insurer to another insurer, as per the circular. On the other hand, the latest definition of Migration means, 'the right accorded to health insurance policyholders (including all members under family cover and members of group health insurance policy), to transfer the credit gained for pre-existing conditions and time-bound exclusions.'
Topics: Health Insurance
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