How to Switch Health Insurance Providers Without Losing Benefits?

As companies grow, they often find their insurance no longer fits their needs. This could be due to limited coverage options or rising premiums. These challenges can reduce the plan’s overall effectiveness and value.

What Does Health Insurance Portability Mean for Your Business?

Health insurance portability was introduced by the Insurance Regulatory and Development Authority of India (IRDAI) in 2011. It provides businesses with the flexibility to transfer their existing health insurance policies to a new insurer without losing the benefits accrued over the policy term. It applies to both individual and group health insurance plans.

Note: Portability requests must be initiated before the policy renewal date. Otherwise, it may result in it being declined or delayed.

Why Switch Insurance Providers?

There are several reasons why you may want to switch to a new insurer. The most common reasons are -

• Poor customer assistance
• Higher premium
• Not enough coverage
• Better plan with another insurer 
• Facing problems with claims settlement.

Irrespective of any reasons, the IRDAI rules for insurance portability allow you to switch. Just remember to retain the existing benefits. These benefits include No-Claim Bonus (NCB), waiting period credits, and coverage for pre-existing conditions. To keep these benefits intact, it is essential to follow the correct health insurance portability process.

Also Read: How to port an existing health insurance?

How to Switch Insurance Providers?

Let's find out how to switch insurance providers without losing benefits -

Review your current policy - Before you switch, assess your current group health insurance policy. Review the sum insured and any benefits you have already received. Make sure the policy meets the needs of your business and employees.

Understand IRDAI regulation - As per the IRDAI portability rules, a business must initiate the process at least 45 days before the policy's renewal date. The new insurer must provide a policy with coverage and a sum insured that are at least equal to the current plan.

Choose a new insurance provider - Before you select a new insurance provider, compare available policies. You can use trusted platforms like the IRDAI website or Policybazaar to do research. You can also visit insurers’ official websites.

Apply for portability - Submit the portability and proposal forms after you have chosen your new insurer. You also need to submit the following documents -

• Current policy copy
• Renewal notice
• Medical history
• Identity proof and address proof

Wait for the insurer’s decision - Within 7 days, your current insurer will share your claim and medical history through the IRDAI’s official portal. Then, the new insurer has 15 days to review your application. During this time, they can accept or reject the portability request. If they reject, they must provide a valid reason.

Get the new policy - Once the policy is approved, you pay the premium and receive your new health insurance policy. Your benefits from your previous policy will be carried forward.

Note - If you increase your sum insured when switching, the amount may be subject to fresh waiting periods.

The table below shows a quick recap of the steps to change health insurance providers in India -

Tips to Keep Benefits Intact While Changing Insurers

Here is how to retain benefits while changing insurers -

• Keep your coverage active. Do not let your policy expire while switching.
• Give your new insurer full and correct health information about all employees. Be honest and don’t hide anything.
• Make sure the new policy offers the same or better coverage than before.
• Mistakes to Avoid While Switching Insurance Providers
• Switching insurers isn’t difficult. But not paying attention to the details below can cause coverage loss or unwanted complications:

Missing the notice period - If you fail to inform your new insurer at least 45 days before policy renewal, it may result in portability rejection.

Letting the policy lapse - You cannot port if your current policy has lapsed. So, ensure premiums are paid on time.

Not comparing properly - Not comparing policies properly is risky. Switching only for a lower premium without reviewing the claim settlement ratio, network hospitals, and coverage can cause problems later.

Incomplete disclosure - Provide complete and correct health information to the new insurer. Hiding health issues can cause problems later.

Ignoring sub-limits and co-payment clauses - Read the details carefully, especially about room rent limits, ICU charges, and co-payments.

Summarizing

Changing your insurance provider does not mean you lose the benefits you already have. Knowing how to port a health insurance policy in India is key. It makes sure your coverage is not interrupted and your services improve. All you need to do is follow the health insurance portability process set by the IRDAI rules.

If you are still not sure, consider consulting a certified insurance advisor. You may also reach out to a POSP insurance agent (POSP's full form in insurance is Point of Sale Person). Or, use online platforms like Policybazaar for assistance.

Frequently Asked Questions - (FAQs)