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One of the best features of any health insurance policy is the “Cashless service” offered by the insurance company. In a cashless claim arrangement, the insurance company directly pays to the hospital and the policyholder does not have to pay for the treatment or hospitalisation from his/her pocket. But there can be times when this blissful cashless service can become really painful and annoying. There have been many instances where the policyholder or his family members spend a lot of their time and energy in chasing the Insurer, following up with their Third-party administrator (TPA) and the Accounts department of the hospital.

Hospitalisation and treatment can be broadly classified in two ways – 1) Unplanned Hospitalisation and 2) Planned Hospitalisation. Unplanned situation arises in case of an accident, emergency or any situation requiring immediate hospitalisation without prior planning. Planned situation, as the name suggests, means that you are aware of the illness or injury and prepared for hospitalisation at a sooner or later date. This article is mainly aimed at cases involving planned hospitalisation. Getting a Cashless claim settlement on your health insurance policy can be easy provided you know a few things before hand.  

Some of the useful tips are listed below -  

1. Cashless Hospital Network List – Health insurance companies tie up with TPA’s who actually process your claims and handle the entire paperwork. These TPAs have a list of network hospitals and they will provide cashless facility only if you go to one of these hospitals for treatment. So, it is a good practice to check this network hospital list before deciding on the hospital. Every policy kit comes with a list of all network hospitals in the country.

2. Know what is Covered and what are the Exclusions - An insurance company always gives the details of the expenses they will cover such as Inpatient Treatments, listed Day Care Procedures, doctor’s fees, etc.

·         Inpatient Treatment - means any treatment which requires minimum 24 hour hospitalisation. So in simple words, if your treatment does not require you to be admitted to the hospital for a minimum of 24 hours, then the same is not covered

·         Day Care Procedure - There are certain treatments which do not require 24 hour hospitalisation due to medical advancement, nature of treatment, etc such as chemotherapy, radiotherapy, cataract, removal of tonsils etc. These are listed in your policy document and differ from one policy to another. Remember – your insurer will only cover procedures listed in the policy. 

3. Intimate your TPA (as an extra precaution, intimate your Health Insurer as well)

Your health insurance policy document mentions that in case of emergency hospitalisation, you must contact your TPA as soon as possible or within 24 hours of admission. The sooner you contact your TPA, the better are the chances that they will make a cashless settlement to your hospital. In case of a planned hospitalisation, it is best to contact your TPA at least a week or 5 days before getting admitted.

4. Complete all the paperwork

As soon as the policyholder is admitted in the hospital, one of the family members should go to the TPA desk or insurance desk at the hospital and fill up all the necessary forms. Send a copy of this duly filled form via Fax and Email along with the Doctor’s diagnosis and any medical reports you may have like XRay, CT scan, Blood report etc to the TPA.

Do not delay or waste any time in doing this process no matter how frustrating it may be. The TPA desk at the hospital may have hundreds of claim forms lying with them and may not always be prompt and quick. Ultimately, it is you who needs a cashless settlement, not them. As soon as the fax and email is sent out to your TPA, call and confirm the receipt. Check if any further documents are required and do it, call them again and confirm.

5. Verification process and payment release

The TPA will check your claim form, other documents and nature of treatment and sends you an initial approval of some amount. For instance, if the estimated cost of the treatment is Rs 1.5 lakhs, the TPA may send an initial approval of Rs 1 lakh. This does not mean that they will not pay the full cost of treatment. The balance amount will be paid at the time of discharge when the hospital gives the final bill to the TPA. After verifying all the paperwork, the TPA gives the final approval and pays the final settlement amount to the hospital.

Many of us feel that insurance companies keep too many restrictions and processes so that they do have to pay the money in advance, but this is not the case. Insurance companies are constantly working on innovative ways to improve their customer offering, claim process and customer service. It is our duty to be prepared with the required paperwork and formalities at such times to make it easier for them to process our insurance claim.

Also Read –

Insurance Complaint - Step by Step Guide

Not happy with your Health Insurance Company – Change It

Health Insurance Portability

You are a working professional with a monthly salary and a degree that can take you places. Perhaps you already are on your way to get that big promotion you have been eyeing for. Chances are that you will get a jump in your monthly pay or even a fat bonus that will enable you to buy a bigger house or a fancy car or to go to your dream holiday destination. But, what are the chances that you have set aside a few lakh rupees just to take care of your health care costs, if need be? My guess is that you haven’t and you’d rather think of this at a later date say, when you get another raise.

But how will that be of any help? And does it even make any sense to pay for your medical expenses in full from your own humble earnings? Now you’re thinking. Well it’s a start!  

Why does this happen to me?

It’s no big deal if you have to pay your doctor’s fees plus cost of medicines if you catch a flu or food poisoning. But what if you had to pay for a Knee replacement surgery or Gall bladder removal or even worse, a major critical illness like Stroke or Heart Attack. The treatment costs for such ailments can make a huge dent in your earnings. And if you find yourself in this situation saying “Why does this happen to me”, you may have to compromise on your other dreams just to take care of the immediate medical costs.  

What should I do?

Buy a good health insurance plan:

Even if you are fit, healthy and in the best physical state, you must buy a health insurance cover. Generally, people feel that if they buy a health policy, they might as well get immediate benefits out of it. Because of this reason, they tend to delay it and not buy it until the last minute when they see their health deteriorating.  

But do you think that an insurance company will issue a policy to you when you are not healthy? The answer is ‘No’. Even if they do, they will most certainly charge you a higher premium and mind you – they will not pay for any medical conditions you may have undergone in the past. These will be listed under exclusions as pre-existing medical conditions which your health insurer will not cover.

2 is better than 1:

At the risk of over-emphasizing, I am going to suggest you to consider buying 2 health plans from different insurance companies instead of 1 plan. So, just hear me out – if you are planning to take a health cover of Rs 6 lakhs from one company, split it into two covers of Rs 3 lakh each. The reason being, no two health plans would be exactly identical and there will be some exclusions in one plan which will be covered in another.

Moreover, different insurance companies have different styles of processing your claims, some do it via a third party agent (TPA), some have their own in-house claim process which may be faster and efficient.

The other benefit is that once you make a claim, a company may increase your premiums also known as loading charges from the next renewal onwards. If you split your policy into 2, you can retain your no-claim bonus on the other one and continue to reap the benefits.

A stitch in time saves nine

Stay healthy & fit and to ensure that nothing stops you from fulfilling your dreams, plan ahead. Invest in a good health cover even if you don’t see an immediate need for it.

Also read - All you need to know about Health Insurance Portability
                   Not happy with your health insurer - change it

Health insurance portability is the right given to a health insurance policyholder to switch from one insurance company to another or from one plan to another. In the process of switching, the credit gained by the insured member for pre-existing diseases and time bound exclusions, no claim bonus etc also gets transferred.

Let us understand this with the help of an example: Kapil has a health insurance policy with ‘A’ company. His Sum Insured is Rs 4 lakhs and has Rs 50,000 as accrued bonus. When he shifts to the new insurance company ‘B’, this company has to offer Kapil a Sum Insured of Rs 4.5 lakhs. In case the company ‘B’ does not have a health policy of Sum Insured Rs 4.5 lakhs, then it must offer a policy of the nearest higher slab say Rs 5 lakhs but the portability would be available only upto Rs 4.5 lakhs. The premium will be charged as per the sum insured offered.  

Here are a few health insurance portability guidelines that you should know:

›Ensure that there is no break in the policy. A break in the policy occurs when the premium is not paid on or before the renewal date or within 30 days thereof.

›Policyholder must apply for portability at least 45 days before the premium renewal date.

›On receipt of application for porting the policy, the insurance company will provide the applicant with

- Portability Form

- Proposal Form

- Relevant product literature on various health insurance policies that can be offered

›Policyholder must fill the Portability Form and Proposal Form and submit it to the insurance company

›Policyholder must not cancel the existing policy until the confirmation of new policy is received from the insurance company or unless specific request in writing is received from the insurer.

›Within 7 days of receiving the Portability Form, the new insurance company will ask the existing insurance company for medical and claim history of the policyholder.

›On receipt of the data, the new insurance company may underwrite the policy

›If on receipt of the complete information if the insurance company does not communicate it to the policyholder within 15 days, then the company cannot reject the proposal and will have to issue the policy.

›If the waiting period on the new policy is longer than that in the old policy for the same disease, then the additional waiting period must be clearly explained in the portability form.

Poor service, inadequate coverage, bad claim settlement experience - if you are not happy with your existing health insurance company or policy, then the good news for you is that you can ditch your health insurer for a new one. Health insurance portability is here and you do not need to continue with your health insurance company just because you fear losing the accumulated benefits.

Health insurance policies and companies differ from each other in a lot of ways. Some insurance companies offer better policy features or services than their counterparts. There are companies which go to great lengths to design better products, offer excellent service that make a customer feel like a king. Select insurers have shunned TPAs and devised their in-house teams to effectively manage claims. TPAs are third party administrators who are outsourced to work as an intermediary between the insurer and the policyholder. The benefit of this is that the customer directly interacts with his or her insurance company at the time of making a claim.

Attractive Health Insurance Plans

Innovative and unique plans have hit the markets in recent times which offer a wider and better coverage than the old, vanilla plans. For instance Star Health Insurance has a policy for diabetic patients called Diabetes Safe, another breakthrough policy for HIV/AIDS patients. A policy for HIV/AIDS patients was unheard of, as other companies listed it under their exhaustive list of exclusions. There was a time when no policy would cover non-allopathic treatments, but now there are unique health plans available which cover Ayurvedic, Homeopathic, Naturopathy and such treatments. Pregnancy and maternity expenses were an exclusion and most insurers would not provide a cover for this; but some new plans have coverage for these too.

Until recently, it was not possible to cover all members of a family under one health insurance policy. But thanks to the efforts of some insurance companies, there are new plans available in the markets that let you cover not just your immediate family members but also your extended family members like grandparents, grandchildren, in-laws etc in one single policy. Max Bupa Family First is one such policy wherein you can cover up to 13 extended family members.

Pre-existing disease coverage is a big concern for customers who have suffered some medical condition in the past. Most health insurance companies have a waiting period of 48 months, i.e 4 long years before they cover pre-existing ailments. A few of them have a 36 month waiting period. Star Unique Insurance Policy shines brilliantly in comparison with these other policies as it has reduced the waiting period to only 11 months.

There are unique policies which now cover expenses like cost of spectacles, hearing aids etc. Earlier health insurance policies had a maximum age limit for renewal capped at 60 or 65 years. New plans from companies like Apollo Health Insurance, Max Bupa Health Insurance offer guaranteed lifelong renewability. The premiums for innovative plans may be a little higher but the variety of coverage offered is extremely attractive.

Health Insurance Portability a boon

With such an extensive list of new and unique health insurance plans, existing policyholders may find other policies better suited to their needs. Claim settlement ratio, service standards and multiple other factors could also be a reason for some policyholders to have the desire to switch over to another insurance company.

In such a scenario health insurance portability by IRDA comes as a blessing. You can now port a policy without losing out on the benefits earned. These benefits could be the no claim bonus or the credit earned on pre-existing disease earned in your old policy. For instance, you have already served 2 year waiting period on your old policy and now want to move to a new policy which has a waiting period of 3 years; in this case you will only have to wait for another 1 year before the new company covers your per-existing conditions. Your no-claim bonus will also be transferred to the new policy.

If you have a Group Health Insurance Policy, you can port it to an individual health policy as well.

Words of caution!

• Don’t just jump to another policy without assessing your needs completely
• Have a valid reason for switching to a new company
• Read the terms & conditions and exclusion list carefully

The grass always looks greener on the other side but reality may be completely different from illusions. You have the power to make your own decisions, so use it wisely.

A small white chip came off my tooth while having breakfast today. It concerned me and I rushed to the dentist with the earliest possible appointment. The dentist made a big hole in my tooth and an x-ray in the name of examination and THEN told me that I need to do some Root Canal Treatment and a cap over it, which would make a bigger hole in my pocket than my tooth…. Sigh… I didn’t have an option since my tooth has already been dug out. Thus, I had to undergo the so-called treatment for an itsy bitsy white chip off my tooth…

Well...well… that is the story everywhere. I am being told that it takes about Rs 500 per visit to any dentist, not necessarily the best one, if the dentist has nothing extra to do to the tooth. Any treatment is charged a bomb and billed extra! Out-Patient Dental Treatment, without surgery, can cost upto Rs 15000 – Rs 20000 per tooth or maybe more.

Thus, my new area of interest is Dental Insurance, which is technically designed to pay a portion of the costs associated with dental care. In general, a Dental Insurance Plan covers a percentage of the dental charges incurred at a dental office, and may include free preventative services such as cleanings as well. There is no industry standard annual maximum limitation, deductible, or co-pay. Such coverage and benefit limitations are determined by each insurance company. Dental Insurance has not gained enough importance in India but is very common in the western world. However, having good Dental Insurance can save you quite a few unpleasant surprises -- and definitely a lot of money in the longer run!

But, in India, there are no stand-alone Dental Insurance Policies. Sometimes the Dental Care Product Companies come up with Stand Alone Dental Insurance Plan which covers the expenses related to general dental problems, such as periodontitis and extraction of permanent teeth due to ailments such as caries. The usual Mediclaim Policies cover dental surgery only if it requires a minimum of 24 hours hospitalization and is caused by an accident and not otherwise.

Dental insurance cover that is usually provided is a part of general health insurance plan such as health advantage policy or student medical policy. Through this scheme, one can claim dental expenses along with the other kinds of reimbursements, such as the cost of medicines or hospitalization.

Most health insurance policies exclude dental treatment in their list of common exclusions. However dental surgery and treatment would definitely be covered under certain policies if the same requires a minimum of 24 hours hospitalization and especially if the same is caused by an accident. Among the policies that you can consider to avail which definitely covers dental surgery which requires 24 hours hospitalization would be:

Oriental Insurance Universal Health Insurance Scheme

Royal Sundaram Family Health Policy

But my major concern was Out Patient Treatment, like Root Canal Treatment, etc. If you are looking for cover for dental expenses in OPD, then you can consider Chola MS Advanced Individual Healthline Plan. In that plan, 1% of Sum Insured is paid after a waiting period of 3 years subject to a maximum of Rs. 5,000 once in a block of 2 years with 30% co-payment by insured.

Since I have burnt my finger with dental expenses, I would not like to take the risk of going through the same trouble all over again! I would take up one of these policies which provide for dental care as there are no stand alone dental insurance policies in India, although I sincerely wish there was! So, my dear friend, if you do not wish to get blown away by the sheer magnitude of the possible dental care expenses, you should also hurry up…. To take a health care plan for yourself and your family, I meant!

This is a personal experience which I went through just a few days back. I am sharing my experience so that you can save some pain when you go through the same. Hope it helps!

Mediclaim policies are not a luxury anymore; it has become a necessity in today’s world.  With inflation more than 9% in India, middle class Indians are finding it very difficult to make both ends meet. And the cherry on the cake is the rising medical expenditure, which has increased more than 10% in the last 4 years. And now with 5% service tax on health care introduced in finance minister Pranab Mukherjee's Budget, the burden of medication and treatment will toll heavily especially on the middle class.

The average Indian spends about Rs 117-Rs 120 per month on medicines etc. It might seem to be a small amount of money to us, but for a person from the lower middle class family, this amount may become a huge burden, especially if it tends to rise. It might constitute about 20-30% of his income. Then invariably, the health care is sacrificed and proper treatment and care is not taken. 

Thus, to ensure proper treatment and a healthy lifestyle, a comprehensive health policy needs to be taken. Most of us either has a health insurance policy from our company or is contemplating purchasing one. But have you thought about your parents? They are the ones who would need maximum health care and has highest chances of hospitalization. Hence caring about them is of utmost importance.

Thankfully there are some insurance companies who have thought about them and have designed special health insurance policies for the Senior Citizen.

There is National Insurance Varistha Mediclaim for Senior Citizen. This plan is a very good plan for the senior citizen from 60 to 80 years of age and it takes care of all hospitalization expenses till an extended age of 90 years. This is a specially designed plan for Senior Citizen and hence it covers for pre-existing diseases just after one year of claim free renewal. You need not wait for 3-4 years for it to be covered like in normal health insurance policies. Pre-existing diseases like Hypertension and Diabetes will be covered from the inception on payment of additional premium. There are other benefits in this plan as well like Cumulative Bonus and cost of Health Check-up is also available on claim free years. This plan also covers Critical Illnesses.

Another popular Senior Citizen Health Insurance Policy is Star Health Senior Citizen Red Carpet Plan for 60 to 69 years of age but can be continued forever. This plan also covers pre-existing diseases from the second year of operation and it also covers major surgeries and other treatments. Some diseases are however covered from second and third year of operation and there is no requirement for pre-medical tests in this plan.

There are other plans like Max Bupa Heartbeat Health Insurance Plan which can be availed for your parents as well and it has no age limit. In this plan, both your parents can be covered together under a family floater and can be taken at any time and can be continued till death. In fact, you can avail Max Bupa Heartbeat Family First Health Insurance Policy for each and every member of your family irrespective of their age under the same plan. In this plan, even your parents-in-laws can be included.

Thus, like it is never too late to plan for your house, car or umpteenth honeymoon, it is never too late to plan for your health insurance policy as well. Since health is wealth; its proper care is of extreme importance. And now, it is in your control to en sure that you take the best efforts to take care of the people who matter to you, especially since your parents have done their best to take care of your health; it’s your turn to pay them back by doing your bit the best!

How often does this happen to you! – there is a lucrative offer for investing and you cannot make up your mind. Your friends or colleagues take this chance and put in their money and within no time they start enjoying really good returns. This leaves you with a bitter experience and you promise yourself to be more active the next time such an opportunity shows up. Well, we all have our share of experiences of not taking quick decisions at the right time and then living with a quiet regret. Be it investing in a property, gold, airline tickets, shares, mutual funds or insurance, everyone has seen the advantages of buying things early and at low prices.

But with so many choices around us today, it is understandable when people take a lot of time to decide and finalise their purchase. People want to give time to each of their purchase and more importantly want to understand the core benefits of buying a product or service. People get into multiple interactions with the sellers and extend the buying process to weeks and at times up to several months. Even though such a lengthy process may help in saving some money and choosing a better product, sometimes it can cost us much more than what we are capable of managing. To explain this better, think about the case of Rajendra Shah who kept evaluating health insurance from 5 companies for 8 months but did not buy any. Just a month ago, when he was experiencing mild abdominal pain, Mr. Shah went to the local medical centre for a check up and found out that he was showing symptoms of stomach cancer.  The medical centre advised him to conduct a few tests and referred him to couple of bigger and better equipped hospitals. Also when it comes to critical illnesses such as cancer or heart diseases, doctors themselves would advise to take expert medical opinions from two separate hospitals which means double the cost. Such situation hits the individual both emotionally and financially plus his personal life hits a road block. If there is no health insurance like in the above case, then the person or his family members have to break in to their savings to meet the costs of tests and overall treatment. Frequent visits to hospital means lesser time towards work and there is often a dip in earnings be it a job or one’s own business.

Mr. Shah was in a great fix. He cannot go back to any of the five insurance companies he was speaking to and buy a policy without revealing his disease. And if he mentioned that he has been diagnosed with a disease, then there is a high chance that the insurance company will reject his application. Even if an insurance company considers his overall medical history and issues him a policy, then they would not cover this particular disease or any illness related to the same under the exclusion clause of Pre existing diseases. Any pre existing disease would be only covered if the customer renews his health insurance policy with the same insurance company for 3 or 4 years as per the policy rules.

So what should one do when faced with such a situation? Should a person who has been diagnosed with one illness still avail a health insurance or drop the idea completely. We suggest that the person should still seek an insurance cover. However, now because the situation has changed, one may need two or more health insurance policies to achieve what could have been done with a single health insurance plan earlier.

Step 1: Apply with the Public Sector Insurance Companies
First, approach one of the public sector general insurance companies and apply for their mediclaim insurance cover. You could go approach companies like Oriental Insurance or United India Assurance directly or if your bank is tied up with any of the insurance companies, then you can buy the insurance policy from your bank too. Example – PNB Oriental Mediclaim, BOI National Swasthya Bima, Baroda Health Policy, etc. Even if the insurance company is offering you a moderate sum assured of 2 to 3 lacs, take it.

Step 2: Approach the Private Insurance Companies
The second step is to apply with any of the private health insurance companies from the wide variety of health insurance policies offered by them. Few of the general insurance companies who have popular health insurance products are Apollo Munich, HDFC Ergo, Max Bupa, Bajaj Allianz and Star Health. Unlike the public sector insurance companies who would usually have only one mediclaim policy, the private sector companies will have 4 to 5 different kinds of medical insurance – one policy offering cash benefit, another covering critical illnesses only, one specially tailor made for senior citizens and of course the standard health insurance. 

Declare all personal details, medical history, family medical history, etc in the application form wherever the company is requesting for it. At such times, many people would advise you to withhold information and not reveal the same – while it is tempting to do so, we strongly advise you not to indulge in any misrepresentation of facts. Sooner or later the insurance company will find out about this and they will reject all your claim requests.

Here you face a high probability of rejection during the application stage itself but that should not stop you from being honest. Private insurance companies understand the high risk involved and may accept the application by charging a slightly higher premium.

Step 3: Take a top up insurance policy
Once you have taken the basic mediclaim (health insurance) policy from one of the insurance companies, then avail a top up medical insurance policy. Top up policy means if your basic (and primary mediclaim) policy is of Rs. 3 lacs then expenses over and above Rs. 3 lacs will be paid by this top up policy. The top up policy works like an add-on policy or a second policy. Also the premiums of such top up plans are very low. Some of the top up plans are United India Top up policy, Star Health Super Surplus, etc

Why Multiple policies!
Now the idea behind this approach is to
1) safeguard you against any unknown health related issues in future
2) start the process of protection which may be able to cover your existing illnesses in few years

Important Points
To be sure that everyone has registered the key points in their minds, here’s a quick recap of the important things –
1) Always reveal correct information and complete medical history at the time of application
2) Renew your health insurance policy every year without any break
3) Try to take health insurance policies from two or more companies to be on the safe side
4) If possible, avail a top up insurance policy in addition to the basic mediclaim
5) Do not hide any detail from the insurance company at the time of application or making a claim

The fundamental concept of insurance is to protect an individual from any unforeseen circumstances which may affect his/her financial position. In recent times, insurance companies do realise that they also need to shield people from existing situations if the individual is ready to pay the corresponding premium and wait for a few years. Of course, this in no way justifies postponing the purchase of a product as crucial as health insurance. So remember that you can take the liberty of postponing your health insurance purchase only if you are covered to some extent in the first place.

Health Insurance is a financial tool that protects you and your family from the burden of unexpected medical expenditures. But have you sometimes felt let down or, have been dissatisfied with the service of your health insurance provider? Well, here is the era of portability. After mobiles, the latest entrant is Health Insurance Portability. So what is this concept and how do you stand to gain? Read on to find out more.

Forty Year old Mrs. Kapur suffers from diabetes, which has been listed as a pre-existing disease in her health insurance policy. When her health insurance provider recently increased her premium, she wasn’t quite happy about it. After having held the policy for two years, she wanted to change over to a new insurer. However she realised by doing so she would lose the cover on her Pre-Existing Disease (PED) as the new insurer would treat her as a fresh customer. She would have to wait for another two years to get this pre-existing disease covered in the new policy.

The Concept of Health Insurance Portability

To solve problems like Mrs. Kapur’s IRDA has set guidelines to implement Health Insurance Portability from July 1, 2011. Health Insurance Portability is a provision to switch over to a new insurance service provider, under the same terms that exist under the current policy. With this provision one need not compromise, or fear losing the waiting period of PED, while opting for a new policy.

Key Benefits

Carry Forward of Waiting Period of Pre-Existing Diseases (PED)

Health Insurance policies follow a waiting period in the initial policy years, during which time, PED are not covered. This waiting period could be for 2 to 3 years, depending on the disease. Suppose you shift to a new insurer after say 3 years, the new insurer considers you a new customer and would impose his waiting period for the PED.

Now with portability of your health insurance, this waiting period of PED is carried forward (known as “credit” in insurance parlance), to the new policy. So you wouldn’t lose the waiting period already completed in the previous policy.

Window period waived

Every new health insurance policy has a 30 day window period, diseases arising in which time are not covered. With portability, this waiting period of 30 days is waived off.

When Should One Opt For Health Insurance Portability

Dissatisfaction

If dissatisfied with the insurer’s service, one could move one to another insurance provider for better service and policy features.

When Moving Cities

When moving to another city, at times the insurer may not have an office or service outlet in the new place. At such times, one may desire a new insurer who would be able to provide the necessary policy servicing at the new location.

Shifting of Jobs

Different employers provide health insurance through different providers. During times of job change to prevent loss of insurance cover, portability could be an ideal solution.

Exceeding Maximum Age of Policy during Renewal

Some policies restrict age at which renewal is possible. One could thus opt to move to another insurer who could renew policies at a much higher age.

Exclusions in policy

What is exclusion in one policy may not be exclusion in another. If you have a change in your insurance requirement, and have specific needs that are offered by another insurer it’s time to move on. 

Drawbacks of the Provision

Not all benefits continue in the new policy

Though the waiting period credits are portable, not all the features of the old policy continue.  It is actually the features of the new policy that would be applicable for any future cover.

Presence of Ambiguity

Being a relatively new concept, health insurance portability has various aspects which are ambiguous in nature. Despite having set guidelines by IRDA, the following points need more clarity before, implementation in July 2011.

(a) The status of continuity benefits like free-medical check ups and no claim bonuses in the new policy

(b) No clarity about how portability would take place between indemnity policies and benefit policies. Indemnity policies offer cover for hospitalization expenses where as benefit policies provide a lump sum amount for a pre –specified diseases or condition. Also there is no clarity if such portability is possible between life and non- life insurance companies

(c) IRDA is yet to specify details regarding premium payment in case of portability

Making the Most of Portability

The process of portability would involve similar steps as in applying for a new health insurance policy. Before you shift between insurers it pays to do your bit of homework.

1. Be clear of your motive. Shift for genuine reasons such as dissatisfaction, change in job or increase in premium etc.

2. Do your bit of research about the new insurer you have chosen. Ensure you are getting a better deal in comparison to your existing policy.

3. Have a clear understanding of the coverage and the sub coverage such as hospital room rent, check up etc...the policy has to offer. It could have slight variations from the earlier one.