Insurance Regulatory and Development Authority of India (IRDAI) via its circular numbers IRDAI/HLT/REG/CIR/002/01/2020 and IRDAI/HLT/REG/CIR/003/01/2020 has issued guidelines on Migration and Portability.
A. What type insurance covers are these guidelines applicable to?
The IRDAI Migration and Portability guidelines are applicable to all Retail (Individual) and Group indemnity Health insurance products.
The guidelines are applicable to both Individual sum insured and Family floater sum insured policies.
B. What is Portability?
IRDAI 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.”
Which means any Individual health insurance policy holder has an option to port his/her policy to a similar health insurance product of another Insurer.
While doing so, insured will get continuity benefit for applicable waiting periods for the number of years the policy was continuously renewed with the previous Insurer.
The Cumulative Bonus (if any) will be accrued in the sum insured, if the insured opts for higher sum insured while porting the policy. However Cumulative Bonus will lapse if insured opts for same or lower sum insured.
What are the conditions applicable for Portability?
The insured can only port the existing policy to a similar health indemnity policy of other insurer.
The continuity will be applicable to:
General waiting period
Waiting periods for coverage of pre-existing conditions
Any time bound exclusions (for example 2 year waiting periods for listed conditions in Health Total)
The continuity for waiting periods will be applicable only up to the sum insured and cumulative of the previous policy.
The premium applicable would be for the enhanced sum insured (Sum Insured + Cumulative Bonus) and if the same is not available, to the next higher Sum Insured available if requested by the Insured Person.
The proposal acceptance is subject to the insurers underwriting guidelines as well as the perusal of pre-policy medical tests (if required)
C. What is Migration?
IRDAI Definition: - “Migration means, the right accorded to health insurance policy holders (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, with the same insurer.
Which means an insured having a health insurance policy has an option to shift his/her policy to a similar policy with the same Insurer.
An Individual Health Insurance Policy holder shall have option to shift to either a
Similar Individual health insurance policy. Or
to a Group Health Insurance Policy , provided the members meets the terms related to health insurance coverage of the group policy.
A member of Group Health Insurance policy can migrate to a similar Individual Health Insurance policy. However the same will be applicable in case:
Exit from Group Policy
Modification of Group Policy (including the revision in the premium rates)
Withdrawal of Group Policy
While doing so insured will get continuity benefit for applicable waiting periods for the number of years the existing policy was continuously renewed previously
What are the conditions applicable for Migration?
For Individual policies if the policy holder has continuously renewed the previous policy without break for minimum 4 years, migration is allowed without any underwriting to the extent the sum insured and the benefits available in previous policy. However respective product underwriting guidelines will be applicable
Migration from a Group Health Insurance policy to an Individual Health Insurance policy will be subject to underwriting.
Where underwriting is done the Insurance company has to inform its decision to the insured within 15 days of receiving the request.
D. How to apply?
Policyholder desirous of migrating his/her policy to a similar policy of same insurer has to apply to Us at least 30 days before the premium renewal date of his/her existing policy.
Policyholder desirous of Porting his/her policy to a similar policy with Us to apply to Us at least 45 days before the premium renewal date of his/her existing policy.
For more information and details please contact:
Customer Service Cell, Future Generali India Insurance Company Ltd. Corporate & Registered Office
Helplines: 1800-220-233/ 1860-500-3333/ (022) 67837800
Right to migrate from one product to another product of the company
Right to port the from one company to another company