Porting your health insurance policy to a new insurer allows you to switch providers without losing accrued benefits, but many policyholders worry whether claims might be rejected after the switch. Here’s what you need to know.
How Porting Works
Definition: Policy porting allows you to move your existing health insurance policy from one insurer to another without losing cumulative benefits like waiting periods for pre-existing conditions.
IRDAI Guidelines: The Insurance Regulatory and Development Authority of India (IRDAI) mandates that policyholders can port policies anytime after the first year of coverage.
Continuity of Benefits: Waiting periods already served with the old insurer are credited to the new insurer, ensuring seamless coverage.
Can Claims Be Rejected After Porting?
Yes, claims can be denied under specific circumstances, but not arbitrarily:
Waiting Period for New Conditions:
Any new illnesses or conditions not covered in the old policy may still be subject to waiting periods with the new insurer.
Incomplete Disclosure:
If you fail to disclose pre-existing conditions or past claims during porting, the new insurer may reject related claims.
Policy Lapses During Porting:
Claims can be denied if the policy lapses during the porting process due to delayed renewal or documentation issues.
Non-Compliance with Terms:
Claims for services outside the scope of the new policy, like treatments excluded by the new insurer, can be rejected.
Tips to Avoid Claim Rejection After Porting
Disclose Complete Information: Ensure all pre-existing conditions, previous claims, and medical history are transparently shared.
Check Waiting Periods: Understand which conditions are still under waiting periods in the new policy.
Avoid Policy Gaps: Port your policy before the old policy expires to maintain continuous coverage.
Read Terms and Conditions: Carefully review the new insurer’s policy clauses, especially exclusions and limits.
FAQs
Q1: Can I port my policy at any time?
A1: You can port after the first year of continuous coverage, as per IRDAI guidelines.
Q2: Will my pre-existing condition benefits carry over?
A2: Yes, waiting periods already served are credited to the new insurer.
Q3: Can a claim for a pre-existing condition be denied after porting?
A3: Only if there was non-disclosure of information or incomplete documentation.
Q4: How long does the porting process take?
A4: Typically, 15–30 days, depending on documentation and approvals.
Q5: What if my claim is rejected unfairly?
A5: You can appeal to the insurer, and if unresolved, approach the IRDAI Grievance Cell.
Published on : 17th October
Published by : SMITA
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