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Did You Know | How portability from group health cover to individual health insurance will work

Did You Know | How portability from group health cover to individual health insurance will work
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First Published: Tue, Nov 08 2011. 09 52 PM IST

Updated: Tue, Nov 08 2011. 09 52 PM IST
You can port the health insurance policy given by your employer to an individual health cover. From October this year when the Insurance Regulatory and Development Authority allowed portability of similar health insurance policies from one insurer to another, it also allowed for portability from group health insurance policies to individual policies. Here is how it will work.
Group versus individual
Unlike an individual policy that underwrites you, a group health insurance policy underwrites a group and is hence more relaxed. Typically, there is no waiting period in a group health insurance scheme, so not only are you covered from the time you get your health insurance card but all your pre-existing ailments are also covered. In an individual health insurance policy, there are three kinds of waiting periods: an initial waiting period of 30 days before health insurance can be invoked for a medical condition, waiting period of up to four years for pre-existing diseases and waiting period for specified ailments.
What is portable?
In an individual health insurance scheme, it is the waiting period that is portable. So if you have served two years of waiting period when the total waiting period is three, you would have to serve only one year of waiting period in the new policy.
When moving from group health insurance to individual health insurance policy, it is the number of years of continuous coverage from your group insurance policy that is portable. For instance, if you have been covered under a group cover for, say, two years and then decide to port your policy to an individual health cover having a waiting period clause on pre-existing diseases of, say, four years, the new policy will waive off two years of the waiting period.
What to watch out for?
When porting from a group policy to an individual one, the insurer may underwrite you again as an individual and there is a good chance that even ailments you contracted during the term of the group health policy will now be termed as pre-existing diseases. This is because the insurer will treat you as a fresh customer and any ailment present at the time of buying a policy will be considered as a pre-existing disease. In the example mentioned above, you will need to wait out the pre-existing clause for two more years (total four) under your new individual policy. Most insurers will not consider it as a pre-existing disease and will offer continued coverage as soon as you port the policy, but some may load your premium accordingly.
Initially you can port from a group insurance cover to an individual cover of the same insurer. However, after a year you can change your insurer. Also, you have a window of 45 days before the expiry of your policy to port the policy. If you don’t meet the deadline, the insurer can refuse portability.
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First Published: Tue, Nov 08 2011. 09 52 PM IST