Health insurance guidelines modified by IRDAI: Check your rights as a policyholder

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Published: January 4, 2020 10:58:32 AM

Both Migration and Portability are important when a policyholder seeks to migrate from one insurance plan to another or from a group insurance cover to an individual cover of the same insurer or another insurer.

Health insurance guidelines, policyholder, Migration, Portability, health insurance policyholders, pre-existing conditions, health cover, port to another insurerImportantly, the guidelines remain the same but the applicability of Migration and Portability has now been clearly defined.

The Insurance Regulatory and Development Authority of India (IRDAI) has recently come out with a circular on modifications in the Health insurance guidelines. In fact, the modifications relate to the insertion of two new definitions in the list of Standard Definitions for 42 commonly used terms in health insurance that IRDAI had issued earlier.

The two definitions included in the list are – Migration and Portability. Both Migration and Portability are important when a policyholder seeks to migrate from one insurance plan to another or from a group insurance cover to an individual cover of the same insurer or another insurer.

Importantly, the guidelines remain the same but the applicability of Migration and Portability has now been clearly defined. With the introduction of the two definitions, it has been made clear that switching a plan with the same insurer will be referred to as Migration, while a switch to another insurer will be referred to as Portability.

Also Read: Know the features of Standard Health Insurance Policy- Arogya Sanjeevani Policy

What is migration in health insurance policy

Migration means the right accorded to health insurance policyholders 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.

What it means: It means if one holds a health insurance policy as an individual policy, Family Floater or as a group cover, the policyholder has the right to get the credit for pre-existing conditions and time-bound exclusions while switching to a new health insurance policy of the same insurer.

What is portability in health insurance policy

Portability means the right accorded to an individual health insurance policyholder including family cover, to transfer the credit gained for pre-existing conditions and time-bound exclusions, from one insurer to another insurer.

What it means: It means if one holds a health insurance policy as an individual policy, Family Floater or as a group cover, the policyholder has the right to get the credit for pre-existing conditions and time-bound exclusions while switching to a new health insurance policy to another insurer.

The need for Migration of health insurance policy arises typically health covers specific to age groups such as maternity covers, children under family floater policies, students etc. Health insurance guidelines are clear that the insurer will have to offer an option to migrate to a suitable alternative available health insurance policy at the end of the specific exit age or at the time of withdrawal of the policy. In the process, due credit for all previous years also needs to be provided to the policyholders. The need to port a health insurance policy may arise anytime and the policyholder is allowed to get the credit for pre-existing conditions and time-bound exclusions while porting to another insurer.

So, if you want to switch from one plan to another of the same insurer, it will be Migration while a switch to another insurer will be called Portability. As a policyholder, now that you know your rights, making optimum use of the health cover is possible now.

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