The IRDAI Migration and Portability guidelines apply to all Retail (Individual) and Group indemnity Health insurance products.
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. The guidelines apply to both Individual-insured and Family floater sum-insured policies.
Migration:
The insured person may migrate from existing health insurance products/ plans to other health insurance products/plans offered by the same insurance company. In other words, an insured having a health insurance policy has the option to switch his/her policy to a similar policy. The insured has to apply for migration of the policy at least 30 days before the policy renewal date as per IRDAI guidelines on Migration. If such a person is presently covered and has been continuously covered without any lapses under any health insurance product/plan offered by the company, the insured person will get the accrued continuity benefits in waiting periods as per IRDAI guidelines on migration.
A member of a Group Health Insurance policy can migrate to a similar Individual Health Insurance policy. However the same will be applicable in case (i) Exit from Group Policy (ii) Modification of Group Policy (including the revision in the premium rates) (iii) Withdrawal of Group Policy. The members of a Group Health Insurance Policy may also migrate provided the members meet the terms related to health insurance coverage of the group policy.
If the insurance company withdraws its specific plan/product, it shall inform the insured person about the same 90 days before the expiry of the policy. Then insured person has the option to migrate to a similar health insurance product available with the Company at the time of renewal with all the accrued continuity benefits such as cumulative bonus, and waiver of waiting period, as per IRDAI guidelines, provided the policy has been maintained without a break.
Portability:
Clause 18 of Schedule – I of IRDAI (Health Insurance) Regulations 2016 specifies that the portability shall apply to the sum insured under the previous policy and also to an enhanced sum insured, if requested by the insured, to the extent of cumulative bonus acquired from the previous insurer(s) under the previous policies. A policyholder desirous of porting his/her policy to another insurance company shall apply to such insurance company to port the entire policy along with all the members of the family, if any, at least 45 days before, but not earlier than 60 days from the premium renewal date of his/ her existing policy.
The continuity of the ported insurance policy with the new company will apply to (i) General waiting period (ii) Waiting periods for coverage of pre-existing disease conditions (iii) Time bound exclusions (for instance 3 year waiting periods for listed conditions (iv) The continuity for waiting periods will be applicable only up to the sum insured and cumulative of the previous policy and (v) 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.
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