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IRDAI Regulations for Health Insurance: Key Provisions Explained

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Can You Switch Policy Without Losing Waiting Period Credit? What IRDAI Rules Say

Yes, you can switch your policy without losing your waiting period credit, as long as you port at renewal and do not let the policy lapse. IRDAI rules let you carry your waiting period credits and no-claim bonus to a new insurer, up to your existing sum insured. Apply 30 to 60 days before renewal, and the time you’ve already served stays with you.

IRDAI Regulations for Health Insurance

What IRDAI Means by Portability

Portability lets you change insurers without starting over. It’s a right set by the regulator, not a favour from the insurer.

IRDAI defines portability as moving the credits you’ve earned for pre-existing diseases and specific waiting periods from one insurer to another. It applies to individual, family floater and group health insurance policies, and you can only use it at renewal. With a family policy, the whole policy moves, along with every member on it.

If you switch to a different plan with the same insurer, that’s called migration, and your credits carry over in the same way.

What Moves With You When You Switch

The main thing that carries over is the time you’ve already served. That’s what makes porting worth it.

Under IRDAI’s 2024 master circular, these credits move to the new insurer, up to your sum insured:

  • Time served on the pre-existing disease waiting period
  • Time served on specific waiting periods, such as for cataract or hernia
  • Your no-claim bonus
  • Time counted towards the moratorium period

The new policy must also show that you have had continuous coverage since the start of your first policy.

The Catch: Credits Only Cover Your Old Sum Insured

Porting your health insurance policy is a good opportunity to increase your cover. But the extra amount doesn’t automatically come with your old credits.

Say you had ₹5 lakh of cover and ported to ₹10 lakh. Your waiting period credit generally applies to the first ₹5 lakh, subject to any eligible accrued No Claim Bonus. Under the IRDAI (Insurance Products) Regulations, 2024, the new insurer may underwrite the additional ₹5 lakh, which means that this enhanced portion may have its own waiting periods.

The moratorium period works similarly. After 60 continuous months of coverage, including eligible ported years, the insurer cannot contest the policy or claims on grounds of non-disclosure or misrepresentation, except in cases of established fraud. For any increase in sum insured, the 60-month period starts afresh from the date of enhancement, but only for the enhanced portion.

How to Port Your Policy Step by Step

The process is simple, but timing matters. If you apply too late, you could end up with a gap in cover.

1. Apply to the new insurer at least 30 days before your renewal date, and no earlier than 60 days before it.

2. Fill in the portability form along with the proposal form.

3. The new insurer gets your policy and claim history from your current insurer through the Insurance Information Bureau portal.

4. Your current insurer must share these details within 72 hours.

5. The new insurer must give you its decision within 5 days of receiving them.

Insurers can still accept a request made within 15 days of renewal, but the new insurer then has to make sure there’s no break in your cover.

How You Can Lose Your Credits

Your credits are protected only while your cover runs without a break. A missed renewal is the most common way people lose them.

IRDAI gives you a grace period of 15 days for monthly premiums and 30 days for quarterly, half-yearly and annual ones. If you renew within the grace period, all your credits stay safe. If you miss it, your policy has a break, and you can lose everything you’ve built up. So keep your old policy active until the new insurer confirms it has accepted your proposal.

Other IRDAI Rules That Protect You

Portability is only one of the regulator’s safeguards. A few others also matter when you renew or switch.

  • Renewal can’t be refused just because you made claims in earlier years.
  • No fresh underwriting at renewal unless you raise the sum insured.
  • Waiting periods are capped at 36 months, including the one for pre-existing diseases.
  • If your product is withdrawn, you can renew it one last time within 90 days or move to another plan without losing your credits.

Final Thoughts

Switching insurers no longer means starting your waiting periods from scratch. Under IRDAI’s rules, the time you’ve served goes with you, as long as you port at renewal and keep your cover running.

Plan the move 60 days ahead, keep your current policy active, and remember that any extra cover you add starts its own waiting period.

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