Talk about the health insurance portability option has been on since at least two years before it actually came into effect. Also, much was written about it when it finally became effective. Yet, the response it has got so far has been lukewarm. The reason, insurers say, is that policyholders still have little information.
Insurance companies say a large number of port-in requests they receive is from agents, and not policyholders. Some policyholders who are aware think they can port policies at any time. But, that’s not true.
Companies blame industry experts’ ‘policyholder-friendly’ portrayal of the portability option. Your request to port your health insurance policy to another insurer may not always be accepted. Here are some reasons why it can be rejected.
Policyholder’s age
Your age can play spoilsport. “If you are above 45 or 50 years old, it’s like a red mark on your report card. The insurer gets sceptical about continuing your cover,” says a health insurance company official. Those in the higher age group are more likely to claim against a policy than young people. And, given that a ported policy is not considered new, there can’t be any waiting period applied to it. As a result, it can be a risky proposition for the insurer, who may want to reject the port-in request.
Many insurers issue health insurance policies till the age of 60. But, you might not be allowed to port in even if you are nearing 60, says the official.
Though the primary reason for portability is supposed to be continuation of coverage, don’t be surprised if an insurer asks you to undergo medical test (those above 45) before porting in your policy. This is mainly to find health issues and reject your request.
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Claim history
If you have claimed against your policy once, you might not stand a chance to port your policy out. A M Mallesh, vice-president, Star Health and Allied Insurance, says: “We have rejected many policies that had claim history.”
Insurers say most policyholders want to port out of their present insurers because they have a grouse against claim settlement procedure(s). This means there is a possibility of early claim against such policies, if these requests are accepted, say insurers. And, these claims can be very high, which insurers aren’t comfortable taking up.
A private insurer says a customer is asked why he/she wants to shift, before porting in a policy. If he/she says a claim settlement has been made more than once, the request is rejected.
Association with current insurer
If you have been with an insurance company for five years or more and want to shift to a new one, you may not be allowed to do so. Mahavir Chopra of medimanage.com explains many new insurers (whom policyholders want to shift to for better service) may not have the capital to service your claim. Insurers say in such cases, mostly agents request to port the policies and policyholders are not aware about the pros and cons. That is also a reason for rejection.
Bharti AXA General Insurance CEO Amarnath Ananthanarayanan says an insurer need not always reject your request to deny you the port-in option. “In many cases, companies accept your request but offer their policies at high prices, which you would not accept.”
Lifestyle issues
Pune-based BPO employee Siddhartha Roy’s request to shift his health insurance policy from a public sector insurer to a company specialising in health insurance was rejected. Roy thought it would be easy for him to port his policy as he was young. But, that’s not true. The application of the 30-year-old was rejected on the ground of his would-be lifestyle problem(s).
Roy was told his was a 12-hour job, which did not allow him much movement. So, he might become overweight in the coming years and develop bone and posture-related problems.
For similar reasons, port-in requests of others, such as chain smokers, those who are underweight or very close to obesity level 1, suffering from low and/or high blood pressure, or those in stressful jobs could also be rejected. So, beware.