Porting Your Health Policy? Here's Why You Should Check When The Coverage Kicks In

Policyholders often port their health insurance policy to a new insurer in the hope of wider coverage that can better justify the premiums they are paying. However, have you ever wondered what could go wrong while you are in the process of porting? For instance, you (or any of your loved ones) fall sick soon after porting a policy, and later when you file for a claim something goes wrong. But what?

Let’s understand this from a hypothetical case story;

Anil Sharma, 42, decides to port his health insurance policy to a new insurer for better coverage. After making the switch, Sharma found himself in a dire situation because of one critical information gap. What typically should have been a straightforward process turned into a nightmare when his mother was hospitalised and his claim was denied due to a gap in coverage.

Anil had followed the standard porting process and assumed that his new insurer would provide seamless coverage. His first policy was set to expire on February 27th, following expert guidance he ported his existing policy a few weeks before this expiry date, on January 16, 2025.

In between this porting, around late January, his mother was hospitalised due to pain in the chest (breast) area. After some tests, the doctors informed Anil the worst they could have imagined: Carcinoma cancer. This caused his mother to undergo some urgent treatments. Anil was troubled but also relieved that he had family floater insurance to fall back on and started with the treatment for his mother.

Later, around 2nd March, he filed for a claim but that got rejected after being flagged as a ‘fraudulent claim’. After some queries, he was informed that the new policy had not officially commenced leading to the rejection of medical claims.

The old policy had expired, but due to procedural delays, the risk commencement of the new policy had not been confirmed. As a result, the insurer denied the claim, leaving Anil to cover a hefty hospital bill out of pocket.

Here are some key lessons to learn from this case;

According to Siddharth Singhal, Head of Health Insurance, Policybazaar.com, an online insurance marketplace, while porting their policies, policyholders should;

1. Begin the porting process at least 45 days before their current policy’s renewal date to allow sufficient time for processing and resolution of any issues.

2. Ensure that the new policy offers comparable or better coverage than the old one. Check for differences in coverage limits, exclusions, waiting periods, and additional benefits like no-claim bonuses.

3. Ensure that accumulated benefits such as no-claim bonuses or cumulative bonuses from your old policy are transferred to the new one to avoid paying higher premiums or getting less coverage.

4. Make sure that you share accurate documents, including your existing policy details, medical history, and lifestyle habits, to ensure a smooth transfer.

5. Make sure there is no gap in coverage between the old policy expiring and the new policy commencing

Are there any specific points to note regarding the factors like noting when exactly the coverage kicks in?

Says Singhal, policyholders should confirm that the new policy begins immediately after the old one expires. “The coverage under the new policy starts when the insurer issues the policy, but it’s essential to make sure that the risk commencement is aligned with the expiration of the old policy.”

Additionally, policyholders should also be aware of any waiting periods for pre-existing conditions or specific treatments. “If any waiting periods have already been served in the old policy, ensure they are carried over to the new policy,” he advises.

What should policyholders do if they undergo any urgent healthcare treatment and have to file a claim later while their policy is still being ported?

1. If you’re in an urgent situation, check with the new insurer to ensure there’s no gap in coverage and that the new policy is valid immediately after the old policy expires.

2. If there’s any uncertainty about coverage during the transition, contact the old insurer to see if they can extend coverage temporarily or provide emergency benefits, even if the policy has expired.

3. If possible, file the claim under the old policy if it covers the event before it expires. If the new policy has already started, make sure to file the claim under the new policy, ensuring all documentation is in order.

When is the best time to port your insurance policy?

The best time to port a health insurance policy is at least 45 days before your current policy’s renewal date.

Says Singhal, “This allows time for the new insurer to process your application, address any issues, and ensure that coverage is transferred seamlessly without any gaps. Starting early also gives you the chance to compare multiple options and make the best decision for your healthcare needs.”

Policyholders should know that porting their health insurance policy can be a good way to enhance coverage and reduce costs, but only if done correctly. You can follow the steps mentioned above to ensure that no financial or emotional strain befalls you in your time of need.