As a 55-year-old government employee nearing retirement, I’m considering switching insurance providers for a better premium rate. I currently have a ₹20-lakh policy, and I’ve accumulated a 50 per cent no-claim bonus with my current insurer over the past five years, effectively increasing my cover to ₹30 lakh. 

· If I switch to a new insurer, will this bonus be transferred to my new policy? 

· What portability benefits should I be aware of at my age, especially concerning waiting periods for pre-existing conditions? 

· How will the new insurer calculate my premiums considering my age and claim history? 

· Are there any special considerations or plans for government employees transitioning to retirement?

When it comes to health insurance portability, the decision to switch insurers needs serious consideration. While the option to port your health insurance provides flexibility, it’s crucial to consider whether the new policy aligns with your healthcare needs and financial situation.

The primary consideration should be finding a plan that offers broader coverage against a wide range of medical conditions and treatments. Some policies may appear to offer extensive coverage but might have exclusions or limitations that can significantly impact your ability to access necessary care.

While it might be tempting to switch to a plan with a lower premium, it often comes with trade-offs, such as higher deductibles, co-payments or restricted coverage, which can result in higher out-of-pocket expenses. Additionally, as you age, particularly after 55, premiums tend to increase due to higher health risks. Therefore, it’s important to factor in how the premium costs might evolve over time and whether the new policy will be affordable in the long term.

Access to a network of hospitals and doctors is another vital aspect to consider. Before making the switch, ensure that the new insurer’s network includes the hospitals, specialists and medical facilities you prefer. A policy that offers broader coverage but limits your access to trusted healthcare providers could result in inconvenience and additional costs if you need to seek treatment outside the network.

According to IRDAI regulations, when you decide to switch health insurance companies, the new insurer will review your existing policy details and health history before deciding whether to accept your application. Factors such as pre-existing conditions, past claims paid, or any adverse information on your record can lead to a denial of coverage or higher premiums. Therefore, it’s crucial to be aware that switching insurers might not always guarantee the same level of coverage or affordability, especially if your health status has changed since you first purchased your existing policy.

If your application is accepted, the new insurer is required to match the coverage amount from your previous policy, including any no-claim bonus you’ve earned. Portability also allows you to carry forward waiting periods for pre-existing conditions. If you’ve already completed or partially completed these waiting periods with your current insurer, they will be credited to the new policy. It’s advisable to consult with the prospective insurer and clarify any specific terms or conditions before deciding to port your policy.

While portability offers flexibility, it’s essential to approach it with a comprehensive understanding of all the factors involved. Broader coverage and better access to healthcare providers should be prioritised. By thoroughly evaluating the new policy’s scope of coverage, you can avoid higher out-of-pocket expenses and ensure that you remain adequately protected.

The writer is MD&CEO, Star Health and Allied Insurance

Related Topics