Health Insurance Portability in India – Is it helping the customers?

I know people who waited for 4 years for portability to come in Health Insurance. It came but has left many of them disappointed. It is natural that any scheme has to have guidelines so that interests of customers are not affected.
Over period of time many strict guidelines have been issued. Let us look at some of these.

1. 45 days–Proposal to reach the new company 45 days before the expiry date of the policy.
Drawback: (a) Client does not get renewal notice 60 days before expiry. He should get 15 days to make up his mind as hundreds of products are available. He has to choose the company and also the specific product, so that he can consider porting to a new company at least 45 days before the expiry date.

(b) No Insurance Company issues renewal notice 60 days prior to renewal .It is noticed that even if client asks for it is very difficult to get the same.
Positive Point:
In case the new company refuses to issue the policy the insured has the chance to go back to the existing insurance company.
Suggestion:

• Insurance company should issue the renewal notice 60 to 75 days prior to renewal.

2. Medical Record/ Insurance policy record for past years since inception of the policy.
Drawback:

If some one is having policy for 1 year then data is required from 1 insurance company for 1 year only. But if some one is having policy for 12 years then data is required from all insurance companies / TPA’s involved for full period i.e. 12 years.

Positive Point:

Opportunity to new Insurance Company to look at past data.

Client gets benefits that no chance is left with insurance company for refusing claim at a later date due to treatment being for pre existing disease.

Drawback

In 2002 era many Insurance Companies were operating with manual systems / data and of course claims were being passed on ‘in-house basis’ TPA’s came later on. Many a times company changed TPA year wise. If data is not provided by existing insurance company for all the years new Insurance Company can not issue the policy. Many customers are suffering because of this requirement. For them portability was a dream which has turned sour.

Suggestion:

Limit the data requirement to 4 years – let us bring cheer to the insured who want portability to have the freedom of choosing insurance companies as their number has increased to 25.

3. Claim Documents for all claims lodged during period, policy has been in force.

Drawback

a) If client had lodged claims in last 2 or 3 years – then there are good chances that record will be available. But if any claim was lodged 12 years back then expecting client or existing insurance company to provide all documents pertaining to the same is neither feasible nor possible.

b) If there was a major claim say 7 years back or 12 years back then portability is not being allowed by the new insurance company. It means portability is for those who have not claimed any claim in the past.

Positive Point:

(a) Nothing

Suggestion:

Insurance companies should not ask for claim data for claims which were lodged earlier tha
4 years.

We are sure Insurance Companies will accept these suggestions and help in growth of Health Insurance.

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