Health Insurance Portability: How to Switch

Compare health insurance coverage, waiting periods and premiums before switching insurers.

By Sachin Maheshwari | Insurance & Financial Services Expert

Sachin Maheshwari brings over 22 years of specialised experience in insurance and risk management, including roles with ICICI Lombard and Care Health Insurance. At GreySmiles, he writes on insurance, health insurance and mutual funds, helping readers understand financial products and make informed decisions about their financial security.

Changing your insurer for your health cover does not have to mean starting your waiting periods all over again. Under India’s health insurance portability regulations, eligible policyholders can carry forward specified benefits when switching insurers.

But portability is not guaranteed acceptance. The new insurer assesses your application, and the terms offered may differ from those of your existing policy. For older adults and people with pre-existing conditions, understanding this distinction is particularly important.

When Should You Switch Health Insurers?

Portability makes sense when another insurer offers a meaningful improvement in protection or service. A lower premium alone is rarely enough reason to take the risk.

• Better coverage: Look for fewer restrictive room-rent limits, lower co-payments, fewer disease-specific sub-limits, suitable coverage for modern treatments and access to hospitals near you.
• Service concerns: Repeated claim delays, poor communication or difficulties with policy servicing may justify exploring alternatives.
• Premium increases: Compare the revised premium against the actual benefits, exclusions and potential out-of-pocket expenses of another policy.
• Product withdrawal: Ask your existing insurer about migration options before assuming you must move to another company.

Take particular care if you or a family member has recently received a diagnosis, undergone hospitalisation or has a pending claim. A new insurer may assess your medical history during underwriting.

If you are approaching retirement, also consider the role of health insurance in your wider financial plan. Our guide to health insurance after 60 explains what older adults should check before buying or renewing a policy.

Portability vs Migration: Know the Difference

These two options both deal with continuity benefits, but they are not the same.

• Portability: You move to a different insurer. The new insurer assesses your application and the eligible credits transferred.
• Migration: You move to another eligible policy offered by your existing insurer, subject to the applicable rules and terms.

If your insurer is withdrawing your product, ask about migration before shopping elsewhere. The applicable IRDAI framework provides for suitable migration options and, in specified circumstances, a one-time renewal option for a withdrawn product.

Migration should not automatically be assumed to be free of underwriting or changes in terms. Ask for the proposed conditions and continuity benefits in writing.

Your existing insurer generally cannot refuse renewal merely because you made a claim. Fresh underwriting at renewal is also restricted, subject to applicable rules, including provisions relating to an increase in the sum insured. These protections are worth considering before giving up an established policy.

What Happens to Your Waiting Periods?

The main advantage of portability is that eligible continuity benefits can be carried forward. These may include credits relating to the sum insured, accrued benefits, waiting periods for pre-existing diseases and specified conditions, and the moratorium period.

However, the extent of the credit matters. Portability does not mean every benefit under a new, larger policy automatically inherits your entire insurance history.

1. Sum insured and accrued bonus

Suppose your existing policy has a sum insured of ₹5 lakh and an accrued bonus of ₹1 lakh. You apply for a new policy offering ₹10 lakh.

The eligible continuity credit may include the existing sum insured and qualifying accrued benefits, subject to the applicable rules and the new policy’s treatment of those benefits. The additional cover may be subject to fresh waiting periods and underwriting conditions.

Ask the new insurer to confirm in writing the amount credited, how the bonus is treated and whether any waiting periods apply to enhanced cover.

2. Pre-existing diseases and specified conditions

Under the current framework, the waiting period for a pre-existing disease is generally capped at 36 months of continuous coverage, subject to the applicable rules and policy terms.

Eligible waiting-period credit already earned can transfer when you port. However, do not assume every waiting period in the new policy disappears. Check the treatment of additional cover, specific conditions and benefits that were not part of your previous policy.

Disclose your medical history accurately in the new proposal form, including relevant diagnoses, treatment and medication as requested. Portability does not remove your disclosure obligations.

3. The 60-month moratorium

After 60 continuous months of coverage, including eligible periods carried forward through portability and migration, a policy or claim generally cannot be contested for non-disclosure or misrepresentation, except in cases of established fraud, subject to the applicable framework.

Where the sum insured is enhanced, the moratorium period applies separately to the enhanced portion as prescribed by the rules.

Keep records of your earlier policies and obtain written confirmation of the continuity period recognised by the new insurer.

How to Port Your Health Insurance

Portability is time-sensitive. Begin well before renewal so that medical information, underwriting queries and missing documents do not leave you scrambling at the last moment.

1. Apply within the prescribed window. The usual regulatory window is at least 30 days before renewal, but not earlier than 60 days before the renewal date. Portability generally happens at renewal rather than midway through the policy term.
2. Submit the required details. Complete the proposal and portability forms and provide the existing policy details for all insured members.
3. Allow the insurers to exchange information. The existing insurer is required to respond to the relevant information request promptly and within the prescribed 72-hour period.
4. Wait for the decision. The acquiring insurer must communicate its decision at the earliest and within the prescribed five-day period after receiving the relevant information.
5. Verify the new policy. Check the issue date, start date, sum insured, continuity credits, waiting periods, exclusions and any underwriting conditions.

The framework allows insurers to consider certain late applications within 15 days of renewal where continuity has not broken. This is not a guarantee of acceptance. Start early rather than relying on this provision.

Documents to keep ready

• Proposal and portability forms.
• Previous policy schedules and renewal documents covering the continuous insurance period.
• The latest renewal notice and details of accrued benefits.
• Relevant claim records, discharge summaries and medical documents, where applicable or requested.
• Identity, address and other documents requested by the insurer.

Keep copies of your submissions and the insurer’s responses. Do not rely on silence or a verbal assurance as evidence that your application has been accepted.

What Can Go Wrong During Portability?

Portability protects eligible continuity benefits; it does not guarantee that the new insurer will accept your application on the terms you want.

• Rejection: The new insurer may decline the application following its assessment under the applicable underwriting policy.
• Different terms: The final offer may include a premium adjustment, exclusions or other permitted underwriting conditions.
• Family floater complications: A member’s medical history may affect the assessment of the proposed family policy. Splitting family members into separate policies is a different decision and should be evaluated separately.
• Age and affordability: Premiums may change with age, product pricing and other permitted factors. Consider whether the new policy will remain affordable over time.
• Lost or misunderstood credits: Missing policy records or unclear confirmation of waiting periods can lead to disputes later.

For a wider view of how insurance costs fit into retirement planning, read our guide to health insurance premiums after retirement.

Your Checklist Before Switching

Before accepting the new policy, check the following:

• Keep the existing policy active until the new cover is issued and its terms are acceptable.
• Obtain written confirmation of the sum insured and continuity credits transferred.
• Compare room-rent limits, co-payments, deductibles, disease sub-limits, exclusions and restoration benefits.
• Check whether hospitals near your home are in the new insurer’s network.
• Clarify how pending claims or ongoing treatment may be affected.
• Check riders, critical illness benefits and top-up policies separately; they may not transfer on identical terms.
• Confirm the new policy’s start date and ensure there is no unintended gap in cover.

Also remember that health insurance may not cover every healthcare expense. Deductibles, co-payments, medicines and other out-of-pocket costs can still affect your retirement finances. Our guide on how much to keep aside for healthcare in retirement explains why a separate healthcare reserve can be useful.

Frequently Asked Questions

Can I port my health insurance at any time?

Portability generally takes place at renewal. Apply within the applicable window and allow enough time for underwriting and documentation.

Can the new insurer reject my application?

Yes. Portability does not guarantee acceptance. The acquiring insurer assesses the application under its applicable underwriting policy.

Will I lose my waiting-period credit?

Eligible waiting-period credits can transfer subject to the rules. Confirm the treatment of pre-existing diseases, specified conditions and any enhanced cover in writing.

Should I cancel my existing policy after applying?

No. Keep the existing policy active while the application is being assessed. Check the new policy’s issue date, start date and continuity credits before deciding to move.

Sources & References

• IRDAI — Master Circular on Health Insurance Business, 29 May 2024. Refer to the portability, migration, renewal, grace-period and moratorium provisions.
• IRDAI — Master Circular on Protection of Policyholders’ Interests, 5 September 2024. Refer to the policyholder protection and portability provisions.

This article is for general information and educational purposes. Portability eligibility, continuity credits, underwriting and coverage depend on the applicable regulations, the insurer’s written decision and the policy wording. Confirm the current position with the insurer or a qualified insurance professional before acting.