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New Delhi's Dhruv Sharma, 47, had a family health insurance of Rs 5,00,000 from Reliance General Insurance Company for four years and was paying a yearly premium of around Rs 5,700, but in March this year when he received the renewal notice he was astonished to see a nine times hike in the premium, to Rs 50,000, although he had not registered any claim in the previous year. He then decided to discontinue that plan and take a new plan from Star Health and Allied Insurance Company by paying around Rs 18,000, by sacrificing his no-claim bonus and coverage of pre-existing diseases. He thinks that the Insurance Regulatory and Development Authority's move to make health insurance portability mandatory will benefit the end customer and will make insurers more policyholder friendly.
With all the excitement over implementation of health insurance portability from July 1, Financial Chronicle sought the opinion of policyholders to understand their expectation from portability. Mumbai's Vishal Mundadha, 31, who had an ICICI Lombard individual health cover of Rs 3,00,000 for past four years found the claim procedure to be too complex when he was hospitalised. He was asked to submit various documents on numerous occasions and he felt that if insurer had better tie-up with the hospital, he would have faced less difficulty. Later, on a friend's recommendation he decided to buy Bajaj Allianz health insurance with an annual premium of around Rs 9,000 for a cover of Rs 4,00,000. He now thinks if portability had been introduced earlier he would have been able to transfer the cover for pre-existing diseases while switching over to his new policy.
The portability regulation allows policyholders, who have continued their policy from one insurer for certain period to switch to some other insurer, in which case the waiting period for some pre-existing diseases will be waived off and policyholders gets cover for those diseases in the new policy. Also in cases where policyholder believes some features such as life-long renewal, maternity or critical illness cover available in other insurer's health policy to be useful, he will now be allowed to port his policy to that new policy under the portability regulations.
However, there are customers who are satisfied with their insurers. New Delhi resident VC Dogra, 62, has never faced any difficulty with New India Assurance in claim settlement or services and so he is inclined to continue with the existing policy. But he believes portability guidelines will bring more discipline among private insurers and would make them develop better relations with health care centres and customers so that in cases of emergencies patient is not harassed.
It is clear that allowing portability will force the insurers to set their own benchmark in terms of service standards and delivery mechanisms. "Portability will call for minimum service requirements among all insurance players and in the long run, it would be the company with better services and integrity that would stand to gain," said Antony Jacob, CEO, Apollo Munich Health Insurance Company.
The insurers are also deciding on the factors, which will be considered to provide portability benefits to a policyholder. "Since the waiting period for pre-existing diseases differ from insurer to insurer, the insurer's primary focus will be that. Apart from that, age, current medical status, past medical history, claim history and sum insured of existing policy will be the deciding factors," said Arun Mehrotra, head of retail underwriting and product development at Iffco Tokio General Insurance Company.
Source : www.mydigitalfc.com
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