Hyderabad, A customer cannot expect continuity of benefits in case he wishes to migrate from a common portable mediclaim to another health insurance product, according to the portable health insurance policy drafted by the General Insurance Council.

The policy document, which is awaiting clearance from the Insurance Regulatory and Development Authority (IRDA), also states that continuity of benefits is not assured if the insured is migrating from another insurance product to a common portable mediclaim.

The portable policy, however, would provide complete continuity in case the insured is migrating from common portable mediclaim of one insurer to common portable mediclaim of another insurer.

“The common portable mediclaim has been developed primarily for the purpose of offering a policy which provides full portability of covers. As a corollary, insurers do not envisage guaranteeing portability in their other health insurance products,” the Council said in its document.

The Council has also recommended that the scheme should be applicable to those in the age group of 18 to 40 and the portable cover would be available for a three-year period initially.
Standardisation

The benefits of cover would also be standardised across companies which would have the freedom to fix their own premium rates. The GIC has also favoured the portability for policies below Rs 1 lakh.

The document also states that pre existing diseases and conditions, until 48 consecutive months of continuous coverage have elapsed, since the first common portable mediclaim policy with any insurer is not covered under portability.

“However, if the insured was covered under the common portable policy continuously and without interruption for four consecutive years with any non-life insurer, the exclusion does not apply,” the GCI has recommended.

The GIC has also said that the policy is fully portable amongst the various non-life insurance companies and the shift from one company to another will be allowed only during annual renewal. “In case of roll over, a policy will be issued at the same wording with a continuity of coverage,” it said.

Also, it states that if a claim is preferred under this policy, the loading of premium (the amount an insurance company adds to the basic premium to cover the expense of securing and maintaining the business) will be at the discretion of the existing underwriter or taking over underwriter.