Not Happy With Your Insurance Plan? Here's What You Can Do

Bynamita mody

Buying health insurance has become vital in today’s uncertain times. Scores of people signed up for new general health and COVID-specific plans since the pandemic wreaked havoc in the year 2020. Thousands more already had health insurance before the Coronavirus struck. However, not every person is pleased with their plans.

When is your health insurance plan unsatisfactory?

  • It does not have too many features.

When most people buy their first health insurance plan, they often opt for basic coverage and a simple plan that doesn’t cost them a high premium payment. One might also have company-sponsored coverage, so one may not choose a higher priced plan. But a basic plan without too many useful features may not offer the kind of comprehensive coverage you seek. You should aim to include as many beneficial features and riders as possible, to get a well-rounded plan.

  • Its maximum sum assured is not adequate for your needs.

The sum assured on the health insurance plan is the amount you receive from the insurance provider when you file the claim against hospitalisation and treatment. When you bought the plan a few years ago, the sum assured on it may have seemed sufficient. But as the years pass and the needs of the family increase, along with the possibility of one or more family members developing critical illnesses, the plan coverage needs adjustment. The sum assured must be periodically enhanced to ensure that the coverage amount can beat inflation and be high enough to match current healthcare costs. A low coverage amount often results in the policy holder having to pay treatment and hospitalisation costs out of pocket.

  • The insurance provider is not responsive to queries or claims.

Another reason why some people remain unsatisfied with their health insurance plan, is the insurance provider the plan comes from. While most insurance providers in India offer a wide range of both family and individual health insurance policies, not all of them are equally adept at handling customer queries or claims. The insurance provider must be available 24/7 to answer queries and give more information about the product. The most important attribute to look for is how the health insurance provider settles claims. The claim settlement must be done as quickly as possible, without you or your family members having to gather additional documents, do repeated follow-ups and wait for long.

  • The policy renewal does not leave much scope for plan enhancement.

Policy renewal is an online process. You must renew your health insurance plan at the end of the policy year, i.e. annually. This can – and should – be done online easily in just a few steps. During renewal, you may review the plan afresh and add more riders or enhance the coverage amount to suit current needs. If the plan does not allow much enhancement, and you discover better plans out there, you should consider changing your plan altogether.

What to do about it…

You may port to another insurance provider. Porting a health insurance plan is akin to porting your existing mobile number to another provider, and it is often done for the same reasons: customer dissatisfaction.

Customers are allowed to port their health insurance plan from one insurance provider to another if they wish for a better policy, less premium or other reasons.

The IRDAI mandates that the porting be allowed without any discontinuation in the plan’s benefits from one provider to another. The following are some of the porting conditions:

  • Customers may port from their current insurance provider to any other general or specialised provider of their choice, and also from one policy to another within the same insurance provider
  • One may port both individual and family plans
  • The new provider must maintain status quo on the waiting period for pre-existing conditions that the customer gained with the previous provider, and provide coverage that is at least the same as that of the previous policy
  • The porting is completed between the two insurance providers within certain timelines mandated by the IRDAI, once the customer writes to their current insurer (at least 45 days before policy renewal date) about their desire to port to a specific provider. The customer must also renew the plan without a break