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Time of India
12 hours ago
- Business
- Time of India
Planning to port your health insurance plan? Here are some challenges you should be aware of
When Pune-based Diwan Varma's father had to be admitted to a hospital twice in quick succession, the insurer paid for the first hospitalisation and rejected the second claim, stating that it was for a pre-existing disease not disclosed earlier. While Varma was awarded the claim after escalating the issue to the insurance ombudsman in 2022, he was disillusioned enough to decide to shift to another health insurer. Being frustrated with long claim settlement delays or poor service by your existing health insurance company may not be the only reason you would want to dump your health plan and opt for a new one. You could be stuck with a policy bought over 10 years ago that has a room rent sublimit, co-payment and a very low cover size, or perhaps you'd rather have a plan that offers restoration, OPD and day-care benefits. 'Insurers have introduced many new plans that are not only more affordable, but are also packed with innovative features tailored to evolving consumer needs. Around 64% of customers who opt to port their health insurance policies cite the pursuit of better coverage at similar or lower premiums as their primary reason, especially given the rising medical inflation in India,' says Siddharth Singhal, Head of Health Insurance at Policybazaar. While it is a good idea to shift to a different plan for enhanced benefits, the transition may not always be the quick-fix solution you would expect. Here are some things to keep in mind before taking a decision to find a new health product and insurer. Should you port or migrate your plan? The first step is to know the difference between moving to a new product with the same insurer (migrating) and shifting to a different plan with a new insurer (porting). 'Deciding between migrating and porting depends entirely on your specific requirements, health needs and satisfaction with your current insurer,' says Pankaj Shahane, Head of Health Claims, Digit Insurance. 'Porting may be a better option when one is dissatisfied with the current insurer's claim service, network hospitals, policy features, or pricing structure,' says Bhaskar Nerurkar, Head, Health Administration Team, Bajaj Allianz General Insurance. One may want features such as wellness benefits, outpatient care, and access to newer or modern medical treatments. Should you port or migrate? Know the difference between the two to be able to take the right decision. 'Migration, on the other hand, is a convenient way to shift to another plan, especially when customers are satisfied with the current insurer and want to explore broader coverage,' says Priya Deshmukh, Head Health Products, Operation & Services, ICICI Lombard. This type of transition to a new plan can also be smoother compared to porting due to the maintenance of continuity with the same health insurer. Migrating also comes with a typically lower risk of underwriting rejections. Problems while porting Porting does offer several benefits because, as per Irdai guidelines, continuity benefits such as waiting periods for pre-existing diseases and specific treatments are transferable. Any no-claim or cumulative bonus can also be credited to your new plan. However, there are hurdles you need to be aware of not only to avoid rejection of your proposal, but also to ensure a smoother transition to the new insurer. Restrictive timeline: A big limitation with porting is that you can shift only during the annual renewal of your existing policy, not mid-term. The window for doing this is at least 45 days before renewal and not before 60 days. So if you have just renewed your policy and realise its shortcomings or face a bad customer service experience, you will have to wait another year before switching your insurer. Another big issue is that you cannot port if your policy has lapsed or does so during the process of porting. So make sure you start the process well before your policy's term ends because the evaluation, medical check-ups and underwriting may take a long time as it is similar to buying a fresh insurance plan. Pros & cons of porting Advantages You can get an insurer with better claim and customer service, and hospital network. You can get an upgraded plan with better features, fewer limits, and lower premium. You can get a plan suited to your medical condition and health needs. Waiting period for pre-existing diseases can be carried over. Accrued benefits and bonus can be moved to new insurer. Drawbacks Underwriting risk is much higher and so is the risk of rejection. You may have to pay a higher premium for better features. You may not be able to get a much higher coverage, especially if you have a claim history. You can move to a new insurer only at the time of renewal. Loyalty discounts and rewards cannot be carried over to new insurer. Underwriting: One of the biggest hurdles while porting is the underwriting process. 'Underwriting usually involves a thorough review of the consumer's claim and medical history, which can impact policy issuance. So, if the applicant has a history of a heart condition, the new insurer may impose exclusions or a waiting period for specific diseases, increase the premium, or even decline the porting request,' says Indraneel Chatterjee, Co-founder & COO, RenewBuy. This is true even if a minor new condition, say borderline high cholesterol, is discovered during the medical check-up, since it could indicate a potentially bigger health problem. 'Before deciding to port your health plan, it's important to assess whether the new insurer's offering aligns both with your current as well as future healthcare needs.' BHASKAR NERURKAR HEAD, HEALTH ADMINISTRATION TEAM, BAJAJ ALLIANZ GENERAL INSURANCE Higher cover limits: If you had bought a basic medical plan before Covid and have a low cover of, say, Rs.3 lakh, you may want to secure a bigger cover. While it is possible to enhance your cover while porting, it may not always be a good idea. Even as the new insurer is bound to offer you a plan that is at least the same size as your existing cover, increasing the sum insured may not make it cost-effective for you. It may be better to opt for a top-up or super top-up plans, which offer a much higher coverage at a lower cost. Secondly, the accrued benefits of waiting periods and no-claim bonus will be carried over only to the extent of your existing cover. 'If you had a sum insured of Rs.5 lakh in your old policy and choose to port to a new plan worth Rs.10 lakh, the benefits of the served waiting periods and accumulated no-claim bonus may apply only up to the Rs.5 lakh limit. For the additional Rs.5 lakh, new waiting periods or other terms of the new policy may apply as per the new insurer's guidelines,' explains Shahane. Adds Chaterjee: 'No-claim bonus may not always be transferred directly; some insurers may adjust it in the new sum insured, while some might not. If the insurer does not adjust it, the consumer might need to start accumulating it from scratch.' Loyalty rewards, other features: While benefits like waiting periods for pre-existing diseases can be transferred during porting, any loyalty discounts offered by the insurer or features specific to your policy will not be shifted. So, if you bought the previous plan with a domiciliary hospitalisation benefit because of your specific medical condition, this feature will not be carried over to the new plan, and the policy you pick may or may not offer it as an inbuilt option. Check before porting Before switching insurers, make sure the new plan bridges the medical gaps and addresses the shortcomings in your existing policy. 'Evaluate key factors, such as the insurer's claim settlement ratio, premium affordability, customer service quality and co-payment or sub-limit clauses, and review exclusions or pending waiting periods in your current policy,' says Deshmukh. Specific features: While focusing on an affordable premium and crucial features, make sure the new plan has features specific to your ongoing medical condition or future requirements, say, maternity benefits if you are planning to start a family. 'It's important to assess whether the new insurer's offering aligns with both current and future healthcare needs,' agrees Nerurkar. OPD & day-care benefits: If you have a lifestyle disease or a family history of lifestyle or mental health illnesses, make sure you opt for the OPD benefit since you will use it more than the in-patient hospitalisation. This also covers dental treatments, teleconsultation, diagnostics and physical consultations. Besides, advanced technology means several treatments can be taken as day-care procedures, such as dialysis, chemotherapy, eye surgery, etc., instead of hospitalisation. 'Underwriting usually involves a review of the consumer's claim and medical history.... and the new insurer can impose exclusions, increase the premium or even decline the porting request." INDRANEEL CHATTERJEE CO-FOUNDER & COO,RENEWBUY Restore benefit: This is another feature that serves well due to the rising healthcare and surgery costs. It allows you to fully or partically recharge the sum insured if you exhaust your limit in a given year. Claim settlement ratio: Check whether the new insurer's claim settlement ratio is the same or better than that of your existing insurer as it reflects reliability and efficiency in settling claims. Portability proposal can be rejected due to… Underwriting risk Since porting is like buying a new policy, it is subject to fresh underwriting and if your health condition, claim history, family's medical history or your age poses a significantly high risk for the new insurer, he has the right to refuse your proposal. Non-disclosure If you accidentally or deliberately fail to give information about a pre-existing illness or disease while filling the proposal form, and it shows up during the medical check-up by the new insurer, your proposal is likely to be rejected. Policy differences Portability is allowed only between similar policies. If you want to move from an indemnity plan to a critical illness policy, or from a group plan to an individual plan, the insurer may decline your request. Also, if you want high coverage compared to your existing plan, it can be denied as being an indicator of an impending health issue. Previous cancellation If there is a history of your previous policy being marked for cancellation or being cancelled for non-disclosure or attempt to misguide, the new insurer can decline your portability request. Procedural issues You are supposed to send in porting request at least 45 days before renewal. If there is a delay or if you submit documents with errors or incorrect information, the new insurer can deny your request. Policy lapse If your policy has lapsed or does so during the process of porting, your new insurer can reject the proposal. It can also be denied if your previous policy shows any renewal gaps in the past.
Time of India
28-05-2025
- Business
- Time of India
General insurance industry to invest Rs 100 cr annually for next 3-5 yrs in nationwide awareness campaign
The general insurance industry has committed to investing Rs 100 crore each year for the next 3–5 years in a awareness campaign to improve insurance adoption. Backed by the General Insurance Council and regulatory support, the campaign is looking to bridge the gap between insurance availability and its penetration across vast population and diverse geographies. The industry leaders today came together to discuss the need for the campaign- Achha Kiya Insurance Liya- with a vision to increase the insurance penetration which at 1% of the GDP against the global average of 3.3%. Tapan Singhel, MD & CEO of Bajaj Allianz General Insurance , said the industry quietly pays claims when it matters the most, that is at the time of need. 'Last year alone, 2.69 crore families benefited from health claims worth ₹83,000 crore. During COVID-19, the industry paid five times its annual profit in claims, without a single bailout request from the government. Insurance silently cushions people in their most vulnerable moments,' he said. Live Events Drawing a sharp comparison between developed and developing economies and how the two gets affected post a catastrophe, he said, in Florida, when a hurricane hits, the state's GDP goes up, thanks to insurance payouts fueling recovery. 'In India, GDP dips because of underinsurance. This campaign is about changing that reality,' he said. He said that ninsured MSMEs take the biggest hit during catastrophes, dragging GDP down by 1.82%. 'If we plug this leaking bucket, India's 6–7% GDP growth can climb to 10–11%. That's the power of insurance,' he said. Anuj Tyagi, Joint MD, HDFC ERGO General Insurance , stressed the role of digital infrastructure in expanding reach saying that with data from IIB, we can now pinpoint uninsured vehicles on Indian roads. 'This opens the door to precise, data-driven enforcement and outreach,' he said. 'Insurance is the only product needed from birth to death,' said Mayank Bhatwal, CEO of Aditya Birla Health Insurance. 'Whether rich or poor, people don't want to compromise on quality healthcare, and only insurance can make that quality accessible.'
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Business Standard
27-05-2025
- Health
- Business Standard
Is your health policy Covid-ready? Key features you must look for
Check if your health insurance covers home care, tele-consultations, PPE kits, room rent waiver and has sufficient sum insured to deal with Covid-related hospitalisation costs Sanjeev Sinha Listen to This Article With Covid-19 cases in India crossing 1,000, policyholders must assess whether their health insurance policies offer adequate coverage and possess the features required to deal with this threat. Gaps uncovered The limitations of many retail health policies were exposed during the first and second waves. 'These included sub-limits on room rent, and exclusion of non-payable items like PPE (personal protective equipment) kits,' says Bhaskar Nerurkar, head – health administration team, Bajaj Allianz General Insurance. The rigid definition of hospitalisation was another impediment. 'Domiciliary treatment was not commonly covered across plans at the time,' says Siddharth Singhal, head of health insurance,
Time of India
21-05-2025
- Business
- Time of India
ICS 2025: Strike the right narrative, then stick to it
HighlightsNidhi Verma, Senior Vice President at Tata Consumer Products, emphasized the importance of self-awareness for brands, stating that authenticity is key to building trust with customers. Akanksha Jain, Assistant Vice President of PR and Communications at Swiggy, highlighted the shift in consumer behavior post-pandemic, urging brands to adopt more genuine narratives that align with their core values. Nikhil Bharadwaj, Vice President and Head of Corporate Communications at Bajaj Allianz General Insurance, pointed out that trust in the insurance industry is built through honoring claims and sharing genuine customer stories. In today's VUCA (volatile, uncertain, complex, and ambiguous) world, maintaining the authenticity of a narrative is crucial. Just as nations strive to control their narratives, corporations aim to project and preserve their brand stories. At the recently concluded India Communication Summit 2025, industry leaders gathered to explore how brands can safeguard their narratives in a dynamic environment. They emphasised that a consistent and genuine narrative helps build trust and credibility. The session featured Nidhi Verma, senior vice president, head – investor relations, corporate communications and vending business, Tata Consumer Products; Sipika Khandka, director and head of corporate communications, Myntra; Nikhil Bharadwaj, vice president and head – corporate communications, Bajaj Allianz General Insurance; Akanksha Jain, AVP – PR and communications, Swiggy; Shilpashree Muniswamappa, director – ESG and communications, Colgate-Palmolive India; and Nitin Mantri, president, APAC, We. and group CEO, AVIAN We. The session was chaired by Manisha Singh, corporate vice president and head of corporate communications and CSR, Axis Max Life Insurance. Verma spoke about the importance of understanding what authenticity means for a company, noting that self-awareness is key. If a brand follows trends or portrays something it is not, customers will quickly see through it. Knowing your values and staying true to them is the first step towards building authentic narratives. 'One thumb rule we follow before launching any campaign is to ask, 'Is this who we are even when no one's watching?' This principle helps ensure that the brand remains authentic to its core values,' Verma said. Khandka shared that when the company launched, with e-commerce still in its early days, the focus was on democratising fashion through technology—a theme central to its early storytelling. However, a few years later, the company paused to re-evaluate whether this narrative still reflected its essence. The conclusion was clear: it was time for a shift. Today, the brand's purpose is to inspire vibrant, joyful self-expression and expand fashion possibilities across India. This vision shapes campaigns, guides storytelling, and influences hiring and internal communications, ensuring brand values are reflected across all levels. Bharadwaj pointed out that there are no shortcuts in insurance and that trust is built by honouring claims. 'Insurance is about selling a story. You're not selling a tangible product, but a narrative. If you're genuine in your commitment, customers will trust you. And that trust comes from paying claims—there's no other way. You must consistently share stories of claims you've settled.' He added, 'Authenticity grows when customers speak positively about their experiences, especially after receiving a claim. It's not about promising the cheapest policy or vague assurances like 'We'll be there when you need us.' People need to understand that insurance is not the business of collecting money—it's the business of paying claims.' Jain spoke about the shift in consumer behaviour post-pandemic, which pushed brands to adopt more authentic narratives. 'During COVID, consumers began valuing what is real and authentic over fairytale stories. Brands had to wake up, take a stance, and return to the drawing board to craft a playbook for more genuine storytelling across all platforms.' According to Jain, this shift coincided with the rise of Gen Z, who, according to research, prefer brands with a clear purpose. 'Your narrative must align with your core values to avoid feeling like a hard sell, which fails to connect. Authenticity should be seamless across all touchpoints—from campaigns to customer interactions—to ensure the brand remains genuine. 'You can't have authentic storytelling on one platform while pushing aggressive sales on another. Similarly, if senior management champions a narrative but the on-ground team doesn't reflect it, the effect is diminished. Authenticity must flow from top to bottom for a cohesive brand story.' Muniswamappa shared an example from her time at Alstom, a company known for manufacturing trains and metros. 'I hadn't realised how passionate many young people in India are about trains,' she said. 'People would eagerly point out Alstom's contributions—like their role in the Make in India initiative, the jobs they've created, and their supply chain efforts. By keeping your narrative focused and consistent, and delivering on your promises, you build trust. That's the only way to foster long-term confidence among stakeholders.' Mantri said, 'Legacy is a platform to nurture and build upon, not a museum piece to be preserved.' 'Inconsistent narratives over time erode trust, as they signal dishonesty in the brand. Our research revealed that customers may quickly embrace a brand, but they're equally quick to criticise if something goes wrong. This raises a critical question: if your brand faces swift backlash, how deep is its relevance and loyalty among customers?'
Time of India
19-05-2025
- Health
- Time of India
Mental health insurance problems continue: 5 things to check before buying a cover
There has been a 30-50% rise in mental health-related claims in the past 2-3 years, claims a recent study by Policybazaar (see graphic). 'We've also seen a 41% year-on-year growth in mental health insurance searches in 2025,' says Siddharth Singhal, Head of Health Insurance, Policybazaar. The surge is corroborated by Bhaskar Nerurkar, Head, Health Administration Team, Bajaj Allianz General Insurance: 'We've seen a steady increase in mental health related claims, with a CAGR of about 33% from 2021-22 to 2024-25. In the last year alone, there was a 23% rise in such claims over the previous year.' These figures seem reassuring in the face of grim societal stigma and the fact that 10.6% of adults in India suffer from mental disorders and the lifetime prevalence of mental disorders is 13.7%, as per the National Mental Health Survey 2015-16 by NIMHANS. However, Anuradha Sriram, Chief Actuarial Officer, Aditya Birla Health Insurance, strikes a discordant note. 'While awareness and conversation around mental health have increased in recent years, we have not observed a significant rise in mental health related hospitalisation claims,' she says. This is because most treatments for mental health continue to be outpatient-based, which are generally not captured in the scope of hospitalisation plans, she explains. The in-patient focus of most plans is only one of the several problems faced by people seeking mental health covers despite the insurance regulator's proactive approach in widening the scope of coverage. Live Events Irdai guidelines Though the Mental Healthcare Act, 2017, was enforced in May 2018, Irdai was forced to issue circulars in August 2018 and then again in October 2022, requesting compliance by insurers and removal of mental illnesses from their list of exclusions. The guidelines stated that mental illnesses had to be treated at par with physical illnesses when it came to providing coverage. While insurers eventually started offering mental health coverage in their plans by the end of 2022, in February 2023, Irdai was again forced to issue a circular to 'mandatorily launch and immediately offer' an 'appropriate product' and a 'specific cover' for persons with mental illnesses, disabilities and HIV/AIDS, which translated to a standardised, standalone cover. A crucial inclusion was the need to put in place a 'Board-approved underwriting policy that ensures no proposal is denied'. This meant the insurers could not refuse a cover to a person with pre-existing mental disorders. Problems in getting coverage Today, all general and standalone health insurers do abide by the Mental Healthcare Act, 2017, and include mental illnesses in their health plans. 'We offer mental health coverage as part of our health insurance plans in alignment with Irdai guidelines. The plans typically cover hospitalisation expenses arising from mental illnesses, including depression, anxiety, bipolar disorder and schizophrenia,' says Priya Deshmukh, Head, Health Product, Operations & Services, ICICI Lombard. Other insurers too cover mental illnesses under their comprehensive plans. In-patient, not OPD plans: The problem with most such covers is that these are indemnity plans that only cover hospitalisation or in-patient expenses, whereas most mental disorders require periodic doctor consultations, therapies, counselling, medication and psychiatric evaluations, which are out-patient features. Policybazaar data shows that conditions like anxiety (30-35%) and depression (25-30%) are the top reasons for claims, which are usually managed through out-patient care rather than inpatient admission. 5 questions to ask before buying a mental health plan Without these features and benefits, the insurance policy may not be of much use to you. 1. Does it have a pre-existing disease waiting period? If the applicant already suffers from a mental illness, buying a plan may be a challenge, depending on the severity of the disorder. In all probability, he will have to clear the waiting period for pre-existing diseases, which is 2-3 years for most insurers, before he can be covered for the disorder. 2. Does it offer OPD benefit? Doctor consultations and medication are an integral part of mental health treatments, which can only be covered by a plan with an OPD feature. So, if OPD benefit is missing, either as a part of the base cover or as an optional feature, the plan won't be of much use to you. 3. Does it cover therapy & counselling? Even if the OPD benefit is included in the plan, not all insurers offer all the features that are crucial for mental health treatments, such as therapy, counselling and psychiatric evaluations, which can be very expensive. Make sure these are a part of the cover. 4. Is your therapist or health care centre in the network? Most insurers require the treatment to be conducted by a qualified practitioner in a recognised institute, hospital or clinic that falls in its network. If these don't fulfill the insurer requirements, you will not be able to make a claim. 5. Is your illness covered? You will need to ensure that your particular mental illness is included in the plan. The disorders usually covered by insurers include anxiety, depression, bipolar disorder, schizophrenia, PTSD and dementia. If the illness is not covered, there's no point buying the cover. Agrees Sriram: 'Our flagship products are hospitalisation-focused indemnity plans, covering in-patient treatment for mental health conditions. However, many mental health treatments, like therapy or consultations, are outpatient in nature and are not covered under the base plan.' 'OPD coverage is crucial even as an addon because a plan that only covers hospitalisation may not suffice for real-world needs,' says Singhal. So, either the policy buyer needs to find a plan that has an in-built OPD feature, or buy an OPD rider along with the base cover, both of which require additional expense due to higher premiums that these entail. Underwriting hurdles: For people with existing mental conditions, especially with a high degree of severity, it can be difficult to buy a plan despite Irdai specifying that insurers cannot refuse it. 'While Irdai has mandated insurers to cover mental health conditions, underwriting still applies. This means that individuals with a known history of mental illness may face medical assessments, loading on premiums, or specific exclusions,' says Deshmukh. This could mean either expensive plans, limits on coverage, or long waiting periods, usually between two and three years, and sometimes even rejection for severe disorders. Network practitioners: Since the treatment for many mental illnesses requires therapy and counselling, many people pick private therapists or clinics, which may not be in the insurer networks or empanelled. Besides, correct diagnosis and effective therapy can often mean sifting through various doctors and counsellors before finding the right one that suits the patient, and not every such practitioner may be a part of the insurer network. Standardised plans: Many general and standalone health insurance companies offer a standardised plan that provides a cover of `4-5 lakh and includes mental illnesses among other disabilities and disorders. This standardised plan is an affordable base plan with similar offerings across insurers, but is available under different names and varying premiums, which is typically low. However, since it is not a comprehensive plan and offers low coverage, it means the policyholders would need to pad it up, besides buying another cover for other illnesses as well. What to look for in a plan 'Consumers should look for comprehensive plans that include mental health as part of their base coverage and evaluate whether the insurer offers any additional riders/add-ons that support out-patient care or wellness programs,' says Sriram. Agrees Nerurkar. 'It's advisable to consider whether the policy offers OPD benefits for consultations, therapy sessions, and medication. Some plans also provide wellness programs or teleconsultation services, which can be highly valuable for ongoing support. Transparency regarding waiting periods, exclusions (like illnesses related to substance abuse), and pre-existing condition disclosures is critical to ensuring seamless claims later,' he says. One should also check whether the insurer has a strong hospital network with the required facilities. 'Ensure that the insurer's network hospitals include facilities offering psychiatric services and that these are accessible in your area,' says Deshmukh.
