- Date : 15/03/2023
- Read: 3 mins
The IRDAI suggests that an employee covered by company health insurance can migrate to family or individual coverage.
It is possible to convert your group health insurance to a personal policy cover upon quitting or getting fired. You can also request the insurer to enhance the cover. However, the insurer decides on the porting and enhancement.
The Health Insurance Regulations, 2016, of the IRDAI suggests that an employee covered by company health insurance can migrate to family or individual covers. The employer's cover policy start date will be the waiting period credit for specific ailments like cataract surgeries or hernias or for other pre-existing illnesses not covered under the first year's policy.
Also Read: Covid-19 insurance cover in India.
How Does Group Insurance Work?
A company gets a master policy, and the employees become the group policy's part when a company purchases group insurance. Employees are given health cards containing the necessary information. The kind of plan determines whether an employee can add any of their family members. The employer mostly bears the employee's, children's, and spouse's insurance premiums. However, they might ask the employee to contribute if they want their parents added. The group health insurance policy lasts one year, and the employers must renew the plan upon its expiration. Employers can choose other insurance companies if they are unhappy with the existing one. You must remember that you will not be a part of the company health insurance if your employment is terminated or ends with the employer.
Porting to Individual Cover From Group Cover
Individuals can migrate from a group health insurance plan, including their family members, to a family or individual insurance plan with the same insurance company. You must inform the insurer at least 45 days before the last working day with your company to port the cover in these cases. If you have not started the process, you will get a few additional days after the last working day to inform the insurer about the migration.
Remember that the porting option only applies to the insured sum under the group insurance policy. However, you can ask the insurer to enhance the cover. You might have to furnish additional details before receiving a family or individual insurance policy. However, the decision solely lies with the insurer about approval and the price, based on the underwriting guidelines.
Transfer of Benefit
The waiting period also gets transferred upon migrating to a family or individual plan from a group health insurance plan. It means you don't need to repeat it before filing a claim. The porting guidelines set by IRDAI also suggest that if the waiting period for a specific treatment or disease under the family or individual policy is more than the group policy, the insurer must explicitly explain it to the policyholder during porting. Individuals are given waiting period credits during porting based on the continuous insurance coverage years. It does not matter if the group cover contained any time-bound exclusions or pre-existing diseases.
We advise you to have personal insurance coverage above the employer's coverage even though there is a port option. It ensures that you and your dependants have continuous and turbulent-free coverage. It also helps lower the ambiguity and effort involved in migrating an insurance policy.