Group health insurance is often offered to employees of an organization
Conversion to individual health plan can provide all-inclusive benefits
The waiting period benefit gets carried over when you port your policy
Group health insurance is a common benefit offered to employees in India. Its premium is paid by the employer so you, the employee, can avail cover. On the other hand, individual health insurance is purchased by individuals for themselves.
An individual policy offers wider coverage and long-term continuity. Group health insurance, however, has several limitations in coverage amount, flexibility, and duration. It ceases to exist once you leave the organization. But you can convert your employer’s group health insurance to an individual policy.
As per the IRDAI Health Insurance Regulations, 2016, an individual or a family member covered under group policy can migrate to an individual or family floater policy with the same insurer [1, 2]. So, if you are planning to leave your job, port your group health policy to an individual health plan. This way you can continue enjoying its benefits. Read on to know why and how you can convert your policy.
You get a comprehensive cover by switching from group health insurance to an individual plan. An individual policy allows you more customized options to suit your health requirements. You can carry forward the existing benefits to your new individual plan. You can also transfer your waiting period benefit to an individual policy. But the benefit of the waiting period applies to the existing sum insured only. Here are some benefits of switching to an individual health plan.
Compared to a group health policy, an individual health plan offers better coverage. It covers medical expenses of hospitalization, daycare procedures, room rent, ambulance, and more. It provides you with financial support by covering pre- and post-hospitalization expenses. Besides, you can customize an individual medical plan as per your health needs.
With increasing medical costs, you need better coverage for your medical expenses . To get this, you can transfer your employer’s group health insurance to an individual policy with an increased sum insured. Remember, the waiting period benefit applies only to the existing sum insured. It is not applicable to the increased amount.
One of the benefits of converting a group policy to an individual health plan is the waiting period. If you or your family members have a pre-existing disease, migrating can be very helpful. You can carry over the credit gained in the form of a waiting period when you port to an individual plan. Simply ensure your existing policy continues without interruptions to enjoy this benefit.
Take a note of the following before you port your group policy to an individual health plan.
As per IRDAI guidelines, you can switch your group health policy to an individual plan with the same insurance company. The acceptance of your policy conversion depends on your insurer. The insurer has the right to frame the terms and conditions and decide on the premium amount. The porting of your health insurance plan to other insurance providers can only be done after one year.
If you wish to convert your employer’s group health policy to an individual plan, remember to inform your insurer. You should inform the company at least 45 days prior to the expiry of your existing group policy or before the policy lapses. Your request to switch after this period will not be successful.
The acceptance or rejection of your conversion request depends on the discretion of the insurer. As such, some health insurance companies may require you to undergo a pre-conversion medical checkup to assess your health conditions. The test report helps the insurer evaluate your medical history.
Conversion of a group health policy to an individual health plan requires you to follow the given procedure.
When you plan to port your group health insurance to an individual policy, choose the health plan you wish to buy. Check factors like coverage amount, premium, inclusions, exclusions, policy benefits, and terms and conditions. Doing so will help you choose the right health plan for yourself or your family.
Once you have selected the individual plan, fill up a form for porting your policy. You need to furnish all information asked in the form. Provide details of your existing policy, your age proof, medical history, claims made, and declarations, if any. In some cases, you may need to attach reports of your medical tests.
After filling the form, submit it to the insurer along with the required documents. It is mandatory that you submit the documents at least 45 days before the renewal date of your existing policy.
Upon receiving the documents, the insurer will process your application. The process of underwriting may take up to 15 days to complete. If you accept the new terms and conditions, activate the new policy by paying the premium.
Whether you are a member of a group health insurance or not, buying an individual health policy or a family floater plan is important. The right health insurance policy provides you with comprehensive coverage at affordable premiums. Consider the Aarogya Care Complete Health Solution Plans offered by Bajaj Finserv Health. With these plans, you can cover your healthcare expenses more affordably. Along with medical insurance cover of up to Rs.10 lakh, you can get coverage for regular health expenses related to illness and wellness. Get reimbursed for doctor consultations, lab tests, and avail preventive health check-ups. Start enjoying the benefits by signing up today!