Policy reforms, innovative products
Regulatory changes have made portability easier. The regulator has removed the entry age for new and ported business while also allowing continuity of benefits such as waiting periods. “The launch of dedicated plans for senior citizens, insurers offering riders that reduce the waiting period, and day-one coverage for common pre-existing diseases (PEDs) are encouraging more seniors to port,” says Siddharth Singhal, head of health insurance, Policybazaar.
Hurdles seniors encounter
Underwriting norms for seniors are stricter. Insurers often make them undergo extensive medical tests. “The new policy may carry a steep premium. Seniors with multiple existing conditions could be denied coverage. High-risk ailments could be excluded from coverage,” says Vinita Porwal, associate director, Anand Rathi Insurance Brokers.
Documentation requirements can be heavy. “Seniors usually need to provide copies of the past policy, claims records, and health declarations,” says Singhal. Rejection rates are typically higher in this group.
Seniors may consider porting if their current insurer does not provide timely services, a sufficient sum insured, or new features. “It may be considered to add coverage for lifestyle diseases or OPD (outpatient department) benefits,” says Porwal. Rising premiums also call for a switch.
However, porting may not suit all. “If a senior has multiple recent claims or critical illnesses, they would be better off staying with their current insurer as their chances of porting would be slim,” says Singhal.
What to look for in the new policy
Waiting periods, moratorium benefits, and no-claim bonuses must be carried forward. “Before switching, get written confirmation of continuity benefits—like credit for waiting periods—to avoid surprises,” says Vaibhav Goyal, managing director and chief executive officer, Navi General Insurance.
Pankaj Verma, chief technical officer (products and underwriting), Zurich Kotak General Insurance Company (India), advises checking the new insurer’s claim settlement ratio. Seniors must confirm that the hospital network is strong and includes the best hospitals in their area.
Experts caution against policies with sub-limits. “Avoid room rent capping and disease-wise or treatment-wise sub-limits, especially on modern treatments, which increase out-of-pocket expenses,” says Shilpa Arora, co-founder and chief operating officer, Insurance Samadhan. If a patient opts for a more expensive room than the policy allows, the entire hospital bill would get inflated.
The policy should offer a reasonable or zero co-pay. Arora cautions that seniors must ensure no deductibles or co-payments are added without consent.
Seniors must avoid choosing a policy based on price alone. “A cheaper plan may come with high co-pay, strict room rent cap, or disease-based sub-limits,” says Goyal.
Seniors must carefully evaluate the benefits and costs of porting and only go for it if there are clear and tangible benefits.
“Start the porting process 45–60 days before renewal to allow time for paperwork and approvals,” says Goyal.
PEDs must be fully disclosed to avoid disputes at the time of claim. “Keep all medical records handy to simplify the process,” says Verma. He also suggests taking guidance from trusted advisers.
After receiving the policy document, seniors must carefully review the fine print to ensure that waiting periods and moratorium benefits have been accurately transferred. Verma says he has come across many cases where policyholders realised only upon hospitalisation that their new policy contained loopholes which they did not discover during porting.
An additional point needs to be remembered regarding continuity benefits. “These benefits only apply to the extent of the existing sum insured. Any enhanced cover may attract fresh waiting periods,” says Arora.
This writer is a Mumbai-based independent journalist.
 "retirement homes, senior citizens")