IRDAI Health Portability Rules: Carry No Claim Bonus When Switching Insurers Without Loss

Switching your health insurer once meant starting from zero. Every waiting period reset, every pre-existing disease exclusion clock restarted, and the cumulative bonus you had stacked over claim-free years simply vanished. Since the IRDAI (Health Insurance) Regulations, 2016 came into force, portability has fixed that. Regulation 12 lets you carry your accrued credits - the waiting periods already served and the no-claim bonus sitting on top of your sum insured - across to a new insurer, provided you apply 45 to 60 days before renewal. The IRDAI Master Circular on Health Insurance dated 29 May 2024 reaffirmed these rights and routed the paperwork through the Bima Sugam marketplace at no charge. This deep dive explains exactly what ports, what does not, and the 15-day clock that quietly works in your favour.

The Rule / Product

Health insurance portability is the statutory right to transfer a retail health policy from one IRDAI-registered insurer to another, or from one plan to another within the same insurer, while preserving the credits you have earned. The governing provision is Regulation 12 of the IRDAI (Health Insurance) Regulations, 2016, supplemented by the consolidated Master Circular on Health Insurance Business issued by IRDAI on 29 May 2024. The legal backbone sits in the Insurance Act, 1938, under which IRDAI derives its rule-making power. Portability is not a goodwill concession; it is an enforceable contractual right that every IRDAI-registered health insurer must honour for individual and family floater retail policies.

Two distinct flavours exist. The first is insurer-to-insurer portability, where you move from Insurer A to Insurer B. The second is intra-insurer portability, where you switch plans within the same company - say from a basic indemnity plan to a comprehensive one - and Regulation 12 still protects your served waiting periods. Crucially, group health cover from an employer is excluded from direct insurer-to-insurer porting, though IRDAI does permit migration from a group policy to an individual retail policy with the same insurer, carrying credit for the continuous period of cover.

The single most valuable credit is on the waiting period. If you have served three years of a four-year pre-existing disease wait, the accepting insurer must credit those three years - you do not begin the 36-month clock afresh. Under the 2024 norms IRDAI capped the maximum pre-existing disease waiting period at 36 months, down from the 48 months that older contracts carried, so porting also lets long-tenure policyholders benefit from the shorter ceiling.

The timing rule is strict and non-negotiable. Regulation 12 requires the policyholder to apply to the new insurer at least 45 days before, but not earlier than 60 days from, the renewal date of the existing policy. Miss that 45 to 60 day window and the new insurer is within its rights to decline on timing alone, leaving you to renew with your current insurer for another year.

Once you apply, a 15-day decision clock starts. The new insurer must obtain your medical and claims history through the Insurance Information Bureau (IIB) portal and decide within 15 days of receiving that data. If it stays silent past 15 days, it forfeits the right to reject and must accept the proposal - a rare consumer-friendly default in Indian financial regulation. The application, historically Form 6 and now filed through Bima Sugam, is free of charge under IRDAI rules.

The sequence is mechanical once you understand the dates. On receipt of your portability proposal, the new insurer has seven days to seek your data from the existing insurer through the IIB system, and the existing insurer must furnish it promptly. The 15-day acceptance window then runs from when the new insurer receives that history. Because the whole exchange is electronic since the 2024 Bima Sugam routing, the friction that once let insurers stall a port for months has largely disappeared, though you should still apply at the 60-day end of the window to leave room for any back-and-forth.

Why It Matters

Portability matters because it removes the penalty for shopping around. Without Regulation 12, a policyholder five years into a contract would face a fresh 36-month pre-existing disease wait on switching - effectively a three-year lock-in that let insurers neglect service quality. By preserving credits, IRDAI converted health insurance into a genuinely competitive market where a 2016-era policyholder can move in 2026 without surrendering a day of accrued protection.

It also protects the cumulative bonus, the silent wealth inside a claim-free policy. Most retail plans add 5 to 50 per cent to the sum insured for every claim-free year, and some super-bonus variants reach 100 per cent or more. That bonus is not a marketing gimmick; it is contractual cover you have paid for through years of premiums without claiming. Regulation 12 requires the accepting insurer to credit an equivalent sum insured, so a policyholder who built a Rs 5 lakh bonus on a Rs 10 lakh base does not walk away from Rs 15 lakh of effective cover.

The reform sits alongside the broader 2024 push toward consumer mobility through Bima Sugam, the unified electronic marketplace, and the use-and-file product regime that lets insurers launch products faster. Together these mean a policyholder unhappy with claim settlement - India recorded an industry incurred-claims ratio around 89 per cent in IRDAI's FY 2022-23 health figures, with wide variation by insurer - can vote with their feet without forfeiting credits. Before deciding, it is worth modelling the new premium against your age band using the health insurance premium calculator.

Worked Numbers

Consider Meera, aged 42, who bought a Rs 10 lakh individual health policy on 1 July 2019. By her 2026 renewal she has gone seven years without a claim and accumulated a 50 per cent cumulative bonus, lifting her effective cover to Rs 15 lakh. Her original policy carried a 48-month pre-existing disease wait, all of which she has served. She is unhappy after a slow 2025 reimbursement and wants to port to a new insurer offering better cashless hospitals.

She applies on 1 May 2026, exactly 60 days before her 1 July renewal - inside the 45 to 60 day window. The table below shows what the accepting insurer must honour.

Now suppose Meera also wants to raise her base sum insured from Rs 10 lakh to Rs 20 lakh while porting. The credit protects only the existing Rs 15 lakh of effective cover. The additional Rs 5 lakh of fresh cover (the gap between her old Rs 15 lakh and the new Rs 20 lakh) is treated as new and attracts the new policy's waiting periods, including the 36-month pre-existing disease wait under the 2024 norms.

The premium Meera pays is the new insurer's standard rate for a 42-year-old at Rs 20 lakh sum insured; portability does not entitle her to a discount, only to credit preservation. If she were instead comparing whether to keep building this health cover or to redirect surplus into protection, the term insurance premium calculator helps size pure life cover separately from health.

Pitfalls

The first trap is the calendar. Thousands of portability requests fail each year purely because the policyholder applied inside the last 45 days before renewal, or applied earlier than 60 days out. Diarise the 45 to 60 day window the moment you decide to switch; a lapse of even one day past the 45-day mark hands the new insurer a clean ground to refuse.

The second trap is the sub-limit and room-rent capping shuffle. Portability preserves your waiting-period and bonus credits, but it does not force the new insurer to match your old policy's clause structure. A new plan may carry a 1 per cent of sum insured daily room-rent cap or disease-wise sub-limits that your old policy lacked, and proportionate deduction on room rent can slash a claim by 20 to 40 per cent. Read the new policy wording line by line before you sign.

The third trap is the co-payment clause, common on senior-citizen and zone-based plans. A 20 per cent co-pay means you bear one-fifth of every admissible claim, regardless of how much cover you ported. If your old policy had no co-pay and the new one imposes 20 per cent, your real out-of-pocket exposure rises sharply even though your sum insured looks identical on paper.

The fourth trap concerns fresh underwriting. Regulation 12 lets the accepting insurer underwrite afresh and reject within 15 days on genuine risk grounds - a recently disclosed cardiac condition, for instance. Never cancel or let your existing policy lapse until you have written confirmation of acceptance from the new insurer; if you cancel first and the port is declined, you can be left uninsured during the gap. Keep the existing policy alive until the new one is firmly in force.

The fifth trap is the enhanced sum insured assumption covered in the worked example: the increment above your ported cover restarts the pre-existing disease clock for that slice. Policyholders often assume the entire enhanced sum insured inherits their served waiting period - it does not. Only the previously held effective cover is protected.

The sixth trap is letting a claim sit before you port. Portability credits attach to a continuously renewed policy; a break of even a single day at renewal can be treated as a fresh policy, wiping out the waiting-period credits you intended to carry. The IRDAI framework allows a 30-day grace period at renewal for premium payment, but cover is not guaranteed during that gap, so never treat the grace period as a planning tool. Port within the 45 to 60 day window and pay the new premium before the existing policy expires to keep the continuity chain unbroken.

FAQ

How many days before renewal must I apply for health insurance portability?

Under Regulation 12 of the IRDAI (Health Insurance) Regulations, 2016, you must apply to the new insurer at least 45 days before, but not earlier than 60 days from, the renewal date of your existing policy. Applications outside this 45 to 60 day window can be rejected on timing alone.

Will I lose my no-claim bonus when I switch insurers?

No. The cumulative bonus accrued on your existing policy must be credited by the accepting insurer at the time of porting. If your base sum insured is Rs 10 lakh with a Rs 5 lakh accumulated bonus, the new insurer recognises an effective Rs 15 lakh of cover without fresh waiting periods on that amount.

Can the new insurer reject my portability request?

Yes, but only on sound underwriting grounds and only within 15 days of receiving your application and your claims history from the IIB portal. If the new insurer does not communicate a decision within 15 days, it loses the right to reject and must accept the proposal.

Does portability cost anything?

No. IRDAI mandates that portability is free of charge. The portability application - historically Form 6, now routed through the Bima Sugam marketplace - carries no fee, though you still pay the new insurer's regular premium for the chosen sum insured.

Can I increase my sum insured while porting?

Yes, but credits only protect the existing sum insured plus accrued bonus. Any enhancement above that figure is treated as fresh cover and is subject to the new policy's waiting periods, including the standard 36-month pre-existing disease wait under the 2024 norms.

Can group or corporate health policies be ported?

Portability applies to individual and family floater retail health insurance only. Employer-provided group health cover cannot be ported directly, though porting from a group policy to an individual retail policy with continuity credit is permitted under the 2024 Master Circular.