“Portability is not the answer to consumer complaints”

The chief executive officer of Max Bupa Health Insurance, Dr Damien Marmion, says that portability will add to complexity from the customer point of view

What are the major concerns affecting health insurance portability?

It is the beginning of a journey. We are in the early stages in trying to understand the issues. Portability will add to complexity from the customer point of view. The Insurance Regulatory and Development Authority (IRDA) is working on behalf on individual consumers (who have no collective power). They lack the bargaining power of group policies. There are consumer complaints related to denial of claims and so on that are pain points. The question is whether portability is the answer to the problem.

Portability will help in some ways, but we don't know what complexities it will drive. The main reason for portability is pre-existing diseases (PED) waiting period of four years, not applicable after moving to a new insurer.

What about the conditions (not PED) that were developed before or after moving to the new insurer? Is it PED for new insurer and waiting period before they are covered?

Insurers have waiting periods for specific diseases like kidney stones (may be two years waiting period) after joining the policy. Will portability make the insurer pay for these diseases even if the claim comes within two years? The insurer would not want kidney stone claims on day one and the policyholder leaving on day two. What about no-claim-bonus (NCB) or other benefits that earned with one insurer? Will it be ported to the new insurer? What about benefits like maternity (not PED), but which have a waiting period? Will the new insurer give this benefit just because the policyholder had spent time with the old insurer? Another issue is data transfer from the old to new insurer. How much is needed to understand risk, what parameters to transfer, authenticity of data received and so on. Will IRDA want Know-Your-Customer (KYC) norms? What if the policyholder leaves one insurer and new insurer delays getting approval for a policy and then there is a lapse? What about claims during the transition period?

What about portability from a benefit plan (even offered by life insurers) to indemnity (reimbursement) plans? What about loading by new insurer to accept a policyholder as PED will be covered?

You don't have individual loading, only community rating and premiums based on it. Will that change with portability?

We don't load today. If portability forces us (to do so), we may have to change it. For the new insurer to accept a policyholder and cover PED is a risk. We have to see the size and shape of regulations coming in before making any decision.

According to guidelines, the insurer will have to give a policyholder data within seven days to the new insurer for portability to work. It may be of issue for many insurers who do not even share data across divisions. How long will Max Bupa need to give data?

We have it (the data) in an electronic format and it can be given instantaneously.

Insurers still have the right to deny customer underwriting based on perceived risks What are your comments?  

Isn't that self-defeating for portability? It's good for insurers, but bad for customers.

What if IRDA forces an insurer to accept every policyholder applying for portability?

It is a hypothetical question. It is question for IRDA. Is portability the first step of many or only a single step? If it is only a single step, then there are many issues. If it is first of many, then there are hugely complex regulations around the issue. We are glad Moneylife Foundation has taken the initiative to hold a seminar on portability.

Will young customers be targeted for portability? Companies may ignore the older population.

The young (below 30) are difficult to market and attract. Ages 30 and 40 are value conscious and using services. They may port, but not the younger segment. Also, older population with public sector insurers will port to private players.
Why will the older population from public sector insurers move to private insurers? Most private players like ICICI Lombard and Bajaj Allianz don't even have life-long renewal. The public sector has an advantage here.

Many private players have an age limit for renewal. The philosophy of Indian insurers has been risk protection. It is about protecting insurers from bad risk coming in. The policy restrictions are to keep risk low. We offer life time renewal. Bupa does it everywhere in the world.

Will a common (vanilla) product work for portability? IRDA should issue guidelines for no-frills products, shouldn't it?

It is a starting point. Plain, vanilla and clean products will have to be low benefit (it will be the lowest denominator across insurer products). The uniformity will stifle innovation. We do offer portability across our products even across group to individual insurance.

What about sharing of risk between the old and new insurer (to share payment of PED claims)?

It will get complex, and will need a new insurance act.

How about a common pool like motor third party pool?

Motor insurance is mandatory in India, health is not. Such kind of an option will need legislative change. What if one insurer opts out of the pool and leaves others saddled with high risk?



Udaya Shanker Jupudi

6 years ago

Portability in Mediclaim/Health insurance needs lot of ground work. At present the TPAs are not at all solving the Insured's problems without portability. Insured is roaming around insurance branches for his previous policies/ endorsements raised on policies and id cards for getting cash less approvals. Public Sector companies are changing the TPAs on their choices. When the TPA is changed the old TPA will not transfer the Photo Software of the Clients of particular Insurance company to the New TPA. Again the insured has to submit new photoes. These facts are not known to the Insured/Agent/even Brokers. When the claim comes, the TPA ask id card and the insured will roam around the insurance offices. I have seen a case recently i.e., MD INDIA TPA is asking 64 VB confirmation from the insurance Branch, when the policy is clearly showing the payment has been made by Cash and they want particularly the Cash receipt copy. There are so many cases in which TPAs are gaming with customers. Even if portablity comes, nothing will be happen. Then the TPA asks to submit all the insurance policy copies from various insurers. Then the customers will go around all the Insurance companies, instead of one insurance company, now what is happening. Along with the portability, the IRDA should instruct all the insurance companies to show minimum 4 years policy particulars on the current policy irrespective of insurance companies (even it is their company or another company), so that the TPA will settle the claim on the basis of previous policy particulars mentioned in current policy, even if portability applied.

Nagesh KiniFCA

6 years ago

i entirely agree with melvin joseph. all insurers across the board ought to have a vanilla policy with standard covers that can be easily ported, no questions asked.


6 years ago

Portability among dofferent branch offices in a SAME CITY ( forget about different cities/states) for PSU companies DO NOT EXIST !!!!!!!!! Where is question of portability between different insurance cos and different Mediclaim policies ?? Does IRDA knows ground realities in this Mediclaim policies for a retail individual policy holder ????

Melvin Joseph

6 years ago

The situation will become more complex after the portability is allowed. This is because of the complexities of the existing policies, with different features.
IRDA should mandate all companies to have one Simple policy with standard terms and conditions. This customers can opt for portability without any issues in case they require.Companies can have more complex products also for the HNIs and for different categories.
Portability from group scheme to individual scheme also should be allowed, because, this will help the retiring employees in a big way.

Nagesh KiniFCA

6 years ago

Max Bhupa CEO has touched upon the very concerns like PED, NCB, youngsters vs. oldies, vanilla/frilless policies that I've been constantly highlighting. I strongly hold that these form the very core concerns that must necessarily addressed by IRDA or else prevailed upon to address even on the pain of a PIL which is the only weapon of last resort to make them act on the pain of contempt for non-implementation..

ED arrests Hassan Ali Khan's aide Kashinath Tapuria

Mr Tapuria was arrested after being questioned by the ED for three days. Meanwhile, the I-T department has raised a tax demand of Rs591 crore against Mr Tapuria and Rs20,540 crore against his wife Chandrika

Mumbai: The Enforcement Directorate (ED) today arrested Kolkata-based businessman Kashinath Tapuria, an associate of Pune-based stud farm owner Hassan Ali Khan, accused of money-laundering and huge tax evasion, reports PTI.

Mr Tapuria was arrested here after three days of questioning, ED sources said.

Meanwhile, Mr Khan's chartered accountant, Sunil Shinde, has been asked to appear before the ED for questioning. The ED had conducted searches at his residence in Pune yesterday.

53-year-old Mr Khan has been arrested by the agency on charges of stashing huge amounts of black money in banks abroad. He is also facing a Rs70,000-crore tax demand notice from the Income Tax (I-T) department.

The I-T department has raised a tax demand of Rs591 crore against Mr Tapuria and Rs20,540 crore against his wife Chandrika.




6 years ago

Put a GAY LOVER, with every Looters of India in Jail. Guaranteed, they could DRILL them better than CBI and ED.

New PhD admission rules upset Mumbai university students

Students say the new norms, enforced with retrospective effect from July 2009, upsets the choice of subjects that they have made and which have been officially approved

The University of Mumbai's new admission procedure for the Doctor of Philosophy (PhD) is creating trouble for those students who have already got their topics approved by the Research and Recognition Committee (RRC).

Students have complained that they were being compelled to adhere to the new admission rules despite getting prior approval from the RRC for their research topics for the PhD, which were only pending registration formalities before the new norms were introduced. The new rules were implemented in November, following amendments by the University Grants Commission (UGC) to the procedure for admission to the PhD course at universities.

The UGC (Minimum Standard and Procedure for Award of MPhil/PhD Degree) Regulations, 2009, issued by the University Grants Commission on 1 June 2009, and in the subsequent gazette notification of 11 July 2009 by the Secretary, University Grants Commission, made certain amendments to the procedure for admission to the PhD course in universities.

The UGC directive was implemented by the Mumbai university (vide its circular no. 24140) on 18 November 2010. The new procedure was applied to all students who have registered on or after 11 July 2009.

The new rules have become a worry for the students who have started their research work, but were only waiting for registration formalities to be completed. A student who complained to Moneylife said, "I am a registered student of PhD (Computer Science) at Mumbai university and my topic approval was done in March 2009, however, registration formalities were completed after 11 July 2009. Mumbai University circular dated 18 November 2010 advises to follow the new procedure without appreciating the fact that the crucial step of topic approval at RRC was done before 11 July 2009."

Sainath Durge, vice-president of Maharashtra Navnirman Vidyarathi Sena, the students' wing of the MNS, told Moneylife, "There was a gap of nearly one and half year between the release of UGC's new guidelines for PhD and its implementation by the Mumbai University. Because of the delay, students are suffering, which is highly unfair."

Vinod Malale, public relations officer of the University of Mumbai, said, "The new rules were introduced on the lines of the UGC's guidelines. Tomorrow we are conducting an academic meeting and all these issues of admission norms and other procedures for PhD will be discussed."

Interestingly, the Pune University had in December 2009 applied the new procedures only to students registering after 11 July 2009. It mentioned that students having approval at RRC before June 2009 would follow the old rules. This clearly indicates that there is a different interpretation of the same UGC directive by various universities.

An email to the vice-chancellor of the University of Mumbai as well as the registrar, seeking an explanation on the issue, has not been answered yet. In fact, the vice-chancellor's office, stated, "As the matters of PhD are looked after by the Controller of Examinations (CoE), your e-mail has been forwarded to the Controller of Examinations, University of Mumbai." Moneylife tried to contact the CoE for comment, but was not successful.


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