Beware Of Health Insurance Portability Fraud!

by SMCIB on Saturday, 17 June 2023

Beware Of Health Insurance Portability Fraud!

If you’ve seen the popular show Jamtara on Netflix, you must know the astonishing number of phone scams, frauds, and phishing incidents that happen in India on a daily basis. You must also have received such calls from people pretending to be from reputable organisations, offering you credit cards, trying to convince you to take loans, talking to you about gifts and coupon codes on e-commerce sites, etc.

With the ever-increasing and evolving insurance market in India, these spam calls have spread to the world of insurance as well. You might get calls related to unclaimed bonuses, premium refunds, new plans, and even porting your current health insurance plan - which is what we’ll precisely be talking about in this article.

First, Let’s Understand What Health Insurance Portability Is.

What do you do when unsatisfied with a product or brand? For instance, say you use an iOS phone that cost you around Rs 1 Lakh. You find a lack of customisation options and there aren’t a lot of free apps on the store. You decide to move to an Android phone that costs relatively less and gives you the type of usage you need.

In the same way, you can shift your health insurance plan to a new plan offered by a different insurance provider if you’re unsatisfied with it. This may be because your current plan has become too expensive, the new plan comes with lesser limitations and conditions, etc.

And, the best part is that you don’t have to undergo any additional waiting periods (provided you maintain your previous policy without any breaks) and can retain any accumulated benefits (like No Claim Bonus, etc.) - under your new health insurance plan.

Note: You need to inform your insurance provider about your intention to port your plan 45 days before your renewal date.

Health Insurance Portability Fraud

With the increase in personal data being spread all around, comes an uptick in the number of scam calls you get from fraudsters. This, unfortunately, applies to health insurance as well. People are getting calls from random phone numbers posing as insurance company call centres - which they are not.

How Do You Figure Out If A Call Is A Scam?

A few red flags to look out for when you get a health portability call -

  1. You might be told that your current health insurance plan has been altered and there is an increase in the premium you need to pay as well as the limitations - when that’s not true. They might even have an urgent tone to feel genuine.

  2. You might be told that any claim you make in the future will be honoured - even in writing.

  3. You might be guaranteed that they are employees of the insurance company - but they are not.

  4. You might be told that your plan has been ported, when in fact, you may get a fresh application without any continuity benefits.

  5. You are told not to make any health declarations to make the policy issuance easy-breezy.

You need to understand that these callers are merely small-time call centre scamsters. If you fall into their tricks and traps, you will end up paying premiums from your own pocket and receiving nothing when you raise a claim even if you are assured about it in writing. Your claim might even be denied on grounds of misrepresentation if you provide no health declarations at the caller’s behest.

How Can You Deal With This Problem?

Here are a few effective tips that can help you avoid getting defrauded and swindled -

  1. Validate any plan changes mentioned by the caller

    If you are told about any changes in your current health insurance plan, whether it’s higher premiums or lowered benefits, confirm the same on your insurer’s website or toll-free number. You can also ask your financial advisor about the same.

  2. Evaluate whether you need to port your plan

    You should figure out whether you really have a need to port your current health insurance plan. Evaluate its premiums, benefits, and limitations. And port only when it is absolutely necessary. Why? Because if you raise a claim immediately after having ported - the new insurer may become suspicious and investigate the case. However, this wouldn't happen with your existing insurance plan, because it would already have years of continuity.

  3. Keep an eye out for suspiciously easy processes

    As discussed before, you may be asked to not mention any health declarations on the application form for faster and seamless policy issuance. This will lead to a claim rejection in the future. So, pay close attention to such shortcuts and hacks that will only lead to hassles in the future. For instance, generally, the porting process needs to be initiated 2 months before renewal. Carry out such processes yourself instead of relying on simplified ways.

  4. Fill out the forms yourself

    Make sure you fill out all the forms yourself with honest and accurate declarations. You should declare all the medical conditions you have, even the ones diagnosed after you were covered by your old plan.

  5. Ensure that your plan has been ported

    When you receive your new plan’s documents, make sure that your old plan has been ported and that you haven’t been issued a fresh plan - because this will result in you losing out on any accrued benefits and having to undergo waiting periods again.

    Note: You should also check that the word ‘portability’ is explicitly mentioned in the policy document.

  6. Speak to an SMC Expert!

    Lastly, you should have a chat with an expert at SMC who can guide you through these processes and also help you understand if you’re being scammed. They have a good claims assistance track record and will be with you till the end of the claims process.

Wrapping Up!

Scams and frauds have been constantly increasing. With the onslaught of such spam calls that bombard your device continuously, it may become hard to find the difference between a genuine and a fake call. We hope this article helped you understand a few tips that you can keep in mind to avoid any mishaps.

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