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—practical-guides:health-insurance-portability-waiting-period-reset-wrongly [2026/07/22 17:47] (current) – created - external edit 127.0.0.1
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 +{{htmlmetatags>metatag-title=(Health Insurance Portability Reset Your Waiting Period? Fix)&metatag-description=(Ported your health policy but the new insurer reset your pre-existing disease waiting period? Get continuity credit restored: proof, insurer fix, IRDAI route.)&metatag-keywords=(health insurance portability, waiting period reset, pre-existing disease, continuity benefit, IRDAI, Bima Bharosa, Insurance Ombudsman, porting)&metatag-robots=(index,follow)&metatag-og:title=(Health Insurance Portability Reset Your Waiting Period? Fix)&metatag-og:description=(Ported your health policy but the new insurer reset your pre-existing disease waiting period? Get continuity credit restored: proof, insurer fix, IRDAI route.)&metatag-og:type=(article)}}
 +
 +====== Health Insurance Portability Reset Your Waiting Period Wrongly? How to Fix It ======
 +
 +**You ported your health insurance to a new insurer expecting your old years to count, but the new policy started the pre-existing disease waiting period from zero. Under the IRDAI portability framework, the waiting-period credit you already earned is supposed to carry over as continuity benefit. This guide shows you how to prove your continuous coverage, ask the insurer to correct it, and escalate to IRDAI through Bima Bharosa and the Insurance Ombudsman if it refuses.**
 +
 +{{:practical-guides:health-insurance-portability-waiting-period-reset-wrongly.webp|Health Insurance Portability Reset Your Waiting Period Wrongly? How to Fix It}}
 +
 +**Reviewed on:** 2026-05-29.
 +
 +<WRAP center round info 95%>
 +**Quick Reply:**
 +
 +When you port a health policy from one insurer to another, the years you have already served towards waiting periods for pre-existing diseases and specific ailments are meant to carry over as continuity credit. The new insurer should not treat your policy as brand new. **First step: get the new insurer to confirm the waiting period in writing and gather every old policy schedule and renewal certificate that proves your unbroken coverage.** Then send a written correction request to the insurer's grievance redressal officer asking it to apply continuity benefit. If that fails, escalate to IRDAI through the Bima Bharosa grievance portal, and then to the Insurance Ombudsman. Private insurers are not covered by the RTI Act, so the insurer correction and IRDAI route come first.
 +</WRAP>
 +
 +===== Who this guide is for =====
 +
 +This guide is for anyone who ported their health insurance to a new insurer and then discovered that the waiting period for pre-existing diseases or specific ailments has been reset, and who has either:
 +
 +  * Completed part or all of the pre-existing disease waiting period under the old insurer, but the new policy shows the clock starting again from zero, or
 +  * Had a claim or pre-authorisation declined by the new insurer on the ground that the waiting period is "not yet complete", despite years of prior cover, or
 +  * Seen the new policy schedule record a fresh waiting period with no continuity credit, even though coverage was continuous and the porting was approved.
 +
 +It is especially useful if you ported mainly to keep your accrued waiting-period credit, because that credit is the most valuable thing you carried over, and losing it can leave a known condition uncovered for years.
 +
 +==== Who this guide is NOT for ====
 +
 +This guide does not cover a genuinely fresh policy where you never had prior cover, because there is no continuity credit to carry over in that case. It also does not cover claim rejections based on non-disclosure of a pre-existing condition, where the dispute is about what you declared rather than how much waiting period you served. For that, see our guide on a [[/practical-guides/health-insurance-pre-existing-disease-claim-rejection-appeal/|pre-existing disease claim rejection appeal]]. If your cover lapsed beyond the grace period and continuity was genuinely broken, the legal position is different and you should read the renewal-break section below carefully before disputing.
 +
 +===== What you can do this weekend =====
 +
 +==== Friday evening ====
 +
 +Pull out your new policy document and find exactly how the waiting periods are written. Look for the pre-existing disease waiting period, any specific-ailment waiting period, and the initial waiting period. Note whether the schedule shows any continuity credit, "ported policy" remark, or a continuous coverage start date. Then open your old policy folder or email and list every policy year you held with the previous insurer, with start and end dates. Write down the date your very first health policy began. This single timeline is the foundation of your entire case.
 +
 +==== Saturday ====
 +
 +Gather hard proof of unbroken coverage. Download or print every old policy schedule and renewal certificate, year by year, so there is no gap between one year's end date and the next year's start date. Collect premium payment receipts and any portability acknowledgement or reference number you received when you switched. If you cannot find a year, contact the old insurer in writing and ask for a copy of that policy schedule or a continuity certificate showing your coverage history. Save everything in one clearly named folder so you can attach it to a complaint in minutes.
 +
 +==== Sunday ====
 +
 +Draft your written correction request to the new insurer using the template further down. State plainly that you ported your policy, that you had already served a defined number of years of waiting period under the old insurer, and that you are asking for continuity credit to be applied and the waiting period corrected. Attach the timeline and the supporting documents. Do not send angry messages on chat or social media as your main record. Keep your dispute in writing through the insurer's official grievance email or portal so you have a dated, traceable trail you can later show to IRDAI or the Ombudsman.
 +
 +===== Documents and evidence checklist =====
 +
 +^ Document / Evidence ^ Why you need it ^ Where to get it ^
 +| New policy schedule and policy wording | Shows how the waiting period has been recorded and whether continuity credit was applied | New insurer's app, portal, or your email at the time of porting |
 +| Old policy schedules for every year | Establishes an unbroken chain of coverage and the original start date | Old insurer's portal, your email, or a written request to the old insurer |
 +| Renewal certificates / renewal notices | Proves each year was renewed without a gap beyond the grace period | Old insurer's records and your email or SMS history |
 +| Premium payment receipts | Backs up the renewal dates and shows continuous payment | Your bank or card statements, insurer receipts, payment confirmations |
 +| Portability application and acknowledgement | Shows the porting was formally applied for and accepted, with a reference number | The portability form, email confirmation, or reference number from the porting process |
 +| Continuity certificate (if available) | Some insurers issue a statement of prior coverage and waiting period served | Request in writing from the old insurer |
 +| Any claim or pre-authorisation rejection letter | Shows the practical harm if the reset was used to deny a claim | New insurer, TPA, or hospital desk |
 +| Copy of your written correction request and complaint reference | Starts the formal grievance clock and is needed for IRDAI and Ombudsman escalation | Keep a copy of what you send; email or portal gives a time-stamp |
 +
 +===== Step-by-step action plan =====
 +
 +==== Step 1 — Confirm the reset in writing ====
 +
 +Before disputing anything, pin down exactly what the new insurer has done. Ask the new insurer, in writing, to confirm how the pre-existing disease and specific-ailment waiting periods have been recorded on your ported policy, and whether continuity credit from your previous insurer has been applied. Check the new policy schedule yourself for any "ported" remark or continuous coverage start date. A verbal "it has reset" from a call-centre agent is not enough; you need the insurer's written position so you can show precisely what is wrong.
 +
 +==== Step 2 — Build your continuity proof ====
 +
 +This is the most important step and the one people often cannot complete later. Assemble every old policy schedule, renewal certificate, and premium receipt so that the dates form an unbroken chain from your first policy year to the day you ported. There should be no gap beyond the allowed grace period between any year's expiry and the next renewal. If a year is missing, write to the old insurer and ask for that schedule or a continuity certificate. Without dated proof of continuous coverage, the insurer can argue your waiting period genuinely restarted.
 +
 +==== Step 3 — Send a written correction request to the insurer ====
 +
 +Write to the new insurer's grievance redressal officer, not just the call centre. State that you ported your policy, that you had already served a specific number of years towards the waiting period under the old insurer, and that under the IRDAI portability framework that credit should carry over as continuity benefit. Ask the insurer to apply continuity credit and correct the waiting period on your policy. Attach your timeline and documents. Keep the complaint reference number, because it starts the formal grievance process you will need for any later escalation. Use the template further below.
 +
 +==== Step 4 — Follow up and note the grievance timeline ====
 +
 +Each insurer publishes a grievance redressal policy with a timeline for resolving complaints. If you do not get a written, substantive reply within that timeline, send one firm follow-up referencing your earlier complaint number and the date. Keep this short and factual. A clear paper trail of your request, the insurer's silence or unsatisfactory reply, and your follow-up is exactly what IRDAI and the Insurance Ombudsman will look for when they assess whether you gave the insurer a fair chance to fix it.
 +
 +==== Step 5 — Escalate to IRDAI through Bima Bharosa ====
 +
 +If the insurer does not correct the waiting period within its grievance timeline, escalate to the Insurance Regulatory and Development Authority of India (IRDAI). Register a complaint on the IRDAI Bima Bharosa grievance portal, attaching the same continuity proof and the insurer's complaint reference. Bima Bharosa routes your complaint to the insurer for a monitored response and tracks it. Read more on how a regulator grievance and an RTI can work together in our guide to [[/cpgrams-rti|CPGRAMS and RTI for government service complaints]].
 +
 +==== Step 6 — Approach the Insurance Ombudsman if still unresolved ====
 +
 +If the dispute is still not resolved to your satisfaction, you can approach the Insurance Ombudsman for your area. The Ombudsman handles policyholder complaints, including disputes over policy terms and continuity, free of cost up to the prescribed limit. File within the time limit allowed after the insurer's reply or the expiry of its response window, and attach your full record. For a large or complex dispute, or where a serious claim has been denied, you may also consider the consumer commission or qualified legal advice before deciding the best route.
 +
 +===== Escalation ladder =====
 +
 +^ Level ^ Who / Where ^ How to reach ^ When to use ^ Expected outcome ^
 +| 1 | New insurer's customer service | Insurer app, portal, or toll-free number; ask for written confirmation of the recorded waiting period | Immediately, to confirm exactly what was reset | Written statement of the insurer's position to dispute against |
 +| 2 | Insurer's Grievance Redressal Officer | Grievance email or portal published on the insurer's website; attach all continuity proof | Once you have your timeline and documents ready | Continuity credit applied and waiting period corrected; complaint reference issued |
 +| 3 | IRDAI — Bima Bharosa | [[https://bimabharosa.irdai.gov.in|bimabharosa.irdai.gov.in]]; register the complaint with the insurer's reference number | If the insurer does not resolve within its grievance timeline | Regulator-monitored complaint pushing the insurer to respond |
 +| 4 | Insurance Ombudsman | [[https://www.cioins.co.in|cioins.co.in]]; file the complaint for your area with the full record | If unresolved after the insurer and IRDAI routes | Free adjudication up to the prescribed limit; can direct correction |
 +| 5 | Consumer commission / legal advice | District or state consumer commission, or a qualified lawyer | For large, complex, or denied-claim disputes | Formal adjudication and possible compensation; seek professional advice first |
 +| 6 | RTI (public sector insurer records only) | [[https://rtionline.gov.in|rtionline.gov.in]]; only if your insurer is a public authority | Where a public sector insurer holds the records you need | Access to records held by a public authority; not available for private insurers |
 +
 +===== Copy-paste correction request template =====
 +
 +Replace the text in square brackets with your own details before sending.
 +
 +To,
 +The Grievance Redressal Officer,
 +[New Insurer Name],
 +[Insurer Address / Grievance Email]
 +
 +Subject: Request to apply continuity benefit and correct wrongly reset waiting period — Ported Policy No. [your new policy number]
 +
 +Dear Sir / Madam,
 +
 +I ported my health insurance policy to your company with effect from [porting date]. My previous policy was held with [old insurer name] under Policy No. [old policy number], with continuous coverage from [first policy start date] to [last expiry date before porting].
 +
 +Under the IRDAI portability framework, the waiting periods I had already served for pre-existing diseases and specific ailments under my previous continuous coverage are to be carried over to the ported policy as continuity benefit. I had already completed [number] years of continuous coverage before porting.
 +
 +However, my new policy schedule (Policy No. [your new policy number]) records the waiting period as starting afresh, without continuity credit for the years already served. [Optional: This reset was used to decline my claim / pre-authorisation dated [date].]
 +
 +I request that you:
 +1. Apply continuity credit for the [number] years of continuous coverage already served under my previous policy.
 +2. Correct the pre-existing disease and specific-ailment waiting periods on my policy accordingly.
 +3. Issue a corrected policy schedule confirming the revised waiting period.
 +
 +I enclose proof of my continuous coverage. I request written confirmation of the correction, and a complaint reference number for this grievance. If this is not resolved within your stated grievance timeline, I will escalate to IRDAI through Bima Bharosa and the Insurance Ombudsman.
 +
 +Yours sincerely,
 +[Your full name]
 +[Your mobile number and email address]
 +[Date]
 +
 +Enclosures:
 +1. Old policy schedules for each year of continuous coverage
 +2. Renewal certificates and premium receipts
 +3. Portability application / acknowledgement
 +4. Copy of the new policy schedule showing the reset waiting period
 +5. Claim or pre-authorisation rejection letter (if any)
 +
 +===== When RTI can help =====
 +
 +The RTI Act, 2005 applies to public authorities — bodies owned, controlled, or substantially financed by the government. Most health insurers in this situation are private companies, and the RTI Act does not reach them. However, RTI can still help in specific situations connected to your dispute:
 +
 +  * If your policy is with a public sector general insurer that qualifies as a public authority, you may be able to file an RTI for records it holds about your policy history and the porting process.
 +  * IRDAI is a public authority. You can consider an RTI to IRDAI to understand its general grievance handling process, or the status of action recorded on a complaint you filed, subject to what the law allows to be disclosed.
 +  * Where a public hospital or other public authority holds records relevant to a related claim, an RTI to that authority can obtain copies of those specific records.
 +
 +For the basics of filing, read our guide on [[/file-rti-online-india|how to file an RTI online in India]], and if a public authority does not respond in time, see [[/file-first-appeal-rti-section-19-2026|how to file a first appeal under RTI Section 19]]. You can also browse more consumer and insurance guides in our [[/practical-guides/category/insurance/|Insurance practical guides]] hub.
 +
 +===== When RTI will not help =====
 +
 +**Private insurers:** Standalone health insurers and private general insurers are not public authorities under the RTI Act. You cannot file an RTI against them to force a correction. The correct route is the insurer's grievance redressal officer, then IRDAI through Bima Bharosa, and then the Insurance Ombudsman. These channels are designed exactly for disputes like a wrongly reset waiting period.
 +
 +**What RTI cannot compel:** Even where RTI applies to a public sector insurer, it only gives you information; it does not order the insurer to apply continuity credit or correct your waiting period. The correction itself must come through the grievance, IRDAI, or Ombudsman route, or through a consumer commission. Information obtained through RTI from a public authority can support that case, but it is not a substitute for it.
 +
 +For high-stakes disputes — a denied claim during a medical emergency, or a large recovery — consider qualified legal advice. Read the broader picture in our [[/books.php|The RTI Playbook]] and our overview of the [[/rti-first-appeal-second-appeal-guide|RTI first and second appeal process]] to understand where information rights end and consumer remedies begin.
 +
 +===== Common mistakes to avoid =====
 +
 +  * **Not keeping old policy schedules and renewal certificates.** This is the most damaging gap. Without dated proof of unbroken coverage, you cannot show how many years of waiting period you actually served, and the insurer can treat the reset as correct. Save every year's documents the moment you renew.
 +  * **Letting the policy lapse during the dispute.** Allowing a renewal to lapse beyond the grace period can break your continuous coverage and destroy the very continuity you are fighting for. Keep paying premiums on time, under protest if needed, while the dispute is pending.
 +  * **Disputing only by phone or chat.** Call-centre conversations rarely create the formal record you need. Always put your correction request in writing to the grievance redressal officer and keep the complaint reference number.
 +  * **Ignoring a real renewal gap.** If your cover genuinely lapsed beyond the grace period, the reset may be partly justified. Check your dates honestly before disputing, and focus your case on the years that were truly continuous.
 +  * **Confusing extra cover with carried-over cover.** Continuity credit generally applies to the sum insured that was carried over. Any additional cover you took on top at porting may attract fresh waiting periods, which is not the same as a wrongful reset of your existing credit.
 +  * **Filing an RTI against a private insurer.** Private insurers are not covered by the RTI Act, so an RTI to them has no legal basis and wastes time. Use the IRDAI Bima Bharosa and Insurance Ombudsman routes instead.
 +  * **Missing the escalation time limits.** The IRDAI and Ombudsman routes have time windows tied to the insurer's reply or the expiry of its response period. Do not sit on an unsatisfactory reply; escalate within the allowed time so you keep these free remedies open.
 +
 +===== Official links =====
 +
 +  * [[https://bimabharosa.irdai.gov.in|IRDAI Bima Bharosa grievance portal — bimabharosa.irdai.gov.in]]
 +  * [[https://irdai.gov.in|Insurance Regulatory and Development Authority of India — irdai.gov.in]]
 +  * [[https://www.cioins.co.in|Council for Insurance Ombudsmen — cioins.co.in]]
 +  * [[https://consumerhelpline.gov.in|National Consumer Helpline — consumerhelpline.gov.in]]
 +  * [[https://rtionline.gov.in|RTI Online Portal — rtionline.gov.in (for public authority records only)]]
 +
 +===== Frequently asked questions =====
 +
 +==== Does porting my health insurance reset my waiting period? ====
 +
 +No. Under the IRDAI portability framework, when you port from one health insurer to another, the years you have already served towards waiting periods for pre-existing diseases and specific ailments must be carried over as continuity credit. The new insurer is expected to give you credit for the continuous coverage already completed under the previous policy, up to the sum insured that was carried over. If the new insurer treats your policy as brand new and starts the waiting period from zero, that is generally a wrong application of the portability rules and you can ask for it to be corrected.
 +
 +==== What proof do I need to show I served the waiting period under my old policy? ====
 +
 +Keep your old policy schedules and renewal certificates for every year, ideally showing an unbroken chain of dates with no gap in cover. Also keep the first proposal or policy issued under the old insurer, premium receipts, and any portability acknowledgement, reference number, or data shared between insurers during the porting process. Together these establish the date your continuous coverage began and prove how many years of waiting period you have already completed. This evidence is the heart of any correction request or complaint.
 +
 +==== What is continuity benefit in health insurance portability? ====
 +
 +Continuity benefit means the new insurer recognises the time you already spent covered under the old policy and counts it towards the waiting periods in the new policy. So if you had already completed part or all of the pre-existing disease waiting period under the previous insurer, that credit carries over to the new policy. Continuity benefit is the core protection that portability is meant to give policyholders, so they are not punished for switching insurers. It generally applies to the sum insured that was carried forward; extra cover taken on top may attract fresh waiting periods.
 +
 +==== Can I file an RTI against a private health insurer for resetting my waiting period? ====
 +
 +No. The RTI Act applies to public authorities, not to private health insurers. Most standalone health insurers and private general insurers are not public authorities, so you cannot file an RTI against them. For private insurers, use the insurer's grievance officer first, then the IRDAI grievance route through Bima Bharosa, and the Insurance Ombudsman. If your policy is with a public sector general insurer that is a public authority, you may be able to file an RTI for records it holds, but the faster fix is still the insurer correction and IRDAI route.
 +
 +==== How do I escalate if the new insurer refuses to correct the waiting period? ====
 +
 +First send a written correction request to the insurer's grievance redressal officer with all your continuity proof, and keep the complaint reference. If the insurer does not resolve it satisfactorily within the time stated in its grievance policy, escalate to IRDAI through the Bima Bharosa grievance portal. If you are still not satisfied, you can approach the Insurance Ombudsman, which handles policyholder complaints free of cost up to the prescribed limit. For large or complex disputes, you may also consider the consumer commission or qualified legal advice.
 +
 +==== Does a break in renewal affect my continuity credit when porting? ====
 +
 +It can. Continuity credit is built on continuous, unbroken coverage. A short grace-period renewal usually keeps the chain intact, but a lapse beyond the grace period can break continuity and may cause waiting periods to restart. This is one reason insurers sometimes reset the waiting period. Before disputing a reset, check your renewal dates carefully for any gap. If your cover was continuous and any delay stayed within the allowed grace period, point that out clearly in your correction request with the exact dates.
 +
 +==== Should I keep paying premiums while the waiting-period dispute is pending? ====
 +
 +Yes, generally you should keep your policy in force by paying renewal premiums on time while the dispute is being resolved, unless you have specific advice otherwise. Allowing the policy to lapse during a dispute can break your continuous coverage and weaken your case for continuity credit. Pay under protest if needed and keep written records that you are paying while the waiting-period correction is pending. Losing the policy mid-dispute can leave you both uninsured and without the continuity you are trying to protect.
 +
 +{{tag>irdai insurance health portability reset waiting period wrongly}}