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It can be quite easy for health insurance policies to become inactive without notice. Missing a deadline for paying a premium, a busy lifestyle, or simply forgetting about the renewal date could mean that a health insurance policy is no longer active at the time when one most needs it. Fortunately, not having an active insurance policy does not necessarily mean starting over from the very beginning. Many insurers offer the option of reinstatement, allowing an individual to reactivate their health insurance policy for an additional payment of the premium and potentially other fees. Reinstatement can also mean more than payment; when the policy has been nonrenewed for a certain period of time, the insurance company may request some documentation, medical records or proof of continued eligibility; some benefits might be limited during this period. It is beneficial to familiarise yourself with the reinstatement steps as soon as possible, both to smooth the process and to ensure you can restore your health cover as soon as you are able.
Step 1: Verify the Current Policy Status
a. The first practical step is very straightforward: do you know whether the policy has indeed lapsed?
b. Log in to the insurer’s app/website. Check your policy papers, the renewal notifications you received, or call customer service.
You need to verify three points:
- The policy’s initial expiration date.
- The date when the premium became overdue.
- If the policy is either in the grace period, lapsed or has fallen outside the reinstatement period permitted by the insurer.
c. This information will serve as your next steps.
d. It is also useful to see if the insurer has automatically indicated the policy to be inactive or if the renewal application is awaiting processing.
e. Often the status is not as urgent as it may sound.
Step 2: Before Making Any Payments, Review the Terms of Your Policy
a. Reading a policy document can sometimes be very dull, but today is not one of those days.
b. When reading the policy, check out the sections covering renewal, grace period, lapsing, reinstatement, revival, continuity benefits and waiting periods.
c. Various health insurance products may also have their own reinstatement rules, where some are able to be reinstated after the grace period, whilst some view it as a new proposal upon request. Others only reinstate the policy (within the policy wording) if not renewed during the grace period, subject to underwriting, whereby no lives benefit from the expired cover.
d. That may sound quite technical, but it is actually very practical advice: do not assume that reinstatement simply returns you to the exact same mindset you were in before the lapse.
Pro-Tip: Save your former policy schedule for a moment while you proceed with the reinstatement. It offers you valuable information about the sum insured, members insured, add-ons, policy dates and benefits.
Step 3: Get in Touch with the Insurer Right Away
When a policy lapses, waiting too long to ask for reinstatement is not usually useful
Get in touch with the insurance company via its customer service department to inform them about the lapsed policy and its reinstatement.
Only ask the following questions:
a. Is the policy still available for revival?
b. Is there a limit to this deadline?
c. What is the premium remaining to be paid?
d. Are there penalties/interest or admin charges?
e. Is there any medical examination?
f. Will there be a loss of prior benefit entitlements?
g. Will there be any new underwriting?
h. Can the reinstatement be done online?
All of these questions prepare you far better before you send across money or documents.
Step 4: Cover the Outstanding Premium
a. For some insurers and policies, you are required to make this payment before reinstatement can be approved.
b. The amount can relate to the unpaid renewal premium and, in some cases, further costs set out in the policy.
c. This is how reinstatement can be more expensive than a normal renewal.
d. The policyholder will undoubtedly think, “I only didn’t pay one premium; how come I am being asked to pay more?”
e. However, you need to remember that the policy will have moved on from being a normal renewal, and the insurer can have different reinstatement requirements.
f. Therefore, you should rely on the insurer or the policy to give you the exact reinstatement amount rather than a set figure.
Pro-Tip: Request a full breakdown of the payment made. If you know how much of it relates to the overdue premium and how much relates to the reinstatement charges, then this will be easier to check back over.
Step 5: Send in the Request for Reinstatement
a. Reinstating a policy is not always the same as merely paying the premium.
b. Some insurance companies might demand a reinstatement application, digital validation, or an affirmation before approving the reinstatement.
c. An insurer might ask for a letter confirming your name, policy number, and health.
d. This is the point when it is essential to tell the truth.
e. Reinstatement applications are not places to hide a new disease, hospital stay, or something else important that just happened to take place in your life, thus making your insurance approval process more complex.
f. Insurance is something that relies mainly on providing true information on the application.
Step 6: Prepare for a Medical Evaluation or Health Declaration
a. One of the biggest differences between a regular renewal and reinstatement can be Medical Underwriting,
b. In some circumstances, if the policy has been lapsed for a certain period of time and a particular policy only, the insurer may require a declaration of good health, certain up-to-date medical details or even a medical examination. A number of policy wordings allow the insurer to take into account any changes in the insured person’s health when a lapsed policy is being reinstated and perhaps lower the terms or increase the premium.
c. That can be frustrating, particularly if you had been insured for a long time.
d. However, the insurer may regard a lapsed policy that is being revived as presenting a different risk situation, particularly if there has been a long period of noncoverage.
e. Thus, the company may ask some questions concerning recent treatments, diseases, hospitalisations, or changes in your health.
Pro-Tip: Have all recent medical records, medical prescriptions, and discharge documents saved in an organised manner.
Step 7: Know About Waiting Periods
a. This is one of the most crucial aspects of reinstatement and can be easily neglected.
b. If a policy was reinstated after a break, you should not presume all of the benefits are preserved unchanged.
c. The effect may depend on the wording of the policy issued by the insurer if reinstatement is regarded as a continuation or is subject to further underwriting.
d. Some policies may maintain certain continuity benefits if renewal occurs within the relevant grace period. In other cases, after lapse, applying for a new policy or new underwriting may result in waiting periods and other conditions being reviewed.
Hence, getting the insurer’s verification on:
- Pre-existing illness waiting period.
- Special disease waiting period.
- No-claim benefits.
- Bonus and sum insured.
- Other benefits accrued under the policy could be very essential.
Thus, do not depend on oral confirmation when it comes to something critical financially.
Step 8: Verify If the Amount Insured Stays the Same
a. It is important to verify your coverage amount too.
b. For instance, if your previous policy covered ₹10 lakh sum insured and you were allowed to avail benefits of the previous policy during renewal, you will want to check if you are being restored to the same amount.
c. Furthermore, instead of assuming that the previous policy will be in effect during reinstatement, get in touch with your insurer and ask him to confirm the sum insured with you after reinstatement.
d. This is particularly beneficial in case of family floater policies wherein many family members are covered under a single sum insured policy.
e. Also, check if the add-on and rider features, along with maternity benefits and restoration features, will be reinstated automatically or need to be confirmed separately.
Step 9: Verify the Date of Effective Reinstatement
a. The issue in question may seem negligible at first glance; however, it can become critical as soon as a claim comes into play.
b. There are different points in time in regard to the payment of the premium, in terms of filing the reinstatement request, and in terms of reinstating the insurance company’s policy.
c. The policy wording might stipulate that expenses incurred on a certain date before reinstatement shall not be paid for.
d. Thus, if a policy has been inactive from 1 June until 15 June, it does not mean that the insurance company shall pay for any medical bills incurred during these two weeks.
e. The gap is important.
Pro-Tip: Download and save the revised policy document and get its reinstatement in place. Do not file the email. Verify the revised wordings/endorsements for the policy period, insured members, sum insured, exclusions and insured(s) effectivity.
Step 10: Look for Any New Conditions or Exclusions
a. A reinstated policy may not revert to exactly the same terms.
b. Depending on the insurer, circumstances and policy wording, the insurer may add conditions, exclusions or premium variations following underwriting.
c. This point is especially important for anyone who has experienced a change in health during the policy’s lapse.
d. For instance, let us suppose that a person had no serious medical issues at the time the policy terminated but that they received treatment during the time when their insurance was inactive. Then this person’s medical condition will influence the reinstatement process.
e. This is a perfect example that shows us that we should not assume that reinstatement is simply about paying the dues and moving on with life.
If Reinstatement is Denied bythe Insurer, What Happens?
1. This is the part that nobody wants to dwell on, but it is wise to be prepared for this possibility.
2. If the company refuses to restore the old policy, find out if there is any possible alternative.
3. You may have to purchase a new health insurance policy subject to the insurer’s normal underwriting guidelines.
4. This might have an impact on your financing and coverage. The new policy may come with waiting times, new medical disclosures, and new pricing.
5. The product may also be altered and modified if the old policy is no longer offered.
6. The bottom line is that you should not remain without coverage while dealing with an old policy.
Is It Better to Purchase a New Health Insurance Policy?
1. At times, reinstatement might be the most convenient choice. In other cases, a new policy might make better sense.
2. Your decision should depend on what you will lose should you discontinue the previous policy as well as what you might gain by activating the new one.
3. The older policy might provide continuity/benefit. One example is when already completed waiting periods add value to your older policy.
4. But on occasion, a newer policy may give you more coverage, limits, or even benefits that suit your needs more.
5. The point is not to cancel the existing policy in your mind before you comprehend what reinstatement has preserved.
Can I File a Claim Right Away After Reinstatement?
a. This is another situation where care is advisable.
b. A reactivated policy does not mean by itself that all medical expenses will be reimbursed right away.
c. The particular claims eligibility depends on the terms of the policy, the reinstatement conditions and any waiting periods. For example, if a claim relates to an incident occurring during the period of being uninsured, it may be excluded from coverage.
d. Moreover, when reinstatement entails some new underwriting or further exclusions, application of those conditions will lead to changes in claims processing for the future period.
e. Thus, after restoration of the policy, carefully read the newest terms, and do not presume that everything is back to normal.
FAQs:
1. Is it possible to get a lapsed health insurance policy reinstated or revived?
The possibility of having a lapsed policy reinstated or revived depends upon the insurer, the terms of the policy, and the period for which the policy has remained lapsed. Some health insurance policies allow for reinstatement or revival after the grace period, while others may require new underwriting or purchase of a completely new policy.
2. Will I have to undergo medical tests to reinstate my health insurance?
Not necessarily, as the requirement for medical examinations depends on the conditions related to the lapsed insurance policy, as per the insurer. In some reinstatement scenarios, however, the insured may have to provide their health information.