A request to move a health policy from one insurer to another, with credit for the cover already earned.
Date: 1 April 2026, at Ludhiana
TO:
The Underwriting Manager (Portability)
ABC General Insurance Company Limited
Regional Office, SCO 25, Sector 17-E, Chandigarh 160017
COPY TO:
The Manager, Renewals, ABC Health Insurance Company Limited
FROM:
Harjinder Singh Gill
House No. 412, Sector 38-A, Chandigarh 160036
Phone: 98765 43210
Email: harjinder.gill@example.com
SUBJECT: Request to port health policy no. P/141234/01/2026/003318 of ABC Health Insurance Company Limited
Sir / Madam,
1.1 I hold an individual health policy with ABC Health Insurance Company Limited, number P/141234/01/2026/003318, with a sum insured of ₹5,00,000 (Rupees Five Lakh only). My health cover has run without a break since 2 April 2026, and the present term ends on 3 April 2026.
1.2 The persons covered are: Harjinder Singh Gill (self), 14 March 1978. Manpreet Kaur Gill (wife), 2 August 1981. Aman Singh Gill (son), 9 June 2010.
1.3 No claim has been made under the present policy.
2.1 I ask you to issue me a health policy under your plan Family Health Optima, with a sum insured of ₹10,00,000 (Rupees Ten Lakh only), to begin on the day my present term ends.
2.2 I ask you to give me credit under the new policy for the cover already earned under my present policy, including the waiting periods already served, to the extent the portability rules allow.
2.3 I authorise you to ask ABC Health Insurance Company Limited for the details of my present policy, its claim history and the medical history of the persons covered, and I authorise ABC Health Insurance Company Limited to give them to you.
2.4 I understand that you will decide on my request on your own terms, and that you may accept it, decline it or add conditions.
3.1 The existing illnesses or treatments of the persons covered are: Harjinder Singh Gill: type 2 diabetes since 2019, on regular medication. No others.
3.2 I have given you, or will give you on your own form, every fact you ask about, and I have kept back none that you would reasonably want to know.
4.1 My present term ends on 3 April 2026. Please decide before then and tell me in writing, so that my cover does not lapse. I am sending a copy of this letter to ABC Health Insurance Company Limited.
4.2 I will not let my present policy lapse until you confirm the new policy in writing.
- 1. The new insurer's portability form, filled in. 2. Present policy schedule and the last renewal notice. 3. Claim history from the present insurer. 4. Identity and address proof.
Yours faithfully,
_________________________
Harjinder Singh Gill
Proposer
House No. 412, Sector 38-A, Chandigarh 160036
Date: 1 April 2026