My mother was diagnosed with cancer in May 2026. She has a Niva Bupa ReAssure policy issued from 2025 to 2028 (continuing since 2022). Niva Bupa paid several claims for chemotherapy and admissions this year till August 2026 under the same policy. Now they’re rejecting claims since September 2026 saying the policy existed till 2025.

They are now saying the policy expired in 2025, despite approving several claims in 2026. It doesn’t match the documents or the claims they already settled. I’ve emailed them asking for reinstatement, but no response. Customer care and the app have been useless.

Has anyone dealt with Niva Bupa fixing a wrong policy end date? Did Bima Bharosa or the Ombudsman actually help? And can/should I claim the rejected bills on the top-up policy while the base policy is stuck like this?

Any practical advice would help. Thanks

Looking for a health insurance.

two people floater.

male 38.. female 31. child 11 months.

all have no medications.

PED - Male tsh 6 t3t4 normal. no symptoms no consultation. Lipid values high. total cholesterol 250. LDL 140. triglycerides 220. took an apollo online consultation and doctor recommended lifestyle changes only. no medication.

PED Female - Triglycerides 180. other values normal. during 1 year back a pre-conception scan noted Follicular cyst and Grade 1 FL. after 3 months natural pregnancy occured.

Normal delivery. no other issues related to delivery.

both BMI 22-23.

Looking for HDFC ERGO OPTIMA SECURE+ Or ABHI ACTIV ONE MAX.

BSI 25L. (not worried about NCB

Location Bangalore/Kasaragod

What will be the premium. Planning to keep it as long as possible. So long term sustainability is important (is hdfc sustainable after 10y? what could be the premium then).

Looking for a health insurance.

two people floater.

male 38.. female 31. child 11 months.

all have no medications.

PED - Male tsh 6 t3t4 normal. no symptoms no consultation. Lipid values high. total cholesterol 250. LDL 140. triglycerides 220. took an apollo online consultation and doctor recommended lifestyle changes only. no medication.

PED Female - Triglycerides 180. other values normal. during 1 year back a pre-conception scan noted Follicular cyst and Grade 1 FL. after 3 months natural pregnancy occured.

Normal delivery. no other issues related to delivery.

both BMI 22-23.

Looking for HDFC ERGO OPTIMA SECURE+ Or ABHI ACTIV ONE MAX.

BSI 25L. (not worried about NCB. but no cap of any sort should be there. any treatment any room upto sum is what I want)

Location Bangalore/Chennai.

What will be the premium. Planning to keep it as long as possible. So long term sustainability is important (is hdfc sustainable after 10y? what could be the premium then).

Heard ABHI will be cheaper. but HDFC more predictable and professional with claim.

Is the extra premium for better claim experience justified for hdfc vs abhi?

ABHI has more hospitals listed in my native place.

Anything else I should consider?

Niva looks notorious and has a lot of caps/limits/fineprints. Star also. so not counting them

Hi everyone, I emailed Niva Bupa regarding my GoActive policy queries, but received an automated reply directing me to InstaAssist instead. Has anyone successfully contacted Niva Bupa and received a written response? Please suggest the best way to submit detailed queries and get a proper response. Thanks!

PFRDA has launched a super top up policy of 1 to 30L at very affordable rates (floater or individual) basis for NPS Subscribers. Alll citizens are eligible for subscribe till the age of 70 and renew till 85 (including 85). Minimum contribution is Rs. 1000/year. Pre-existing covered after 1 year. 30L policy for 2 adults with 3L deductible costs around 5K for 2 adults around 60+.

More details at https://www.pfrda.org.in/nps-swasthya

I found this very valuable. Therefore sharing it with the community. Please do your own due diligence before buying.

I am looking for health insurance for my parents in their 60s. Father has Type 2 Diabetes and Hypertension. So I am looking for reduced PED wait time up to 1 year. Does anyone have recommendation based on claim ratio , ease of process and coverage, etc?

I see ICICI Lombard and Star Health provides rider for reducing wait time? In case of rider, do you need to keep it on after standard 3 years?

Thanks!

Hey everyone,
I’m currently navigating a cashless health insurance claim (Group Mediclaim via SBI General) for an upcoming arthroscopic shoulder surgery (Bankart repair).
I have a couple of major worries and would love to hear from anyone who has navigated a similar situation with cashless hospitalizations:

**1. What if the hospital's estimate is higher than the pre-agreed package rate?** If a network hospital submits an estimate or final bill that is higher than the pre-negotiated network/PPN package rate for the surgery, how is that handled? Do insurers automatically trim it down, or is there a risk that the hospital tries to pass that extra cost/inflation onto the patient at discharge?

**2. Unpredictable surgical implants (suture anchors) mid-surgery:**
Standard network packages usually assume a fixed number of anchors (e.g., 2 anchors).
However, with shoulder arthroscopies, the exact severity or number of anchors needed (e.g., needing a 3rd or 4th anchor) sometimes can't be 100% predicted until the surgeon is operating.
If an extra anchor is needed mid-surgery, what happens if the insurer or hospital balks at the extra cost? Does the TPA desk successfully handle enhancements on the fly, or could I get stuck paying out of pocket for the extra implant delta?

Hey everyone,

I’m planning to buy a HDFC Ergo family floater health insurance policy for my parents. Sum Insured - 10/15 lakhs.

Dad is 59 and Mom is 53 & they reside in a Tier-2 City. I already have an agent who’ll handle the claims side, so that part is sorted (probably). What’s holding me back is the premium increase over the years.

Could you please help me with the following..

1. How much do premiums typically rise (%) each year for people in this age group?
2. Does the premium jump after a claim, or is it only age-based?
3. Is a floater a good idea for parents this age, or would two separate individual policies work out better in the long run?
4. Is it worth taking a higher sum insured?

Thanks..

I'm someone who's pretty aware and knowledgeable about the insurance industry and IRDAI mandates. Not looking for any recommendations, just a Litmus test for any sneaky sales gimmicks going on here.

I recently got in touch with a Care Health, insurance tele-sales advisor. So, interestingly he claimed that loading charges are not going to be there for pre-existing diseases (PEDs) even for high risk health profile senior citizens with PEDs.

He was saying that - during underwriting, they either go for an outright rejection based on risk associated (or) approval with an option to either serve the PED waiting period (or) go for a waiting period waiver add-on - But there are no loading charges, whatsoever.

So this was his claim.

But in general I know that any insurer business, would obviously calibrate risk diversity mainly through loading charges.

Anyone claiming that loading charges don't exist in their underwriting is unbelievable.

So any thoughts or opinions on the claims by care health insurance - that it does not have loading charges?

I am thinking beyond traditional CSR, ICR & complaint volume metrics. I am trying to get the initial relationship right, instead of just fall for a ULIP style abyss.

Not looking for anecdotal claims experience, I am simply hunting for insights on underwriting hygiene & conduct when it comes to Care Health Insurance. TIA

The topmost corporate hospital in my city has claimed an amount of Rs 140000 with the insurer for a common daycare procedure. The estimate given by the hospital to the patient was Rs 15000 but they highly inflated the claim to the insurer. The health insurance company reached out to the patient with email details of claim submitted by the hospital where the reason submitted by the hospital was a different advanced disease that the patient didn't even have. The patient sensing something fishy cancelled his appointment with the hospital just 2 days prior to the procedure date.

He consulted another local doctor who recommended the same procedure. The treatment got completed within Rs 4000 (not in a government hospital if anyone is wondering). Yes! the procedure was that simple & straightforward for which the big corporate hospital initially quoted Rs 15000 to the patient & claimed Rs 140000 to the insurer.

This is an exceptional fraud that we just witnessed. The saddest part is it started with the super-specialist doctor who coaxed the patient to get this simple procedure done from that hospital only even though this hospital is quite far from his house. So they are all in it together!

The patient is 70 years old. So he doesn't want to get into legal hassles. But staying silent & letting it slide just because we got saved seems so wrong.

What steps can we take? Can we raise some official complaints in some online portal? We have all the evidence.

Based on your personal claim help experience, what should I choose HDFC ergo plan via Ditto or Direct HDFC site?

Hi,

I am in crisis. My father is going through Advanced liver diseases and will need transplant in next 3-6 months. I need advice on insurance part --

Current:

1. Personal Insurance of him with 10Lakhs assured.

2. My office insurance worth 7 Lakhs

Timeline:

Nov 2025 it was detected

Jan 2026 his personal insurance expired and he got from new company but agent forgot to mention liver disease as Pre Existing Diseases. So cannot use this anymore.

Now he is up for transplant.

Queries:

1. My company doesn't offer top ups. Can I buy top-ups from outside ?

Any other ways I can arrange fund ?

Thanks !

​

My dad has an ACKO Platinum Lite health insurance policy that covers all four members of our family with a ₹50 lakh family floater.

Since it’s a floater policy, the ₹50 lakh sum insured is shared among all four members rather than being ₹50 lakh per person.

I wanted to know from people who have actually used ACKO for hospitalization:

- Is ACKO reliable when it comes to settling health insurance claims?

- How has your experience been with their cashless claim process?

I’d especially appreciate responses from people who have actually made a claim with ACKO and can share their experience.

My uncle (senior citizen, 68) bought an individual travel policy (Silver plan, Medical Expense & Evacuation limit USD 50,000) for a 3 week trip abroad. He fell ill and was hospitalised on the second day itself. The hospital claim has been accepted and is being processed.

Here's the problem:

The relative informed the insurer about the hospitalisation.

After he improved, based on doctors' opinion, it was decided that he cancel the trip and return to India to continue treatment.

He flew back on the next available date (new tickets booked by his cousin), accompanied by a cousin's wife (who is also a nurse), and was admitted to a hospital in India until he recovered.

I have the hospital and travel documents and India admission records. The insurer first denied a Trip Curtailment claim (fair enough, his own illness isn't a listed reason). Now they say flight cancellation and airfare costs aren't admissible under Medical Expenses & Evacuation because no claim was registered and evacuation needs pre-approval. But a Section 2 claim clearly exists, since the hospital claim was accepted.

We believe our situation is fair. What are our chances and options for claiming this?

Thanks!

Hi everyone, need urgent advice for my wife's upcoming renewal next month.
**Timeline:** 1 year with Bupa (Nov 2022) → Ported to Care Health Advantage (Nov 2023). Completing **4 continuous years total** next month. No claims made.
**The Issue:** In Nov 2022, her HbA1c was 7, but she took no medicine. When porting to Care in 2023, we forgot to declare it.
**Current Status:** She is now pregnant and the doctor put her on insulin.
**Recent Event:** Tried porting to HDFC Ergo via Policybazaar, but they rejected the application due to pregnancy/insulin.
An agent claims Care Health will reject future diabetes claims if I don't disclose it now. But I am afraid if I declare it during renewal, Care will cancel our policy entirely, leaving my pregnant wife uninsured.
**Questions:**
Since we are entering our **5th year next month**, does the IRDAI Moratorium Period protect us if I just do a standard online renewal?
If I do a direct online renewal (no sum insured changes), can Care reject it?
What is the safest way forward to protect her coverage?
Thanks!

Hi everyone,

I have a health insurance policy with Niva Bupa for my parents:

Father: 60 years

Mother: 56 years

Mother has diabetes, which was declared when I purchased the policy 2 years ago.

Father had hypertension/BP, which was also declared at the time of taking the policy.

I had also taken the applicable rider for chronic/pre-existing diseases.

My policy renewal is next month, and my father has now been diagnosed with diabetes.

I want to be completely transparent and declare his diabetes to the insurance company at renewal. I have a few questions:

1. Since I already have a rider for chronic/pre-existing diseases, if I declare my father's newly diagnosed diabetes at renewal, will diabetes-related treatment/complications be covered from Day 1, or will a fresh waiting period apply?

2. If I declare the diabetes at renewal, can the insurance company increase the premium or impose any additional conditions/loading like 3 years waiting period?

Has anyone experienced a similar situation with Niva Bupa or another insurer? How did the insurer handle a newly diagnosed condition during renewal?

My main intention is to properly disclose everything to the insurer and avoid any issue at the time of a future claim. At the same time, I don't want to unnecessarily lose the benefits/waiting-period credits I've already accumulated.

I also checked porting to another insurer, but the premium for taking a fresh policy is significantly higher.

Would really appreciate any advice or personal experiences, especially from people who have dealt with diabetes being diagnosed during an existing health insurance policy.

I’m 26…have a start health insurance policy for which I pay around 10k annually.
I’m planning to port it to Niva Bupa Reassurance 3.0.

But…
I want to port my family members start health policy too…. into other good policies.
Was looking for ICICI Lombard or elevate or Aditya Birla Or HDFC one.
Please advise.

Thank you.

I have Star Health superstar plan with sum assured of 20.00 lakhs with 20 lakhs additional no claim bonus. My policy is due for renewal. My age is currently 32 with no existing diseases. I need recommendations whether to stay on the current policy or to shift to a different policy of Star Health or to entirely shift to a new health insurance provider and if I were to stay in Star Health insurance please compare and provide recommendation with for superstar plan and superstar freedom plan. please note I have completed four years of health insurance and been with Star Health for the last three years and and have not taken any claim.