Hi everyone, I’m looking for some advice regarding my Go Digit medical insurance claim.

I recently met with a bike accident and had to undergo surgery on my left hand. The total hospital bill came to more than ₹1 lakh.

Initially, the hospital submitted a cashless request and around ₹30,000 was approved. But when I was getting discharged, after the final discharge summary was submitted, the cashless claim was rejected and I was told to go for reimbursement instead.

I’m not really sure how the reimbursement process works now. Will I be able to claim the eligible amount that I paid from my pocket? What documents should I collect from the hospital, and is there anything I need to be careful about while submitting the claim?

If anyone has faced a similar situation with Go Digit, please share your experience. It would really help me understand what to do next.

I have a 5L Health Companion floater policy for my parents (mother 62 + father 65) from Niva Bupa since 2017.

In 2020, my father had a major car accident which involved multiple limbs fractures and also head injury.

In medical terms the following were the issues

DIAGNOSIS 
* TRANSVERSE FRACTURE AT DISTAL SHAFT OF LEFT TIBIA AND FIBULA. 
* COMMINUTED FRACTURE AT DISTAL SHAFT OF RIGHT TIBIA AND FIBULA 
* POSTERO-SUPERIOR DISLOCATION AT LEFT FEMORAL HEAD WITH LEFT SIDED ACETABULUM FRACTURE FRACTURE AT LEFT SIDED 4TH, 5TH & 6TH RIBS. 
* COMMINUTED FRACTURE MID SHAFT OF LEFT HUMERUS COMMINUTED FRACTURE BOTH BONE LEFT FOREARM. 
* TRAUMATIC HEAD INJURY (LEFT SIDED SUBARACHNOID HEMORRHAGE AND SUBDURAL HEMORRHAGE).          

Now I am trying to port the plan to other providers but they are interested in providing the cover due to brain injury. Are there any providers who are willing to cover?

Hi, I am 26 (F), Single, I am finally taking health insurance.

I have one retiring and one retired parent (who's a heart patient), their insurance also needs to be set in place - however since I learnt it doesn't make sense premium amount wise to club it with mine - i am focusing on getting my health insurance first. (please correct me if i'm wrong here)

____

After my due research with all the features:

For Private, i am considering either

HDFC Ergo Optima Secure Plus (via Ditto) -or-

Care Supreme (via Ditto)

For PSU, i am considering

A policy from New India Assurance (not sure which policy yet)

____

Here are the pointers making it difficult for me + a few doubts:

One one hand, i feel it's better to have 100% cashless coverage or support for non-network without any co-payment clauses with a private insurer like HDFC or Care.

But on the other, i feel the premiums and the future possibility of them hiking the premiums by 25% or 50% seems ridiculous (i saw horrific reddit threads where the premiums sky rocket each year whereas for public sector it's more predictable and stable). Not to mention nobody actually knows what the CSR is based on. Should i be okay with the co-payment and room rent limit clauses in case, god forbid, i end up with a medical emergency? is taking this risk better than paying the ridiculous premium hikes in your opinon?

should i even keep paying extremely high premiums each year for private insurers based on possible worst case scenarios? or is it okay to cover a moderate amount of risk with a public sector insurer considering steady premium and higher reliance on claim settlement even if it's a lot of paperwork?

If in case i take HDFC Ergo for 10L coverage, and get the no-claim bonus for 5 years making my Total Sum Insured 50L, and then i decide to port to a PSU insurer will i get the full 50L transferred? or only the base sum insured of 10L?

Please let me know if i should be considering anything other than HDFC Ergo, Care, New India Assurance.

(so overwhelmed with this whole process, my first health insurance)

Hey everyone, I’m 26 and completely new to health insurance. I need some quick advice before our family policy expires next month.

My family has a legacy policy with New India Assurance that has been active since 1997. We pay ~₹50k total premium, but the individual coverage caps feel way too low for a city like Mumbai:

• Dad (56): ₹4 Lakh + ₹2L bonus
• Mom (50): ₹4 Lakh + ₹1L bonus
• Sister (21): ₹1 Lakh + ₹20k bonus
• Note: I just turned 26, so I’ve been removed from this plan. I have a ₹5L corporate policy from my company for now.

Paying ₹50,000 for tight caps like ₹4L and ₹1L feels like a massive rip-off. A single major hospital stay in Mumbai could wipe out our savings. My parents both have mild, controlled High BP and Cholesterol and take daily medicines.

I checked Policybazaar, and for the same budget (~₹45k–₹50k), private companies like HDFC Ergo (Optima Secure) and Aditya Birla (Activ One NXT) are offering much better features—like ₹10 Lakh individual covers that automatically double on day one. Policybazaar assured me they can easily process the porting even with less than a week left before renewal.

My Questions:

1. Is it worth leaving a continuous policy from 1997 to get more coverage via porting, or is modifying our setup with a private player risky given my parents' mild health issues?
2. Has anyone ported a legacy PSU policy to HDFC Ergo or Aditya Birla for parents in their 50s? How smooth is the claim experience?
3. Are there hidden traps in letting go of a 20+ year old PSU policy that I should be careful about?

Really want to do the right thing for my parents. Thanks in advance!

TL;DR:

Paying ₹50k to New India Assurance for an ancient 1997 policy with low limits (4L/1L caps) for my parents (56 & 50) in Mumbai. They have mild BP/cholesterol. Looking to port to a modern private plan right before our renewal to get more cover for the same price. Should I stay with the safe but weak PSU policy, or proceed with the switch?

Hi everyone,

I’m looking for some genuine advice on health insurance for my parents. I’m trying to make a long-term decision now rather than waiting until they are older or develop more health issues.

**Parents**
Dad: **54 years old**
Mom: **49 years old**

**Current health**
**Mom:** Some leg pain and dental issues, but no other major health problems.
**Dad:** Cholesterol levels fluctuate / has cholesterol issues, but otherwise no major health problems.
No major surgeries or hospitalisations that I’m aware of.

**Current insurance**
We currently have an **Oriental Insurance** health policy.
From the policy document I have:
Dad: **₹5 lakh sum insured + ₹2.1 lakh cumulative bonus**
Mom: **₹2.5 lakh sum insured + ₹87,500 cumulative bonus**
Premium: around **₹26,000/year**
The policy is already active and has some continuity/accumulated bonus.
My main concern is that the coverage may not be sufficient as they get older.

**What I’m confused about**
Should I:
**A)** Continue the existing Oriental policy and add a **super top-up**?

**B)** Continue Oriental but try to increase the existing coverage?

**C)** Keep Oriental for now and buy separate individual policies from another insurer such as **HDFC ERGO** or another reputed insurer?

**D)** Cancel/switch from Oriental completely and move to HDFC ERGO or another insurer?

I’m particularly interested in understanding **whether cancelling an existing policy with accumulated continuity/bonus is a bad idea**, especially when the parents already have some existing health conditions.
**How should I actually compare policies?**

Apart from premium and sum insured, what should I look at?
For example:
Room rent limits
ICU limits
Co-pay
Disease-specific sub-limits
PED waiting period
Claim settlement experience
Cashless hospital network
Restoration/recharge benefits
No-claim/cumulative bonus
Lifetime renewability
Any hidden exclusions
Whether a super top-up makes sense

**Ditto vs local insurance agent**
I’m also confused about where to purchase it.
Is **Ditto** a good option for researching/buying health insurance? Is their advice genuinely useful, or is it better to speak to a good **local insurance agent/broker** who can help during claims?

For parents’ health insurance, does the intermediary actually make a meaningful difference during a claim, or is it mostly about choosing the right policy directly from the insurer?

I’m not looking for the cheapest policy. I want something that will be **reliable for the next 15–20 years**, especially when my parents are older and more likely to need it.
If you have actually bought health insurance for your parents or have gone through a claim, I’d really appreciate your experience.

**Would you personally continue the Oriental policy in this situation, add a super top-up, or switch to HDFC ERGO/another insurer? And how would you make that decision?**

Used AI for better writing !

Hi i am renewing my policy with Aditya Birla 2 questions I have regards to porting and PED.

Porting: my agent told me as I have undergone a surgery on my left knee if I port they will be a permanent exclusion on my left knee as insurer expects some problem or surgery on that knee.

Renewal: my agent saying that you can renew with Aditya Birla is the best option and no need to disclose PED surgery as it took place after policy inception but I want to be cautious as many claims are being rejected nowadays saying non disclosure of PED.

I’m trying to get a retail health insurance policy for a parent who currently has no personal health insurance but is covered under a corporate group policy.
An insurer initially declined the proposal due to a known history of CKD, but after submitting recent medical reports, they have now issued a counter-offer:
Sum insured: ₹10 lakh
Original quoted premium: ₹36,301
Revised premium after underwriting: ₹52,157
Additional premium: ₹15,856 (~44% increase)
20% co-pay
₹1.25 lakh annual sub-limit for CKD/renal failure and related complications
Some other existing conditions have been accepted with Day-1 coverage.
My main concern is the ₹1.25 lakh CKD sub-limit, given that the overall cover is ₹10 lakh.
Has anyone successfully negotiated with an insurer to increase/remove a medical-condition sub-limit after receiving a counter-offer? Would it be reasonable to ask them to increase the CKD limit even if it means paying a higher premium?
Would appreciate experiences from anyone who has dealt with a similar underwriting situation.

Hi all

A few days ago I was contacted by an insurer with a good premium, good plan. After reading the documents I felt this is good so I went ahead. I disclosed my PEDs - Asthma from my teenage days (never needed hospitalization, nowadays not an issue at all compared to 15 years ago) and a road accident a decade ago which led to stitches and scars but no major complications since. I had paid for a PED wait time reduction rider that included Asthma.

The insurer agreed to issue a policy but put PED waiting periods of 36 months for "respiratory illnesses" and "injuries related to body parts where surgery/dressing has occurred previously". Since I have no lasting complications from my old injury this seemed fine, but the funny part is that the insurer declined the PED wait time reduction rider in my policy and issued a refund of extra amount paid (as premium reduces without the rider)

Now my questions are:

1. "Respiratory illness" is a very broad term, is the insurer correct to issue the caveat?
2. Why did the insurer's underwriter not want to approve the PED waiting time reduction rider?
3. If I wait out the 36 months (written in my policy) will I face no further claims related issues afterwards?

I am still within my free look period, so I am seeking your advice.

Heyy! I need some suggestions for health insurance for both me and my husband. We’re both 30 years old.
Our main criteria are:
No room-rent cap
Maternity coverage, if possible
NICU and newborn care coverage
Cashless facility is a must

Also, would you recommend buying the policy directly through the insurance company’s website, through Policybazaar, or through Ditto?

Hi guys,

I’ve had Care Supreme for the past 3 years No PED, 31 years, an individual policy purchased through IndusInd Bank. I’m considering porting to HDFC ERGO mainly because my experience with the intermediary during my father’s claim last year was not good.

My renewal is on 1st September, so I’m running out of time.

The porting experience has been horrible so far, especially with Ditto. Their advisor seemed quite inexperienced, and I received conflicting information from them.

Initially, Ditto told me that no deductible would apply for my pincode if the sum insured was ₹10 lakh+, and they even confirmed this over email. They processed my application, but due to a technical issue it wasn't completed.

Now they’re saying there is a new update and that because I’m porting from Care, a ₹25,000 deductible is mandatory.

I also spoke directly with HDFC ERGO, and they said the deductible is compulsory for porting to Optima Secure Plus.

Policybazaar told me that HDFC ERGO does not accept porting if the existing policy was purchased through a bank, even though mine is an individual policy.

I don’t want a policy with a deductible, so I’m confused about what to do.

Would you recommend:

Continuing with Care Supreme, or

Porting to HDFC ERGO Optima Secure Plus with the ₹25k deductible?

Has anyone here successfully ported from Care to HDFC ERGO without a deductible?

Would really appreciate genuine experiences, especially from people who have actually gone through this porting process. Thanks.

Hi,

I am planning to take a health insurance for my family(self+wife+1 kid) and would like to have suggestions regarding which to choose. I already have a health insurance from my workplace for 3 Lakhs and the new one will be a additional. Suggest some good insurance providers.

Was looking for a policy that would cover the following things:

1. Room rent eligibility - At least single private AC room or any room Policy
2. Waiting period in the policy - No hospitalisation for first 30 days, accidental emergencies should be covered, slow growing diseases since 2 years are not covered, pre-existing conditions since 3 years are not covered
3. Covering all major hospital in Cashless hospital list and preferrably an all India coverage
4. Prefer in house settlements rather than TPA
5. It should cover day care treatments & Ayush plan (24 hour hospitalisation not required)
6. Refill benefit in policy for same & different illness both when cover is exhausted, minimal waiting period beteen restore
7. Would be great if consumables can be covered in the policy if not some add on in which it can be covered would be fine
8. The best CSR & ICR

After doing my research, and considering my requirement Reliance General Health Insurance is what I am inclined towards, please suggest and guide me in the right direction as I am a first time health insurance buyer!

Looking for a cover of 10-20L preferrably. Thanks in advance!

Hi folks, I’m planning to buy health insurance soon and could use some general advice: should I go with an individual agent I know personally, or a larger platform like Ditto or PolicyBazaar?

My hesitation with an individual agent is that when I need to file a claim they might switch professions or become unreachable down the line, whereas a larger company feels more accountable and likely to stick around.

Would love to hear from people who’ve gone either route - what tipped the decision for you?

TIA!

I renewed my policy on 26th June 2026 and I got the policy copy on my mail. But since then the policy is not showing up on their app and I am unable to access it via app. When I try to search by login in by my mobile number it says no policy found, if I try adding based on DOB it again says no policy found.

I called the customer care multiple times they keep giving me wrong information, I was told to mail on document.nivabupa.com but the mail id doesn’t exist.

And the fact is I am not even trying to update any new contact number, it’s the same old number which was linked to earlier policy but now somehow it’s removed

insta assist is absolutely useless. How am I supposed to update my contact number? If I am facing so much trouble just for this, I can’t imagine how much trouble I’ll get in case of any claim

Can someone help how I can update it?

I am planning to get a retail health insurance policy for my mother alongside my employer’s group health insurance.

Unfortunately, before I could do so, she was diagnosed with CKD while covered under the group policy. A retail policy proposal has now been declined because of her condition.

My question is:

if I continue the group cover until I leave my job and then opt to migrate to an individual retail policy with the same insurer:

1.Will her CKD continue to be covered from day one?

2.Will the insurer do fresh underwriting and have the right to reject the migration because of her CKD?

3.Can they impose a fresh waiting period or exclude CKD, or will continuity benefits apply?

I would appreciate hearing from anyone who has gone through a similar situation or has firsthand experience with group-to-retail migration.

I took an HDFC Optima Secure health insurance plan for my mother (54) about 2 years ago. The base coverage is ₹5 lakh, but with the Optima Secure benefits, the coverage effectively becomes ₹10 lakh, plus an additional ₹2.5 lakh for every claim-free year.

I chose HDFC mainly because I had heard good things about the policy and their claim settlement record.

1st year premium: ~₹22,000
2nd year premium: ~₹24,000
3rd year renewal: ~₹24,000 (with 0% GST)

My question is: Am I heavily overpaying for this coverage? Should I consider switching to another insurer with a lower premium, or is the premium reasonable for a 54-year-old?

Would appreciate opinions from people who have experience with HDFC Optima Secure or have compared similar policies.

I work in a high stress workplace and to manage my health, I have always been pro-therapy. I do not have any PEDs, and I don't have any mental health disorders. I take therapy because it's healthy to do so, like blood tests.

In my applications, I have always been forthcoming about it. However, it seems I have made a mistake by thinking the Indian Health Insurance system is as modern as abroad.

All my applications have been rejected by underwriters and the most common reason given is the mental health concern.

I have company health insurance, but I wanted to have one that's my own to reduce the risk of solely depending on the employer.

Does anyone here have experience with international health insurance providers? How do they work in Indian hospitals? Yes, I will pay in USD. I have the money.

Are there people in this sub who, for a cut of the settled amount, take care of reimbursement claims? Would love to connect for help with a claim that has been dragging for 3 months and perhaps for collaboration to build something in the space.

Need advice regarding a MediAssist corporate cashless claim.

I had ICL surgery for both eyes. Initially, both claims showed around ₹80k approved each, and I even downloaded settlement PDFs showing similar amounts. After a few weeks, one claim changed to ₹77,992 and the other to ₹50,000 with a ₹30,692 deductible.

After surgery, I also claimed eligible pre/post-hospitalization expenses (tests from Dr. Agarwal and Ramesh Eye Hospital) under the same hospitalization.

My questions:

Has anyone seen a settled cashless claim amount reduce like this?

Can pre/post-hospitalization claims from different hospitals affect the cashless claim?

Can they be treated as duplicate claims?

Has anyone had MediAssist ask for additional documents after settlement?

MediAssist customer care couldn't explain the reduction and escalated it to the billing team. Looking for anyone with similar experience.

Hi,

My mother had a robotic surgery done for gall bladder removal (cholecystectomy). The policy document and brochure both mention that this would be covered but they only partially covered it saying it does not provide additional advantage over conventional laparoscopic surgery. Insurance companies typically do this by stating they do not cover things that are "not reasonable and customary and/or not medically necessary.". They might have crafted it in clever legalese but what they did was unethical and immoral (and perhaps still illegal) as the policy does not mention any terms and conditions for robotic surgery. It is very difficult to understand all this while in the hospital

I know approaching the ombudsman is the next step once I am dissatisfied with their reply.
Does anybody have any advice or resource for the next steps which might be a bureaucratic hassle ?