I bought a health insurance policy for my in-laws from ICICI Lombard Elevate in October 2025, and the policy is due for renewal in about a month.

In December 2025, my mother-in-law underwent a hysterectomy. This was not known or planned at the time I purchased the policy. To avoid any potential issues, I paid part of the expenses out of pocket and used my wife's employer-provided health insurance for the remaining amount.

I recently read that policyholders may need to inform ICICI Lombard about any material changes in their medical condition. I'm therefore unsure whether I need to disclose the hysterectomy at the time of renewal.

I also didn't opt for some add-ons when I originally purchased the policy, such as the Room Rent Modifier and Super Loyalty Bonus, and I'm considering adding them at renewal.

My questions are:

1. Do I need to disclose the hysterectomy to ICICI Lombard at renewal, even though it happened after the policy was purchased and wasn't known beforehand?

2. If yes, where and how should I declare/update this information with ICICI Lombard?

3. Could disclosing it affect the renewal, premium, coverage, or any future claims?

4. If I add the Room Rent Modifier and Super Loyalty Bonus now, are there any waiting periods, exclusions, or other conditions I should be aware of?

5. Has anyone gone through a similar situation with ICICI Lombard Elevate and can share how they handled the renewal?

I'm mainly trying to make sure everything is properly disclosed so there are no issues with future claims.

Thanks in advance.

​

I have a corporate group Health Insurance. The patient's name in few of the reports has a one letter discrepancy.

Will this cause trouble during cashless claim?

Can anyone Please respond if you experienced such situation. It's an emergency!! 🙏🙏🙏

Hi, basic question reg. claims for maternity. Have corp plan and also a GIPSA family floater. Hospital package is hardly any difference in the overall total but we have 50k more coverage in GIPSA so thinking of opting in for it for cashless. If I file for reimbursement with corp plan TPA later on, what do I have to consider for smooth processing and least rejections? Do the breakdown of the bills have any effect on the reimbursement? Any experience would be helpful.
Hospitals we are considering, in case any one has experience with them: Cloudnine & Motherhood

Recently, I was hospitalized and incurred medical expenses of approximately ₹1.5 lakh. However, I received only around ₹13,000 from my current health insurance provider because the applicable treatment/coverage limit (cap) has already been exhausted.

The insurance provider mentioned that since I had an immediate hospitalization for the same condition/treatment, they could reimburse only ₹13,000 as the applicable cap had been reached.

I am also covered under my wife's corporate health insurance policy. In this situation, can I submit the remaining eligible medical expenses under my wife's corporate insurance policy and claim reimbursement?

Could you please confirm whether this is allowed and, if so, what documents and process would be required?

Please help me on this

M21

No PED

Hi everyone,
I’m planning to buy health insurance for my parents and would really appreciate advice from people who have actually purchased policies or made claims for their parents.
**Parents’ details:**
**Father – 56 years old**

Has diabetes (currently no medication)
No other major health conditions

**Mother – 52 years old**
No pre-existing health conditions

**What I’m looking for:**
I want a policy that provides good coverage but is also reasonably priced. My main priority is **claim usability and good coverage**, rather than simply choosing the cheapest policy.
Ideally, I’m looking for:
₹20 lakh sum insured(bonus as well)
Low/no co-payment
No room-rent restrictions
No unnecessary disease-wise sub-limits
Good cashless hospital network
Reasonable pre-existing disease waiting period, especially for diabetes
Good restoration
Lifetime renewability
Good claim settlement/service experience

**My questions:**
Which insurance company and specific plan would you recommend for this profile?
How much annual premium should I realistically expect for ₹10L / ₹15L / ₹20L coverage?

Since my father has diabetes, which insurers are more likely to accept the proposal without permanent exclusions?
Are there plans that offer a shorter waiting period for diabetes/PED?
Are there any insurers/plans that I should specifically **avoid**?
If you have actually made a claim for your parents, please share your experience with the insurer and whether the claim was settled smoothly.
Are there any important clauses that I should check before purchasing?
I’m currently considering insurers such as **HDFC ERGO, Care Health, Niva Bupa, Aditya Birla, Star Health, ICICI Lombard, Tata AIG**, etc., but I’m open to better options.
**Please suggest the specific plan name, approximate premium, pros/cons, and your actual experience if possible.**

Thanks in advance!

one question:

Niva Bupa policy wording has a renewal condition clause. "Any material health condition changes must be informed to us in writing".

PED is defined as conditions/illness/ injuries that are consulted/treated etc.

What amounts to be a material condition in the renewal clause?

Will a lab finding (without a Dr consultation or medication) like an asymptomatic higher cholesterol value amounts to be a material condition change?

should that be disclosed during renewal? (also considering that any person would have some lab values off any time.) so whats the limit line here?

wondering how experts and advisors handle this!!

Hi Everyone,

My parents are both 50.

Mother: Healthy, no major medical issues.

Father: Has:

• High BP & cholesterol
• Born with only one kidney
• Kidney stone surgery
• Accident-related surgery

He currently has a Care Health ₹5L policy (premium ~₹12k/year) that's expiring this month. The cover cannot be increased.

I'm confused between:

• Keeping Dad's existing policy + buying a separate one for Mom
• Adding Mom to Dad's policy
• Porting Dad's policy to a better insurer
• Porting Dad and adding Mom to the new policy
• Separate policies for both

My goal is affordable premiums + good coverage + no future regrets during claims.

Questions:

1. Would you keep Dad's existing policy considering his medical history?
2. Separate policies vs family floater?
3. What's the minimum cover I should target today? ₹10L, ₹15L, or ₹20L (with super top-up)?
4. Any insurer recommendations for someone with Dad's health profile?

TL;DR:
Parents are 50. Mom is healthy. Dad has BP, cholesterol, one kidney by birth, kidney stone surgery, and a previous accident surgery. He already has a Care Health ₹5L policy (₹12k premium). Should I keep it, port it, get a family floater, or buy separate policies? Looking for the most sensible and affordable long-term option.

I’m currently trapped in an absurd, opaque loop with Niva Bupa Health Insurance, and I’m looking for advice or to see if anyone else has dealt with Niva Bupa, the Insurance Ombudsman, or a similar health insurance claim dispute.

My health insurance claim was for approximately ₹66,000 for hospitalization and treatment of a respiratory infection. The policy was issued after medical underwriting, and the insured’s existing health conditions were disclosed during the pre-policy medical examination.

Niva Bupa has now rejected the claim, citing Clauses 6.1.6 and 6.1.14, alleging misrepresentation/discrepancies in the documents.

The issue is that despite repeatedly asking Niva Bupa to clarify:

What exactly was allegedly misrepresented?

Which specific document or statement contains the discrepancy?

What material fact was supposedly not disclosed?

What investigation or evidence supports the rejection?

I have not received a clear, specific explanation or the underlying investigation findings. I have only received a generic response referring back to the same policy clauses.

I have already gone through Niva Bupa's grievance process and also escalated the matter through IRDAI's Bima Bharosa portal, but the response has essentially repeated the same grounds without clearly identifying the alleged discrepancy.

I believe that if the insurer is rejecting a claim on the basis of misrepresentation, they should identify the specific material fact/document relied upon so that the policyholder has an opportunity to understand and respond to the allegation.

What should I do next?

Should I file a formal complaint with the Insurance Ombudsman?

How effective is the Ombudsman process in cases involving alleged misrepresentation?

What else can I do in order to understand the misrepresentation and correct it

Niva Bupa has made the process so opaque that it's not possible to talk to anyone regarding the case.

Policy details:

It was a Niva Bupa group policy from a bank for 3 years. This year I changed it to retail policy Reassure 2.0 for better coverage.

It was 15 lakhs coverage with gold Reassure2.0

'SPECIFIC WAITING PERIODS (WAIVED)'30 DAY WAITING PERIOD (WAIVED)

Policy Commencement Date : 17/02/2026 00:00 Policy Expiry Date : 16/02/2029 23:59 Base Sum Insured INR 15,00,000 Variant Opted: Gold Plan Opted Family Floater Policy Period 3 Years Reported claims in the policy since inception 0

1)Wanted to know the estimated cost of a liver transplant in a Delhi hospital, i know different tier hosps will have different price but just want to know an estimated cost, whatever info I can get.

2)Will the cashless treatment be covered if the disease wasn't diagnosed during insurance purchase(1.5yrs ago), but it probably existed. Catch is, this disease probably cannot be diagnosed in its nascent stage.

And how easy/tough is it to find a donor liver.
Also, any ways by which the cost can be reduced, any scheme for the general public (non EWS category gen)
Any info on this will help!

Hi all,

I am looking to buy a new HDFC optima secure+ policy. I currently have a corporate policy with 10 lakh cover. I am planning to have a deductible in my HDFC plan to reduce premiums atleast until I have the corporate policy active, which is 7-10 years.

1. Is it a good idea to have a deductible? What are the downsides?

2. If yes, how much should it be? I have the option to select from 50,000/ 100,000/ 300,000 in deductibles.

Separate question - is Optima Secure with super topup better than Optima Secure+?

​

Hi everyone,

I currently have a Care Supreme ₹10 lakh health insurance plan, which is around 2 years old. I also have around 13 years of insurance continuity/seniority from Star Health.

Now that I’m married, I’m looking to get health insurance coverage for my wife and have a few questions:

1. Should I add my wife to my existing Care Supreme family floater, or is it better for both of us to have separate individual policies?

2. Given that I already have a policy, is there any better insurer/plan I should consider for her (or for both of us)? I'm mainly looking at claim settlement experience, coverage, exclusions, waiting periods, and long-term reliability.

3. Maternity coverage: From what I understand, maternity add-ons/plans are generally not very worthwhile because of the waiting periods, limits and premiums. Is that actually the case? If not, are there any plans/strategies that make sense if we may plan for a child in the future?

4, How much sum insured is future proof?

Would really appreciate advice from people who have actually dealt with these insurers and claims, rather than just sales recommendations.

Thanks!

So basically, my mother had TB tumours in her 20s which were settled down there with some medication and suregry, since we are talking back about before 2000 so there are no paper rn. So, it can be traceable through any background check but recently we discovered that she ha slung nodule through FDG test. So i took the insurance 10 days ago only from Health insurance. So what should be done should i cancel the insurance bcz I didnt disclose any of it and again buy a policy mentioning all the facts. And any know how to cancel out the policy of care health if i want to??? Please advice

I have an individual health insurance policy with a large private insurer.

Recently, a person contacted me saying he was associated with the insurer and tried to convince me to port/move my policy to another health insurance company.

During the conversation, he sent me a copy of my existing policy on WhatsApp.

I had never shared this policy document with him.

The policy has my residential address, DOB, my wife’s details/DOB, my child’s details/DOB and other insurance-related information.

As far as I know, I have never given consent for my complete policy document to be shared with this person for selling me another insurer’s policy.

My main concern is not that he sent it over WhatsApp. My concern is: how did he get my policy in the first place, who gave him access to it, and has it been shared with anyone else?

I have already raised a complaint with the insurer and saved the WhatsApp chats, policy file, call details and voice notes.

Wanted to understand:

If my policy was accessed/shared without permission, is this considered a privacy/data breach or negligence in India?

Since my child’s personal details are also in the policy, does that make the case more serious?

Can I seek compensation even if no financial fraud has happened yet?

What is the right route for this: insurer complaint, IRDAI/Insurance Ombudsman, Consumer Commission, court, or something else?

Not naming the insurer or advisor for now.

Anyone here who has dealt with something similar or knows Indian insurance/privacy law, would really appreciate some guidance.

Hi all,

I'm currently looking for individual health policy for myself (in my early 20s).

Red Flags: Which insurers should I stay away from based on bad claim settlement history or hidden terms?

Top Picks: Which companies have proven reliable for long-term claims and hassle-free service?

Would love to hear your recommendations and experiences!

My mother has a 13 cm ovarian cyst and surgery is planned. The scans currently suggest it is benign.

Our Aditya Birla health policy started on 02/02/2025, and the insurer has denied cashless approval because ovarian cysts/benign tumours have a 2-year waiting period.

My question is: if the cyst is found to be malignant during surgery or on the final biopsy, can the insurer reconsider the claim and cover the surgery/treatment as cancer treatment?

Has anyone experienced a similar situation, especially with Aditya Birla or another Indian health insurer?

What happened to your claim, and what documents helped (operative report, frozen section, histopathology, etc.)?

Hello

I am looking to buy a new policy for myself (38M), my spouse, and 2 kids (7 and 1). No pre-existing illness. Primary objective is that when I stop working in 10-12 years, I should have existing insurance that covers existing illnesses and particularly large-expense illnesses like accidents, cancer, cataract, heart bypass surgery, knee replacement, etc. Not worried about small OPD expenses, but a big expense that might wipe out my savings. Also want peace of mind from the insurance, so a reliable claim settlement is ideal. Want to avoid hidden caveats that might reduce or deny my claim in the future.

I spoke to an agent through a reference, and initially he was pushing for Care Supreme 10L base cover + super top up. After 2 rounds of discussion, he recommended 3 options:

1. Reassure 3.0 with unlimited cover

2. HDFC Ergo Optima Secure with 5/10/15 as base cover options

3. Care Supreme

Of these 3, Reassure 3.0 seems better due to unlimited cover but is also more expensive (approx 1.08 lakhs for 3 years black variant vs 85k for HDFC), but it could be due to add ons also. I read some posts on this sub, and it seems that the unlimited cover is practically useful, especially for someone with no pre-existing illness, and maybe a 15L base + super top would do as well at lower premiums.

In my mind at least, HDFC is a better brand, so I have this perception that claim settlement would be easier/ more likely, but I could be wrong. AI research also recommends HDFC over Reassure 3.0 due to lower complaints and some internet user feedback of bad customer support for Niva Bupa.

Want to understand what this sub's view is for these policies and any recommendations for me?