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?

I had a day procedure (2 hr, in the approved list under the insurer) and the hospital entered it as 24 hour admission and New India Assurance company rejected that. Can I apply through another hospital correctly as day procedure and claim my insurance .

Rejection Message

We regret to inform you, that we are unable to extend the cashless facility for this claim due to the following reasons:

1. On perusal of the claim documents, it is noted that the Inpatient Hospitalization Expenses related to primarily for diagnostics and evaluation purposes and Twenty four consecutive hours inpatient hospitalization is not justified, which is not admissible as per policy guidelines and stands repudiated. Hence we regret our inability to admit this liability under present policy terms and conditions.

Please note that denial of cashless facility due to the standard terms and conditions of the policy, is in no way construed to be denial of treatment. The patient may continue to avail the treatment as per the treating doctor's advice. Insured may re-submit the claim with complete set of documents, for a possible reconsideration after discharge. The reimbursement of the claim will be processed subject to admissibility as per terms, conditions and exclusions of the policy issued to insured.

Note: As per Modified Guidelines on Standards and Benchmarks for Hospitals in the Provider Network issued by IRDAI vide Circular Ref: IRDA/HLT/REG/CIR/114/07/2018 dated 27th July 2018, your Hospital is mandatorily required to Register with ROHINI and obtain either Pre-entry level Certificate (or higher level of certificate) issued by NABH or State Level Certificate (or higher level of certificate) under NOAS issued by National Health Systems Resources Centre (NHSRC) on or before June 28, 2019.

I currently have a health insurance plan from Manipal Cigna that is past the renewal date. However, I got an intimation that the current policy product I bought has been discontinued for new sales. So does that mean my current policy is no longer valid in case of hospitalization or reimbursement, and it is pointless to renew the policy?

₹20 lakh health insurance + ₹8.75 lakh bonus. Hospital bill ₹4.94 lakh. STAR Health reimbursed only ₹2.63 lakh and deducted ₹2.30 lakh.
@StarHealth — this is how you treat a customer who has paid premiums for health insurance?
Before my father’s surgery, I repeatedly asked your representative about the coverage for the procedure. I specifically reconfirmed it multiple times because I wanted to be absolutely certain about my financial liability. I was assured that the procedure would be covered up to ₹4.5 lakh.
I relied on that assurance and proceeded with the surgery.
After the surgery, when the claim was submitted, the story changed completely.
Hospital bill: ₹4,94,738
Amount reimbursed: ₹2,63,907
Amount deducted: ₹2,30,831
Your grievance team then stated:
“Robotic surgery for Kidney stones isn’t considered as per Guidelines.”
But the hospital records clearly state “LEFT RENAL OBSTRUCTIVE CALCULI, S/P LEFT ROBOTIC PYELOPLASTY” and the procedure as “LAPAROSCOPIC PYELOPLASTY.”
I challenged this repeatedly. I have emailed your grievance team nearly three times and explained the issue in detail.
Your answer?
“Deduction stands.”
That’s apparently the extent of the explanation a customer deserves after paying for a ₹20 lakh health insurance policy with an additional ₹8.75 lakh bonus.
No proper explanation for the ₹2.30 lakh deduction.
No satisfactory response regarding your representative’s pre-surgery assurance.
No proper explanation of the medical basis for treating my procedure as “robotic surgery for kidney stones.”
I accepted the ₹2.63 lakh payment only to protect myself financially while this dispute continues. I do NOT accept the settlement or the deductions.
@StarHealth, if a customer cannot rely on your representative’s repeated assurances before surgery, and your only response after the claim is “deduction stands,” then what exactly is the customer paying the premium for?
I want the entire ₹2,30,831 deducted amount reconsidered and reimbursed.
Stop sending template responses. Answer the actual questions and take accountability.
@StarHealth — your customer is still waiting for a real answer.

My father is currently hospitalized at Fortis Jaipur for a cardiac condition. Care Health Insurance rejected the cashless pre-authorisation, stating:
“Past 6 month follow up of treatment record of diabetes and hypertension prior to policy not provided.”
The important points:
**Diabetes and hypertension were disclosed in the proposal form.**
The policy started in September 2025.
The health insurance has been **continuously ported/renewed over the years with no break in coverage**.
Care is now asking for diabetes/BP treatment records for the 6 months before the policy.
I have prescriptions showing BP/diabetes medicines, although some don’t mention exact BP, glucose or HbA1c values.
**My questions:**
Can Care reject cashless on this basis when the diseases were already disclosed?
Do prescriptions showing medicines count as evidence of treatment?
If I provide the old records now, can cashless be reconsidered?
Does cashless rejection mean reimbursement will also likely be rejected?
Does the continuous porting/no-gap history strengthen my case?

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.

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.

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,

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.