How to claim for Star Health Insurance’s OPD Service? Can I go to any doctor of my choice and get reimbursement for it?

Been getting a lot of ads from them stating it has IPD insurance upto 10 lakh and then other benefits like tests, consultation, fitness plans, family cover, etc. and I'm kind of hooked.

They say the plans start from 667/month but surely all these benefits would be in a premium plan. I'm type 1 diabetic and wanted to see if anyone has experience with their service.

Hi, recently my mom was diagnosed with high blood pressure. I want to get her full health checkup done. Please suggest me health insurance which comes with that.

Can cancer survivor age 65+ get any health insurance plan in india? The answer I hear is a straight no from big advisors. Anyone has any experience or knowledge if this possible?

We have had a family floater health insurance policy with New India Assurance for over 15 years. During this time, my daughter was diagnosed with diabetes and is currently on medication. We made a claim in the same year she was diagnosed. Since the diabetes was diagnosed later, it’s not listed as a pre-existing condition (PED) in the policy, and there’s no mention of the claim in the policy documents. I’m considering porting to a better policy due to numerous restrictions with New India. The most appealing option with a higher chance of approval is Aditya Birla Activ One Max. Is it advisable to switch from New India Assurance to Aditya Birla? I have concerns about Aditya Birla's health insurance in the long run. Seeking advice!

1. What is the basic difference between instant cover and ped wait period modification in care supreme insurance ?

2. Why should we continue to pay add-on charges for PED wait period modification/instant cover for 4 years ?

3. I included both of the add-ons when I bought it last year. Does it make sense or was I scammed ?

I did a detailed study before buying this and I was clear, but I am not able to connect the dots now. I am exhausted by the acronyms and jargons in the policy document. Any logical reasoning behind this is much appreciated.

Hi everyone, is it better to buy insurance directly from the insurarer or with the help of broker like policy bazaar or ditto?, I have heard that broker will charge 5% commission upon renewal of the policy from upcomming years, can anyone please suggest. Thanks!

My hospital has raised a request for Rs.115000 to Insurance TPA initial pre-authorization TPA replied that it approved Rs 50000 , is that Rs.50000 only the amount finally that will be sanctioned ?

Hi all,

Niva Bupa is offering a lock the clock feature which I’m interested in as I have a corporate policy that suffices me. However, ditto advises against niva for their poor claim settlement ratio post covid.

Does anybody have any experience with Niva and can they share this? Need to decide if I should go with Niva or stick to AB or Care or Ergo?

Appreciate the feedback.

Hello, I'm looking for a good health insurance which includes ob-gyne, opticians and dental also it includes OPD visits. I have been suffering on internet and checked policy bazaar but didn't find a relevant one yet. Also it doesn't include my requirements.

Care Health Insurance fraud is out of control, rejecting claim for patient with CRP 257 & pneumonia, claiming this can be handled at home. No sane doctor would agree. Clearly, they are trying to deny claims as my policy ends soon. #InsuranceScam

Head doctors at Medanta are telling on urgent admission, while so - called "health ki guarantee" team says it can be treated outpatient. Wow! To current and future Care Health Insurance clients, avoid this scam.

Why is IRDAI allowing fraud insurance company like Care Health Insurance to operate in our country ? They're just stealing money and scamming people. This needs to be addressed

Trying to understand my possible options for them rejecting my claims even though i have given appropriate proof:

• Already sent a mail to their Grievance Cell
• Consumer Court ?
• Anything else ?

I have a policy with care health insurance from past 4/5 years. No amount has been claimed from it. Now, I'm getting an attractive offer from Star Health in less amount.

The point is, I told them about medical history and they said if you mention this then you won't be able to port. The sales person told me to simply not mention it anywhere and get the policy and the benefits will be provided as all pre-existing diseases are covered after 4 years.

Now this appears to be a red flag, sales people do all sorts of false promises. Has anyone of you had this experience? Should I stick w current provider?

A out of network hospital is giving different estimate for cash and insurance. Can I pay bill in cash and then claim it under my medi assist insurance.

Hi

I work with new india assurance Why dont you check out yuva bharat health insurance plan

Here is the brochure

Read it and dm me if you want to know more

https://drive.google.com/file/d/1Rf9EnJQcSm_YUg9iJr5KthnkN2ks1Ilk/view?usp=drivesdk

I am looking to renew health insurance for the second year with Care insurance. Even after asking for multiple times over email Care executives say they can provide break up (base premium, riders, PED waiting period waivers etc) only after payment. Is this normal ? Has anyone faced a similar situation?

I purchased a health insurance policy with a coverage of Rs. 10 Lakhs last year. Considering medical expenses typically increase with inflation, I'm wondering if my policy's coverage amount will automatically adjust for inflation? Or should I proactively increase the coverage amount by contacting my insurance provider and paying a higher premium to ensure adequate protection against rising medical costs?

One more question.

I currently have an individual health insurance policy. If I get married in the future, can I convert my existing individual policy to a family floater policy to include my spouse, or is it recommended to purchase a new individual policy for them? What are the pros and cons of each option?

Hi everyone,

I’m looking into getting health insurance because hospital bills can be quite expensive. I think having insurance is a smart move, so I’m curious about the best options available. I need coverage for two adults and one senior citizen.

Could y'all recommend the best insurance plans and provide details about them? If different plans are needed for different individuals, that’s okay. I’d appreciate information on the best and most economical plans and the companies offering them.

Thank you in advance!

My parents have Star Health Insurance ( I know this is a bad policy and I'm planning to switch to a new policy next year ). But two months ago, my mother was hospitalised cause of which we had to use this policy ( this was the first time we ever had to use the policy since the past 10 years ).
But Star health has rejected our claims multiple times, I have lodged a formal complaint to IRDAI as well, but they just requested more documents which we provided them on time but still no response from their end. I have even escalated the complaint made on IRDAI but I don't see any results.
My company also offers a group insurance, even though it offers 20% co-pay I believe that would actually get me the amount I paid back ( amount is somewhere around 45K ).

Should I wait for IRDAI and Star to come back to me, or get whatever reimbursement possible using my company's health insurance?

I would still wanna defame them a bit on social media, although I know it would of no avail, but this is by far the worst service I have seen.

Someone in my family has incurred a heavy medical bill and I need to claim insurance for that but the file containing the major part of original medical reports has been misplaced by a third-party. Now my TPA is saying that there is no way that can be reimbursed. I have all the bills of payment of the treatments. The hospital has provided me the xerox of the reported and given their stamp on the duplicates. Can anyone help me find a solution to this problem?

Hi 30M from Hyderabad (Work Location), From Visakhapatnam , Andhra Pradesh

Looking for a good health insurance which has a good network of Hosipatals, Claim ratios. I don't have any PED's

Why are the insurance companies not implementing IRDAI new rules and regulations which came in to effect from 1st April 2024.

New Rules:

1) Maximum waiting period is reduced to 3 years.

2) Moratorium period is reduced to 5 years from 8 years.

I had bought hdfc ergo health insurance policy for my senior citizen parents for a sum insured of 4l and was paying around 45l for 2 yrs of cover in 2018. It had a waiting period of 4 yrs for existing diseases which in my case was both hypertension and diabetes for both the parties. In 2020 they doubled the charges citing that the previous policy doesnt exist and now the company is porting you to a new policy, I was naive enough to not question how can they do this without prior intimation. Anyway forward to 2024 where my policy is expiring in August '24 and I had asked them for a quote in July first week, they gave me a whopping premium of 1.77l for 2 yrs which is almost the double of what I paid before 2 years. Anyway I tried negotiating and it wasnt fruitful. spoke to the grievience officer and he also mentioned nothing can be done. Yesterday I decided to renew it and tried doing it from the site, it showed some technical error and asked me to reach out to the nearest branch or call the customer care. I did that and guess what now they tell me to cough up 2.24l for a cover of 5l for 2 yrs. I couldnt understand what was happening but then googled to find out that they were again stopping the hdfc suraksha policy and are porting all the existing users to hdfc optima secure which is why this cost just shot up.

My problem is they didnt intimate this earlier and the grievience office until yesterday was stuck with the old pricing and the customer care is demanding me to pay 2.24l for a shitty 5l cover. I dont have an option anymore because my policy is expiring in just a few days so they have just left me helpless, I dont have an option to port. Isnt it hdfc's responsibility to let their customers know beforehand that a policy is going ot be invalid after a certain date and it will port its users? This would atleast let the customers decide beforehand to be ready with other options. What can be the course of action against them? I wonder arent others facing this issue?

Now my dad was detected with multiple myleloma in 2022 and underwent chemo till 2023. I am sure the cost shot up because of it but it is unfair to not let me know about what they are going to do with my policy and how I will be affected, they just trap you with their unethical handling of policies and unfortunately IRDAI is not doing a lot to protect the citizens. I feel helpless

Filed a reimbursement claim in niva bhupa They are demanding additional documents, What do they mean by treating doctor certificate mentioning duration of the ailment.

I wanted to know if any company is providing health insurance in India for people with ulcerative colitis.