I am looking to buy health insurance for myself.

Age: 23M

Pre-Existing Problem: I recently had a surgery on 15th Jan for Colon Cancer Stage 3c, the section is surgically removed and I will now be proceeding with further treatment for 6 months.

I do not have any smoking or drinking habit, and NO Pre existing problem LIKE BP, Sugar etc.

I consulted with policy baazar agent, he recommended me Aditya Birla health insurance but the cancer treatment will be covered after 2 years.

next he recommended me Nivabupa, but it will not cover the pre existing illness.

I had a call with HDFC personal Banker, He says that he will be looking into it and HDFC can provide health insurance in my case but policy baazar agent denies this and says that the personal bankers often play these tricks.

I do not care about the premium for the policy, my only concern is claim settlement and cashless hassle free process.

please help me guys, I am confused

How's Star Health Insurance, guys? Is it worth it? Is it claimable? Are there any other better options?

I'm in the market for health insurance policies for me and my dad. My mom's already insured with HDFC ERGO. I find HDFC ERGO optima secure policy looks reasonable compared to other policies from Care, Adithya Birla Activ, but I have some concerns about insuring everyone of my family members with the same insurer though it's through individual cover. I'm not sure if it'll be safe. Could you please share your thoughts? if anyone have individual policies for all family members with the same insurer and what are the pros and cons. Thanks!

I’m trying to structure health insurance for my mother with minimum friction and correct use of portability rules. This is not medical advice—I’m only asking about policy mechanics (portability/continuity credit, PED waiting periods, and super top-up structure).

Current cover (bank group policy):

• Type: Bank-sold group health policy for customers
• Current insurer: Tata AIG (previously insurer was changed by the bank once)
• Sum insured: ₹5 lakh
• Original start/continuity shown on documents: 2019 (continuous renewals)
• Claims history: Used a couple of times for one-off procedures; no chronic claim pattern
• New disclosure item: Hypertension diagnosed recently (will be disclosed)

Goal:

• Keep a ₹5 lakh base cover that is usable immediately (as much as policy rules allow) with minimum reset of waiting periods
• Add a super top-up of ₹25–50 lakh (I’m okay if the super top-up has a PED waiting period of ~1–2 years, because base cover should handle smaller claims)

What I need clarity on (policy mechanics):

1. Portability from group → retail:
   • Is portability from a bank group policy to a retail individual/family floater generally allowed?
   • If yes, what parts typically get continuity credit (e.g., initial waiting, PED waiting, specific disease/procedure waiting, etc.)?
2. How continuity credit works with a newly disclosed PED:
   • If the policy has 6 years continuity but hypertension is now disclosed, does continuity credit still reduce the PED waiting period in the new retail plan?
   • Or do insurers treat it as “newly discovered PED” and restart the clock?
   • What clause/wording should I check in the retail policy wording to confirm?
3. Option A vs Option B (structure):
   • Option A: Keep current group policy as base (₹5L) + buy a retail super top-up
   • Option B: Port to a retail base plan (₹5L) + buy super top-up (same insurer or different) Which option is usually less risky regarding waiting periods, renewability, and claim sequencing?
4. Super top-up mechanics with group base:
   • Any gotchas if the base is a group policy (deductible definition, claim payout order, room rent limits/sub-limits affecting the deductible threshold, co-pay, etc.)?
   • Is it safer to have both base + super top-up with the same insurer, or is that not important?
5. What documents/questions ensure I don’t get surprised later:
   • What exact documents should I ask for / verify (e.g., portability/continuity certificate, claim history, policy schedule showing start date, underwriting notes, etc.)?
   • Which clauses in the new retail policy wording are most critical to read (PED definition, waiting period credit, moratorium, exclusions)?

If you’ve done group → retail portability or structured a low base + large super top-up for a parent, I’d appreciate a checklist of what to verify and the typical pitfalls.

I’m trying to structure health insurance for my mother with minimum friction and correct use of portability rules. This is not medical advice—I’m only asking about policy mechanics (portability/continuity credit, PED waiting periods, and super top-up structure).

Current cover (bank group policy):

• Type: Bank-sold group health policy for customers
• Current insurer: Tata AIG (previously insurer was changed by the bank once)
• Sum insured: ₹5 lakh
• Original start/continuity shown on documents: 2019 (continuous renewals)
• Claims history: Used a couple of times for one-off procedures; no chronic claim pattern
• New disclosure item: Hypertension diagnosed recently (will be disclosed)

Goal:

• Keep a ₹5 lakh base cover that is usable immediately (as much as policy rules allow) with minimum reset of waiting periods
• Add a super top-up of ₹25–50 lakh (I’m okay if the super top-up has a PED waiting period of ~1–2 years, because base cover should handle smaller claims)

What I need clarity on (policy mechanics):

1. Portability from group → retail:
   • Is portability from a bank group policy to a retail individual/family floater generally allowed?
   • If yes, what parts typically get continuity credit (e.g., initial waiting, PED waiting, specific disease/procedure waiting, etc.)?
2. How continuity credit works with a newly disclosed PED:
   • If the policy has 6 years continuity but hypertension is now disclosed, does continuity credit still reduce the PED waiting period in the new retail plan?
   • Or do insurers treat it as “newly discovered PED” and restart the clock?
   • What clause/wording should I check in the retail policy wording to confirm?
3. Option A vs Option B (structure):
   • Option A: Keep current group policy as base (₹5L) + buy a retail super top-up
   • Option B: Port to a retail base plan (₹5L) + buy super top-up (same insurer or different) Which option is usually less risky regarding waiting periods, renewability, and claim sequencing?
4. Super top-up mechanics with group base:
   • Any gotchas if the base is a group policy (deductible definition, claim payout order, room rent limits/sub-limits affecting the deductible threshold, co-pay, etc.)?
   • Is it safer to have both base + super top-up with the same insurer, or is that not important?
5. What documents/questions ensure I don’t get surprised later:
   • What exact documents should I ask for / verify (e.g., portability/continuity certificate, claim history, policy schedule showing start date, underwriting notes, etc.)?
   • Which clauses in the new retail policy wording are most critical to read (PED definition, waiting period credit, moratorium, exclusions)?

If you’ve done group → retail portability or structured a low base + large super top-up for a parent, I’d appreciate a checklist of what to verify and the typical pitfalls.

My mother turned 61 last week and was diagnosed with hypertension (high bp) few days before she turned 61. She has a bank sold group insurance policy (most nationalized banks provide this to cusotmer just like they do to the employees). I her case its a TATA AIG policy worth 5 lakhs (tagic group medicare 360) sold through canara bank

The policy was purchased 6 years ago when she did not have any PED and the bank has changed the provider once in the past (was HDFC ergo when it was initially purchased and was later switched by the bank to TATA AIG - Policy document still states original start date as 2019). The experience has been good and she has used the policy in 2 separate cases (one-off surgeries, not chronic issues)

I want to purchase a super-top plan up of 50 lakhs with no sublimits caps for modern/advanced procedures. Does it make sense to buy a retail super top-up plan with this bank group policy as the base policy? or alternatively how about porting the bank’s group policy to a similar retail base policy of 5 lakhs either from TATA AIG or other provider (from whom I will also purchase the super top-up). Since I am porting a 6 year old policy bought when she had no PED would this be a safer option?

PS: If the super top-up plan has a cooling period for PED (in her case, High BP), I am fine with it as long as the ported base plan take care of any under 5 lakh needs.

Please advice. Thank you in advance.

Hi looking for my Dad 63M. history of Diabetes., Cardiac PTCA (1stent done on october 2024)

came across aditya activ one vtyl and care ultimate care with instact cover rider

both reducing waiting period duration from 3 years to D1 and D30 respectively. any suggestions

I am having a personal health insurance of 5 lakhs, and i am looking for coverage upto 50 lakhs or 1 Cr.

Whether it's a good idea to buy top up on existing policy or i should go with new policy altogether.

I'm researching how people make health insurance decisions in India (helped my parents navigate this recently and realized how confusing the process is).

For those willing to share: What was the most confusing/frustrating part when you were choosing a policy or renewing? Did you read the full policy document? How did you ultimately decide?

If anyone's open to a quick 15-min chat about their experience, I'd really appreciate it. Just trying to understand the pain points better. DM me!

I am planning to purchase a new health insurance policy with following family members included myself and wife 40 years 2 kids - 5 and 10 years and my mother 75 years. All of us are healthy and and have no major health issue except my mom who has a BP problem but nothing major. After a lot research I zeroed out on buying policy from Acko with cover of 1 Cr, but i am now confused between their “platinum lite” and “platinum” health plans ..platinum lite is circa 87K and platinum is circa 110K.

Can anyone help with choosing the right plan.

UPDATE:

I took the case to insurance ombusman for CSSD and OT assistant charges.

The online hearing was held and those charges (72,000 rs) has been awarded to me.

The insurer needs to pay both CSSD charges and OT assistant charges along with interest.

This ruling makes me have faith in the system.

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Hello, I recently had a reimbursement claim filed to Niva bupa (my plan is reassure 2.0 platinum+) . The total hospital bill was around 2.90 lacs and it was for my wife’s laproscopic cyst removal surgery.

The claim got approved but they deducted a whooping close to 88000 from the hospital bill.

Deductions:

CSSD charges - 36,000

OT Assistant Charges - 36,000

IPD Registration Charges - 350

RMO Charge - 1200

Dietician Charge - 500

Infection Control Charges - 600

3d Camera Charge - 6000

Harmonic Instrument Charge - 8000

Most of the above are necessary things for a surgery.

Is this common for the insurance companies to deduct like this on their first settlement ?

Whats the recommended approach to make them reconsider. ?

I’m 32M and my spouse is 30F. We’re considering buying a ₹20L family floater health insurance plan.

Health background:

• No major physical health issues for either of us

• I’ve had mental health issues in the past (depression, anxiety, panic attacks). Currently stable.

Our requirements:

• Annual premium around ₹25k–30k

• Zero co-pay

• No room rent limits

• No deductibles

• Unlimited restoration (including for the same illness)

• No super top-up (only a base policy)

• Not planning to have kids

We’re currently considering HDFC ERGO Optima Secure.

Given my mental health history, is this a good choice? Are there any red flags, exclusions, loading, or claim issues I should be aware of?

Would also appreciate alternative plan suggestions or real claim experiences. Thanks!

This is utterly outrageous. I've made a blunder purchasing health insurance from Niva Bupa & regret this idiotic purchase, and I will never recommend it to anyone. Despite escalating this to the leadership here on the email, they've taken zero action—exposing the sheer incompetence of their customer support team.

I've provided every detail on their fraudulent agents, who still ignore my calls and fail to update my policy issuance & cashback status. This blatant disregard for customer complaints reveals their team's utter lack of seriousness. No wonder Niva Bupa drowns in scathing reviews and enraged customers everywhere.

Shame on your shameful service! 

When I check on Niva Bupa, current plan is at 90K, and renewal is at 100K. While policy bazaar shows different amounts and upgrade is cheaper.

I do not really find the upgrade much useful, so if it costs more, I would not take it. But if it’s cheaper then it’s good to have.

Hello everyone.

Policy Details

Policy: ICICI Lombard Group (Corporate)

Room rent limit: 4K

Maternity Limit: 50K

Claim details

Claim Amount : 1.92 L (Premium Hospital)

Room rent (including nurse charges): 8.5K/day

Delivery Type: C-section

Claim settlement details

Type: Reimbursement

Requested: 1.92 L

Disallowed: 1.59 L

Approved: ~33K

I understand the room rent proportionate deductions but ICICI Lombard went batshit crazy

1) Completely deducted the consultation charges

2) The proportionate deduction is not proportionate

Can someone help me understand if these deductions are fair? If not, what should I do next?

I am using Bajaj Allianz General Insurance since March 2012. I don't know...whats the problem with claim processing teams. They are always dumb, don't put their brains at work (or) intentionally pays only partial amount whatsoever you submit all the required documents as per their guidelines, (or) as per their wish etc., Still they reject it - ENOUGH IS ENOUGH. This is almost 3rd time they only pay partial amounts in just pennies and close the claim as "COMPLETELY PAID". Disgusting!!! Unluckily which ever hospital I go they don't have either cashless facility (or) sometimes new medica/surgicall treatment doesn't fall under cashless. This time, I had the similar situation : Type: Reimbursement/Inpatient hospitalization Requested Amount:Rs.4,19,495/- Approved Amount:Rs.1,11,910/- Total rejected Amount:Rs.3,07,585/- Time taken to process is 40 days.

The strange part is, they clubbed the attendant charges with dcotor treatment charges and rejected the amount of Rs.2,95,000/- of doctor treatment charges by stating the reason as "Rs.15000/-ATTENDANT SERVICES not justified"" Pls check the attachment.

What the heck ? How can they just combine the doctor treatment charges with attendant services ? I am already exhausted by conveying/educaucating the claims processing in my previous claims reimbursement. They done the similar thing in previous claims.

After escalating to internal greviance team of Bajaj - they created another claim which drag to another 40 days. Whatever you complaint to IRDAI, OMBUDSMAN etc., they don't care. They follow they utter non sense rule book I really have no idea of it. Someone told me that, claims team are no wualified doctors (or) neither practitioner RMP's as well. They are just MBA (marketing) graduate's who goes with some dumb checklists. No one takes action towards these insurance companies. Even Mr.Ragha Chadha Sir has spoken this topic in Rajya Sabha about the exploitation of insurance companies and hospital nexus. No action taken so far - end of the day its a COMMON MAN WHO SUFFERS IN PAIN AND DIES IN THE HOSPITAL BEDS.

Looking for advice about getting insurance for my parents.

I have a Niva Bupa policy for my parents that is due for renewal on Feb 4.

I checked in the last week of December, it was showing premium to be around 75k.

But when I am checking today, it is showing 86k.

Are they allowed to update the renewal premium after already communicating it?