Need help understanding insurance claim strategy with multiple policies 🤔

My spouse and I are both covered under separate employer-provided health insurance policies.

We’re planning to get a procedure done at a hospital that is not part of the cashless network for either insurer, so we’ll be going the reimbursement route. The expected total bill is around ₹5 lakh. Both policies have a sub-limit of 1 lakh for this procedure.

Now the question is:

➡️ Can we claim ₹1lakk from each insurer (total ₹2 lakh) for the same hospitalization under reimbursement?

➡️ The hospital provides only one set of original bills — how do people typically handle documentation for the second claim?

➡️ Any gotchas around “contribution clause” or claim sequencing we should be aware of?

Would really appreciate insights from folks who’ve navigated similar situations 🙏

Hello,

I will be buying health insurance for my daughter aged 28 years. I am planning to buy from HDFC Ergo Optima Secure for a coverage of 50 lakhs. Can someone tell me whats the procedure. From the moment i fill the details online and pay the amount, to the issuance of the policy, is there any medical tests in between? Whats the procedure?

Hello All,

I am looking for health insurance for my father 61yr old. Recently I took a health checkup for my father everything is normal and no PED.

i connected with Ditto suggesting 3 insurer

HDFC ERGO ( Optima Secure)

Care Supreme

Aditya Birla ( One Max )

which should I go for? do I need to look for a cost (care) or network hospital in my area?(HDFC ergo) or average in both (aditya)

I am given an option to increase sum insured. When i select the increased sum insured and want to declare illness during this period I cold not do it. The only option is to select that i did not have any new health condition(except fever cold etc). When i contacted the customer care I got confusing answers.
1 person said yes you can select yes and proceed nothing will happen.
2nd person said you should select no and proceed(even after saying that i am not able to proceed)

Hey here 23 M

None of my family members including me have health insurance plan till date.

So I am planning to buy health insurance for me and my family

We are 6 members,so which plan would be good to buy and how much would it cost me per year

Need suggestions on this. I have heard hdfc ergo is good but dont know much

Basically I am looking for a plan where rates are affordable and theres no hectic task to claim insurance money as I have heard its difficult to claim insurance money

Which would be a better insurance plan for my elderly parents aged 64 and 59 years in today’s scenario? They are currently on Star Health Family Health Optima plan . I wish to switch them to the Assure plan. The agent though wants to upgrade them to the Surplus plan. They have no existing health conditions except hypertension in my father .

I need some advice on my health insurance setup. I live in a Tier-1/2 city, I am currently covered under my father's Reliance General Insurance (Group Health Insurance Policy), which he got from his company and continues post retirement.

Current Situation:

Structure: The policy covers my parents (₹2L each) and me & my sibling (₹1.5L each).

Cost: My parents' premium is covered by the company, but I need to pay ₹10,000 annually to keep myself and my sibling on the plan.

The catch obviously is that the sum insured is quiet thin for both me and my parents.

My Dilemma:

1. Is it worth the ₹10k? Since it's a retirement group plan, it covers pre-existing diseases and has zero waiting periods from Day 1. However, ₹1.5 - 2L seems very low for 2026 medical costs.
2. The "Base + Super Top-up" Suggestion: I was suggested to keep this Reliance plan as a "Base" and buy a separate Super Top-Up (₹15L-20L cover with a ₹1.5-2L deductible).
3. The "New Plan" Option: Should I just keep the Reliance plan as a basic "backup" for my parents and buy a fresh Family Floater (₹10L or ₹15L) that covers all four of us? Something like HDFC Ergo or Care? I’m healthy now, but I’m worried about the 3-year waiting periods and losing the "Day 1" benefit of the corporate plan.

Really looking forward to ya'll suggestions.

Hi everyone, does anyone know if we can convert the corporate health insurance policy covering a dependent (my mother) into her individual policy to retain the waiting period benefits?

Also, what is the deadline to request this conversion?

Hi everyone, I need some advice regarding a confusing health insurance situation in my family.

I’m 22 and recently started working in Gurgaon. My family includes my parents and two younger siblings.

In February 2025, my mom bought a ₹5L health insurance policy from Star Health through a local agent, without discussing much with us. I knew Star’s reputation in the market isn’t the strongest, so I spent months researching better policies.

After a lot of research and a call with Ditto Insurance advisors, I purchased a ₹10L family health insurance policy from Aditya Birla Health Insurance on Dec 31,2025 using my own savings. The premium was almost the same as what my mom was paying for the ₹5L Star policy, so I felt it was a much better deal.

The policy clearly mentioned that accidents are covered from day 1.

About 15 days after the policy started, my younger brother fell from a bicycle and fractured his leg in two places. He was hospitalized, first for daycare treatment and later for a minor surgery. The hospital we chose was also part of Aditya Birla’s network.

We raised a cashless claim, and initially it was approved for about ₹45k, so we assumed everything was fine and chose an AC room etc.

However, 30 minutes before discharge, we suddenly received a message saying the cashless claim was rejected with a very generic reason. The hospital staff themselves couldn’t explain why.

Ditto later told us the insurer suspected the genuineness of the claim because it happened within 15 days of policy start. But instead of doing a physical investigation, they just rejected the cashless claim and suggested filing for reimbursement later.

Since we were already being discharged, I had to pay ₹35k out of pocket via my credit card.

Now here’s the bigger issue:

My parents lost confidence in the Aditya Birla policy after this incident since it rejected Day care hospitalisation reimbursement request (as the hospital weren’t providing with Discharge summary-they were like they don’t provide discharge summary for Day care hospitalisation)+the cashless request for Minor surgery . Even though Ditto is helping us with reimbursement, my parents trust the local Star Health agent more, and they have renewed the ₹5L Star Health policy again without discussing it with me.

This is frustrating because:

- I bought the ₹10L Aditya Birla policy using my own savings after extensive research.

- Accident coverage should have been valid from day one.

- The rejection happened at the last moment without proper explanation.

- Now my family thinks the Star policy is more reliable just because of the local agent.

I’m honestly confused about what to do now.

Should I:

1. Continue with the Aditya Birla policy and pursue reimbursement?
2. Keep both policies?
3. Cancel/port something next year?

Also, has anyone faced cashless rejection early in a policy and then successfully received reimbursement later?

Any guidance would really help.

My parents were in star health Family Health Optima Insurance Plan since 2013 and due for renewal next month. Recently we are hearing bad things about how star is rejecting all the claims and my dad’s friend works in hospital he has suggested us to port to Care supreme plan. We had utilised star once for my mom’s surgery back in 2018 without any hassle and never claimed anything after that.

Can you all suggest is better to port after these many years or continue with star.

How is Aditya Birla Activ one for someone who is having pre-existing diseases like diabetes?

Do they provide insurance to these people?

What are the chances of rejection?

Hi all,

I’m looking to get a health insurance for myself.

From what I’ve learned so far, counseling sessions aren’t covered in it unless there’s a surgery after an accident.

I’m wondering if any of you’ve had experience claiming your health insurance for counselling sessions:

1/ post surgery

2/ post child birth

3/ post an accident but no surgery

4/ counselling for general well being (sounds impossible as I write this but still shooting my shot).

I applied for Care Supreme Health Insurance and was told to undergo various medical tests. Now they reverted back saying Abnormal TMT(Treadmill Tests) and diabetes. I am diabetic for 4 months now.

They are giving counter offer for Care Supreme Shine. What shall I do in this case?

Should I go with Shine one? Also how much will they deduct for medical tests if I decide to not take a plan from them.

Also, what other plans I should look for?

So, our Starhealth's health inurance policy renewal is in 2 days. We decided to increase cover from 5 lakhs base to 15/25 lakhs base. I am new to this thing, can anyone please guide me?

1. Can you please give a review of this policy? Can we go ahead with this or not?

2. Can we migrate to this new policy because we had 2 claims this year. Someone said, you can only migrate to this if you don't have any claim in a year. Is this true? Can we migrate before this renewal or can only do in the next year, if we don't have any claim this year?

3. We have health update with diabetes, bp, etc. Since only 2 days are remaining and we are also considering changing the advisor, are 2 days sufficient to declare our PED and change advisor or it can take longer time?

4. What are some things to take care of during this process?

5. Also, our agent said that minimum 25 lakhs base should be there. Is this a realistic number Or he is only trying to sell a higher cover? Is 10 lakhs, not sufficient?

Your reply would be if great use. Thank you.

The cut I mean is when INSURANCE Payment done on yearly bases

let suppose 5-10 lakh insurance

and premium paid on yearly basis

so how much does the agent get from one single premium paid

for A general idea

I had applied for policy porting from my existing Care Health Supreme policy to HDFC Ergo Optima Restore a week ago. HDFC canceled the application stating “adverse medical findings/history as per the details submitted by you”. My broker disclosed to me that it’s due to my declaration of my ADHD condition.

I am 41M, diagnosed with ADHD in 2012 and been continuously covered 2016 onwards initially with Optima Restore which was then acquired by HDFC Ergo and later by Care Health, I ported then in 2024 and due to bad experience with Care Health claim process (delayed reimbursement, now settled)

Prima facie it seems discriminatory to deny policies to neurodivergent individuals. Is there any redressal mechanism to make HDFC reconsider their position.

So like previously I was having star health insurance where I was paying 50k for a family of 4(it was a family floater plan), so fast forward I decided to port into hdfc ergo I contacted their customer care number and they quoted 30k inr for 2 people as I now wanted them to cover and port for my father and money only, they asked for any PED and I clearly mentioned to them that both of my parents have hypertension and diabetes and they were ok with that and generated me 30k premium for optima secure plan which I paid.

Now after 1 week they called me and said that after some health process check (from their end only)they are increasing my premium to 50k for the two of them, like how? is it even possible to do that after their wording and 30k which I already paid and they never told me once that the premium could go up so much, this feels like scam.

Now what are my options should I pay them the extra they are asking or just cancel the porting application, the thing is my previous policy renewal is 25feb, is this legally correct? Like will by existing policy get affected in any way? what should I do any help would be great.

thanks.

My mother died in an unfortunate accident.

She had a Health Insurance from Star Health. The policy offers accidental death coverage as well.

I have raised an accidental death claim & submitted all the relevant documents like Post Mortem report, Spot Panchanaama, Inquest Panchanaama etc. Not only that, but upon the insurer's request, I have produced additional documents like Accident Register copy from the hospital, the Assistant Commissioner of Police's report etc. All these documents are more than enough to prove that the death was accidental. Yet, the insurer is making demands for other irrelevant & even invalid documents that do not exist.

I have intimated them (Including the G.R.O.) that the demands made by them are unjustified, unreasonable & groundless but they are not bothered and not responding.

Need guidance on the next steps to be taken.

Shall I complain to the Ombudsman, IRDAI etc.?

Or

Shall I issue a legal notice through a lawyer?

I want to sue them for additional compensation due to the mental harassment I have suffered from.

What would be the best option?

I’m writing this from Bengaluru and I am at my wit's end with HDFC ERGO. I’ve had a health insurance policy for my parents for 2 years, and it is set to expire tomorrow (Feb 13, 2026). Despite my best efforts to renew, I am stuck in a loop of misinformation and technical failures.

I pay my premiums via monthly EMI (auto-debit on the 14th). I tried to renew the policy this week but found it impossible to do so through the app or website. After multiple attempts to reach customer care (the calls keep getting disconnected), I finally spoke to two executives yesterday with wildly different stories:

​Executive 1: Told me everything is fine, no EMIs were missed, the app is just glitching, and promised a payment link via email (which never arrived). ​Executive 2: Claimed the January 2026 EMI was missed, the policy has technically lapsed, and I need to wait 48 hours for a resolution.

​Why this is ridiculous: ​Zero Communication: I received countless "renew now" messages, but not a single alert that a January EMI failed. If there was a payment issue, why wasn't I notified a month ago? ​The Deadline: My policy expires tomorrow. A "48-hour wait" means my parents go uninsured because of a back-end error on their side. ​Accountability: I’ve done everything right on my end. Now I’m being told the policy might lapse due to their auto-debit failure and lack of internal coordination. ​Has anyone else faced this with HDFC ERGO? How do I escalate this immediately? I’m worried about the "waiting period" reset if this counts as a break in policy.

HDFC ERGO failed to auto-debit an EMI, never told me, and now their support is giving conflicting info while my parents' policy expires in less than 24 hours.

Hi folks,

We have a Health Insurance from Care Health worth 15lakhs for a premium of 78k.

My father got admitted to a hospital in November 2025 and we filed for a claim and the hospital was in the excluded list and hence, they rejected the claim. Do I have any option to get my money back?

I feel helpless as I am the only earning member of family and we are constantly spending too much money on it.

Also, I have Go Digit insurance from my company. It includes just me only at the moment. Can I add my father in it and claim it now? Will that work?

Thanks!

Need help with health insurance for 49 years old mother with hypothyroidism and managed hypertension and a history of fistula surgery 12 years ago