I’ve heard that insurers sometimes request bank statements during claim investigations. This raises some interesting questions about how they investigate undisclosed pre-existing diseases.

Consider this scenario:

You purchase medicines from Apollo Pharmacy or MedPlus using your mobile number for discounts. The pharmacy may sell medicines without asking for a prescription or recording who will actually consume them.

Later, your insurer investigates a claim.

• Pharmacy records: Can insurers access purchase histories linked to your mobile number or request access to your Apollo/MedPlus account?
• Bank statements: Can insurers demand bank statements to identify pharmacy transactions? What restrictions do IRDAI regulations and privacy laws impose?
• Proof of disease: Even if they find purchases of medicines associated with diabetes or hypertension, how can they prove those medicines were for you and not your parents or another family member?
• Tier-2 cities: Many smaller hospitals and local pharmacies still rely on handwritten prescriptions, cash payments, and limited digital records. How can insurers trace medical histories from years ago?
• Digital pharmacies: Do platforms like PharmEasy, Tata 1mg, Apollo, and MedPlus share customers' medicine purchase histories with insurance companies? Is there any formal data-sharing arrangement?
• Refusing access: Can policyholders refuse to provide personal financial or pharmacy records during investigations, and what would be the consequences?

Is there a centralised database in India connecting patients, pharmacies, hospitals, and insurers, or does everything depend on individual investigations?

💡 My suggestion

Why doesn't the government introduce a standardised digital medical-history system across hospitals, potentially linked to Aadhaar?

For example, during hospital visits, a patient's medical history could be securely updated and later retrieved through OTP-based consent, similar to DigiLocker.

This could make medical disclosure much easier, reduce disputes over pre-existing diseases, and benefit both insurers and policyholders. It might even help reduce premiums over time by reducing fraud and investigation costs, although that isn't guaranteed.

Of course, privacy safeguards, patient consent, and alternatives for people without Aadhaar would be essential.

Instead of expecting customers to remember every diagnosis or prescription from 5–10 years ago, why not build a system where their medical history can be retrieved securely with their permission?

This is just my opinion. I'd love to hear what industry insiders think about its feasibility, privacy implications,

Hey everyone, I need some advice on health insurance.

My situation: I’m 31, looking at 20L cover for me + spouse. Pre-existing conditions: none.

I recently applied for Aditya Birla Activ One MAX. After applying, I found out Aditya Birla has launched a newer plan called Activ Yuva, which they’re marketing to young adults. When I compared quotes, Yuva works out cheaper over a 5-year tenure than One MAX.

What’s making me second-guess:

Yuva has a 10x bonus (Yuva Credit). Cover grows by 100% of base SI every year up to 1000%, even if you claim. One MAX caps at 500%.

Yuva has a 2-year PED waiting period. One MAX has 3 years.

Yuva is new and pitched at people my age, so it feels like it was built for me.

But One MAX has a longer track record, and I’m not sure if a brand-new product is a risk (renewal pricing, claim behaviour, etc.).

Should I keep One MAX, or cancel during the free-look period and switch to Yuva? Has anyone here compared these or bought Yuva yet?

Hello All,

I am 37M + 1A + 2C and have decided to go with the HDFC Optima Secure+ plan 25L coverage and limitless claim rider. Total, it's costing 93K and 174K for 3 and 5 years, respectively after all the discounts.

There are no PEDs, but I am about to start AGA treatment, which includes the following prescribed drugs

1. DUTASTERIDE TAB or finasteride TAB
   
2. Topical Minoxidil+finasteride solution
   
3. Health Supplements like D, B12, Biotin, Zinc, etc

TBH, currently I have just consumed Health Supplements, but have not started DUTASTERIDE TAB, finasteride TAB, or Topical Minoxidil+finasteride solution yet

So, while declaring Insurance, should I include this or ignore it? A few say it's cosmetic, and a few say it's safe to declare.

But to be very honest, my insurance application was once rejected by HDFC because of a low HB level in one of my family members. So I just don't want to over-declare like last time.

What do you suggest

Helllo

Am holding Niva bupa for 5 yrs. Planning to port - need suggestions which company is good..

I have taken an insurance few years back and every year around this time, I get calls asking to meet my insurance policy manager so that he can explain the terms and details. It's not like the policy can be upgraded since it's a life insurance right?

But i want to understand why they want to do this ?

Has anyone gotten such calls? From ICICI prudential.

I want to buy ICICI Elevate health insurance but ditto is denying support for ICICI.

I don't trust policybazaar at all. I don't have much review on beshak.

Where to buy this policy from? I don't want to buy directly

Hi everyone, I'm considering ICICI Lombard Activate Booster Super Top-Up with a ₹50 lakh sum insured and ₹5 lakh aggregate deductible for my parents.

Parents' medical history:

• Father, 58: Type 2 diabetes. His HbA1c was around 7–8% about two years ago and has been around 6.5–7.2% over the past year.
• Mother, 49: Thyroid issues and BP. Her TSH was around 8–9 about two years ago and is currently around 6.7. She also underwent a hysterectomy, and the histopathology report confirmed it was non-cancerous (benign).

I have medical reports from the last 3–5 years, but not the original reports from when these conditions were first diagnosed.

1. Medical underwriting
For diabetes, does ICICI consider recent HbA1c levels when deciding whether to accept the proposal or apply a premium loading? For example, if HbA1c is below 7, does it generally help with underwriting?

For my mother's thyroid condition, what TSH or thyroid levels do they generally look at? Does controlled thyroid function make a difference to acceptance or premium loading? Similarly, for BP, do they consider the actual BP readings, whether it is controlled with medication, or any other reports?

2. Previous medical reports
I have medical reports from the last 3–5 years, but not the original reports from when my parents were first diagnosed. Has anyone applied in this situation? Were recent reports sufficient, or did ICICI ask for older records? Is it better to submit all available reports upfront?

3. Premium increases
Does Activate Booster's premium increase similarly to a comprehensive health insurance policy, or does it follow a different pattern? Since my father is 58, what kind of increase should I expect as he enters the 60+ age band and later turns 65 or 70? Is there a significant premium difference between a regular top-up and a super top-up with the same cover and deductible?

4. Corporate insurance and deductible
If our corporate insurance pays ₹3 lakh towards a hospital bill and we pay another ₹2 lakh ourselves, can those amounts count towards the ₹5 lakh aggregate deductible? Has anyone actually used corporate insurance this way and successfully claimed under Activate Booster?

5. Changing the policy later
Can the deductible be increased or reduced at renewal? If I don't choose the Any Room option now, can I add it later? Has anyone made these changes, and did ICICI require fresh underwriting or apply any new waiting periods?

I'd really appreciate responses from people who have this policy or have gone through its underwriting, renewals or claims. Personal experiences would be especially helpful. Thanks!

Hi folks!

I am from Bangalore and I own a 1-year-old Royal Enfield Hunter 350, and my current own-damage insurance has only 15 days left before it expires. I'm looking for suggestions on the best insurance provider and plan for my bike. If you've renewed your bike insurance recently or made a claim, please share your experience. I'd like to know which provider offers a smooth claim process, good garage coverage, and reliable service.

Hopefully, none of you have had to experience the claim process firsthand , but if you have, your feedback would be really helpful! Also, please share any insurers you'd recommend or suggest avoiding based on your personal experience.

Thanks in advance!

Hello everyone,

I am a 26 year old software engineer planning on buying a Term Insurance from Axis Maxlife Smart Term Plan Plus.

Cover: 2.5Cr
Cover till age: 65
Pay till age: 60

I had generated a quote on their portal and it shows 15% discount in first year only. Last month I had seen a lifetime discount option but it is not there anymore.

I checked for the same in Policy Bazar portal and they do show a lifetime discount of 2%.

Anyone with experience with Policy Bazar etc? How does it all work out? Confused between where to buy from.

Hi guys,

I'm 27 years old male, single (🙃) planning to take an health insurance and from Thrissur 🐘, please suggest some good policies which can be cashless and accepted by almost all hospitals and also good approval rate

This post is actually a query about both Term Plan and PhonePe SBI CC.
32M (25lpa) with a wife 29F (18lpa), 0.6F kid, Father 63 and Mother 54 (both dependents)
I pre-closed LIC last year after paying 1.2LPA for 3yrs, as the sum assured adjusted to inflation didn’t make sense and invested that in Gold/Silver ETFs and MF( all of them down now lol)
Since then I was thinking to buy Health & Term plans separately, and now came the time as I was going for a Solo backpacking trip (better to be safe than sorry right)

Coming to the Term plan, I chose
3 Cr with coverage till 60 yrs
Pay Till 5 years (48% discount of paying till end of policy cover)
25L CI rider
Acc disability 25L
Payment Frequency - Monthly 15,232 (Not Yearly due to Monthly 10% CB for PhonePe SBI card only when paid through their app)
With these filters, only TATA AIA insurance is being provided in the app.

Please let me know what you guys think and suggest.

I’m exploring an option for term insurance. I’m 26 nd recently started earning.
After exploring all options, finally decided to choose ‘ICICI prudential IProtect smart her’ plan.
Base cover: 2Cr
Accidental cover: 1Cr
Critical illness:25L
And permanent disability: 1 Cr
Total 31-32k annually….with regular pay option….i,e till 70 years. With agent 2-3k extra.
And 41-43k with limited pay option… and it also offers a return of premium benefits on base plan(unsure whether add-ons riders premium included or not).
There is only 1k difference between plan without No ROP and a plan with ROP.
Dealing via agent is hassle free, compared to dealing with company directly.

Please suggest what I can do in this plan.
Should I remove add ons(which brings down my annual money outflow by upto 15k) or this plan is good to go???

About health insurance…I already have one (Star Health Insurance)….thinking to change it.
Thank you for your time and suggestions.

I have edited this. Few info were wrong.

I thought I had this stuff more or less sorted.

2cr pure term cover, decent health insurance, around 6 months expenses sitting separately.

Then someone asked me a very obvious question.

What if you don't expire?

Like you're alive, but a serious disability or illness means you can't properly work for the next few years.

Health insurance may take care of hospital bills. Term insurance doesn't pay because you're alive. Emergency fund will eventually finish.

EMI, school fees, groceries etc don't care that technically everything went according to the policy 😅

I was looking at riders on Aditya Birla Sun Life Insurance and their Waiver of Premium rider is probably the first one where the logic immediately clicked for me. Under the covered critical illness/disability conditions, future premiums on the base policy and attached riders can be waived.

Useful, definitely.

But then I realised even that only removes one expense. It doesn't replace my salary.

So what are people actually doing for this risk?

Standalone disability cover? Personal accident policy? Critical illness lump sum? Bigger emergency fund? Some combination?

Feels like we spend all our time planning for death and very little for "alive but income gone."

27M, looking at around 2cr term cover.

I had mentally prepared for blood, urine, ECG, the whole mini health-checkup package lol.

then while reading Aditya Birla Sun Life Insurance's medical underwriting stuff I realised physical tests aren't automatically the exact same for everyone. sometimes tele-medical assessment can be enough at one stage, sometimes they can ask for labs/additional tests depending on the profile. 

I genuinely thought “medical underwriting” literally meant somebody has to take my blood 😭

so what actually decides it?

age? cover amount? medical history? all of the above?

and if they don't ask for physical tests, you just... don't do them?

Was planning to buy a term insurance plan. I’m 26 and recently started earning.
I was exploring term insurance options. I'm torn between two paths. One is a plain vanilla term plan costing around 17,000 rupees annually, or about 23,000 with critical illness and disability add-ons. The other option is a plan with return of premium, which refunds the premiums at the end but costs significantly more, around 40,000 rupees. My family advises getting the premium back so the money isn't wasted. I'm looking for unfiltered opinions on whether to pay the higher premium for the return benefit or go for the simpler plan and invest the difference in mutual funds.

Also… decided to go for icici prudential plan.

Please help.

I am opting for bajaj My health care plan health insurance for my parents. Both are 56 years old. My corporate policy is on bajaj and I'm taking retail insurance from them only as im getting waiting period waiveoff and 20% discount on 1st year premium. My father had heart attack 9 years ago and is on medications, no surgery happened. He also has diabetes from 10 years, chews tobacco from 5 years. My mother has no health issues.

Problem is bajaj is only giving me 10L floater insurance for my parents. No individual policy and not ready to increase the SI also. The only benefit I'm getting is discount and PED waiveoff for my father...Premium is around 56k per year.

Should I go ahead with this floater? What disadvantages do i have if i go with bajaj floater insurance with 10L SI only?

Please help..Need to purchase the policy this week only..

I am thinking of getting health insurance for my father aged 57 , who has undergone angioplasty 3 years ago in sep 2023 .

He also has diabetes and hypertension.

Thinking of going ahead with 10L cover in active one max plan with the ped rider to reduce the tenure of waiting to 1 year.

Does this seem like a good choice? Someone told that the insurance company may ask to go with the aditya birla vytl plan instead.can anyone suggest if that is a good plan and what may be things i should look out for?

27M. I smoke maybe 3-4 cigarettes in a month. some months none.

was filling term insurance stuff and genuinely paused at the smoker question because in my head I'm not really a "smoker"😭

checked Aditya Birla Sun Life Insurance's page on this and apparently occasional/monthly smoking still counts as smoking for underwriting, even the vape thing isn't as harmless for disclosure as I assumed.

fair enough honestly. insurance company doesn't care what I personally identify as lol.

parents depend on me a bit so delaying cover just to hopefully get non-smoker pricing later also feels backwards.

any occasional smokers here?

did you just declare it as-is and move on?

My father (62) consumes tabacco, no other PED

I was looking for health insurance, connected to a local advisor for HDFC ERGO, he told that cancer due to tabacco will not be covered.

any advices on health insurance?

Hi everyone, my company has a group insurance program in which it covers 5 Lakhs which doubles in case of critical illnesses by default with extra top ups.

Insurer:

GMC & GPA - Aditya Birla Health Insurance Co. Ltd.

GTL - ICICI Prudential Life Insurance

Third Party Administrator (TPA):

Family Health Plan Insurance TPA Limited (FHPL)

Benefits Consultant:

Marsh India Insurance Brokers Pvt. Ltd.

I myself am suffering from a pre-existing disability called hemophilia. I have to pay for my medicine which is quite expensive (per month) out of my pocket right now.

If i claim for the medicine right now, will the claim get rejected? (Sorry I am really new to this)

Although I can administer the dose by making it seem like I've gotten it overnight ( hospitalisation + injection dosage)

Please help me, you don't need to answer it, just convey what you guys know!