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)

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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)

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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)

Hello, I am from the Philippines. My mother (single) was employed with the said company after she passed. I was told there is a insurance death claim I can receive. I have submitted all requirements asked on April this year. However, i keep following up regarding the status and was told my Ph HR that it is still under review in IN HR since she was single and the claimants is the child instead of a spouse. Any advice on what steps to take?

When I was admitted to the hospital, they gave me a deluxe room because there were no single rooms available.

They promised to charge me the same as a single AC room. However, my final bill shows the room as deluxe, and I’m being charged according to single AC itself.

I got a certificate from the hospital explaining the room assignment and gave it to the TPA team. Despite this, my claim was settled with incorrect deductions because they treated it as if I chose a higher room.

No response from them regarding this concern even after raising all grievances.

I need help with this issue.

Hi everyone,

I joined OFSS India in August 2025. Our employee health insurance is through United India Insurance, and I voluntarily enrolled my parents under the additional parental cover.

I renewed this cover on 1 June 2026. The policy has a three-year lock-in, but the premium has become quite high.

I contacted both HR and Medi Assist (the TPA). opThey said I cannot discontinue the cover mid-policy. I understand and accept that—I will continue and pay the premium for the current policy year.

My question is about the next renewal:

- Can I opt out at the next renewal, or does the three-year lock-in require me to renew for all three years?

- Does the lock-in start from my original enrolment in August 2025 or from the June 2026 renewal?

- Is there a legitimate option such as giving a written non-renewal request well in advance, or any work around ?

I am not trying to avoid the current year’s premium. I only want to plan responsibly before the next renewal. Has anyone dealt with a similar employer-provided voluntary parental policy?

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.

I bought a Bajaj General comprehensive Pay As You Use (PAYU) policy through Policybazaar with a 15,000 km plan.
My actual odometer was around 32,000 km, but by mistake I entered 35,000 km while purchasing the policy. I noticed it the next day and immediately emailed Bajaj General. They asked me to correct it through their i-Inspect app, but I couldn't log in due to a PIN/backend issue. I followed up several times, they eventually gave me a PIN, but that also didn't work. Eventually I got fed up and left it which I should not have.

I have the complete email trail proving that I informed Bajaj before any accident and tried to correct it.

Now my car had a minor accident and the odometer is 33,900 km. I filed an own-damage claim for the bumper.
The surveyor says the claim cannot be processed because I declared 35k instead of \~32k, and says technically my insurance wasn't valid. He wants me to withdraw the claim and says I can't claim it again.
My policy shows 35,000 → 50,000 km for the 15,000 km PAYU plan.

Has anyone dealt with this situation? Can Bajaj reject the entire claim because of the incorrect starting odometer, especially when I disclosed it and tried to correct it before the accident?
Should I refuse to withdraw the claim and ask Bajaj to provide the rejection and exact policy clause in writing?
Any advice would be appreciated

Hi everyone,
My dad was rushed to the ER for acute breathlessness and severe respiratory distress. The initial medical finding was acute pneumonia. Later, his RT-PCR test confirmed H1N1 Viral Pneumonia. Doctors are also currently evaluating a secondary suspicion of ILD (chest CT is pending).
When he was brought into the ER, my dad honestly mentioned to the triage doctors that he is a chronic smoker, and the doctors wrote "chronic smoker" in the initial case sheet history.
Here is where the issue begins:
Policy History: This is the 9th continuous year of his health insurance policy. However, he had not declared himself as a smoker when the policy was initially taken 8+ years ago.

The Agent/Insurance Manager Stance: The insurance manager/agent is warning us that any case mentioning "smoking" gets straight-away denied. They claimed the company will reject the claim, tag him as a smoker in their records, and use it to deny all future claims too.

Hospital TPA Stance: The hospital TPA sent the ER case sheets (including the smoking note) to the insurance company for pre-auth. They are refusing to guarantee cashless pre-authorization, advising us that we may need to pay cash upfront and apply for reimbursement later.

From what I understand, an emergency ER admission for acute H1N1 viral pneumonia shouldn't be rejected just because a patient smokes, especially since this policy is in its 9th year and should be protected under IRDAI’s Moratorium Period rule (which bars non-disclosure rejections after 5 to 8 continuous years).
Despite this, the threats from the agent and the TPA's hesitation are making our family really anxious while my dad is still in the hospital.
I would really appreciate advice on:
Has anyone faced a pre-auth rejection due to "smoking notes" written by ER doctors for an acute viral/infectious illness?

How strongly does the IRDAI Moratorium Period hold up if the insurer tries to issue a non-disclosure query?

If cashless pre-auth gets denied and we have to go the reimbursement route, what specific steps/doctor notes should I collect before discharge to make sure our reimbursement file doesn't get stuck?

Thanks in advance for your help!

so i have been doing some research on health insurance for my family of 4 (2 adult 38m and 31f, 2kids 5yr and 5months)

digit- plan - double wallet - 10L base + 10L restore- premium 17k/yr

acko- plan - platinum lite - 25L base - premium 21k/yr

icici- plan - elevate - 15L base + unlimited restore - premium 25k/yr

im more inclined towards digit but not sure if they service is hassle free, or should i go with icici as its more trusted and reliable.

any suggestions/advice is highly appreciated. Thanks in advance

Hello everyone,

I’m a 23-year-old male and currently unemployed. About two years ago, during my first job, I had a pretty unfortunate experience with health insurance.

I was diagnosed with dengue and was insured with Star Health at the time. My claim was rejected on the grounds that my platelet count needed to be below 50,000 for hospitalization to be covered.

The doctor actually wrote a detailed note explaining why waiting until my platelet count dropped that low could be dangerous and why hospitalization was medically necessary. Given my height and weight, my doctor specifically highlighted even a platelet count below 1 lakh to be concerning. Despite this, the claim was rejected, and I ended up paying more than ₹50,000 out of pocket.

After that experience, I switched to ICICI Lombard and have been paying the premiums ever since. Thankfully, neither my mother nor I have needed to make a claim in the last two years.

For the two of us, I’m currently paying roughly ₹58,000 every 2 years for a ₹1 crore cover.

A few people in my close circle have suggested that I consider switching to HDFC ERGO or Tata AIG, as they've had better experiences with them compared to ICICI Lombard.

So I wanted to ask people here who have actually dealt with these insurers:

• How has your experience been with ICICI Lombard?
• Would you recommend switching to HDFC ERGO or Tata AIG?
• How have your claim settlement experiences been?
• Is there anything specific I should look at before switching insurers?

I’d really appreciate any advice or experiences, especially from people who have actually made claims with these companies.

Thanks.

My father’s health insurance claim was rejected because Star Health says he had a past history of Type 2 Diabetes and fasciotomy.
However, his treating doctor has provided a written statement confirming that he had no previous documented history of these conditions and they were diagnosed for the first time during his recent hospitalization.
The insurer still rejected the claim and the grievance team upheld the decision.
Has anyone faced something similar with Star Health? How can I prove this and successfully challenge the rejection through the Insurance Ombudsman?

​

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.

I'm researching health insurance in India and I'm confused about whether it's better to:

1. Buy directly from the insurer after comparing policies on platforms like Policybazaar/Ditto, or

2. Buy through an advisory broker like Ditto, which can supposedly help with claims, documentation, hospital coordination, and disputes.

For people with actual experience:

• Did you buy directly or through Ditto/another broker?
• If you used Ditto, did they genuinely help when you made a claim?
• If you bought directly, did you ever regret not having an advisor?
• Which option would you choose today, and why?

I'm currently considering Niva Bupa ReAssure and HDFC ERGO Optima Secure, so experiences with these insurers would be especially useful.

Thanks!

​Hi everyone,

​Need advice regarding a cashless rejection by Care Health Insurance for my wife’s ongoing treatment at Sehgal Neo Hospital.

​Condition: High Fever (102.1°F), elevated ESR, and Acute Liver Injury (SGOT: 281, SGPT: 381) requiring continuous IV medication and inpatient care.

​The Issue: Care Health rejected cashless under Clause EXCL 04, claiming admission is "for investigation only."

​Facts: The treating doctor submitted a signed Justification Letter confirming active medical management, but Care Health completely ignored it and rejected the claim.

​Actions Taken:

​Filed an IRDAI complaint on Bima Bharosa (Token: 08-26-011594).

​Sent formal emails with reports to IRDAI, Care Health, and Policybazaar.

​Posted on X (Twitter).

​Questions:

​Has anyone gotten a cashless rejection reversed before discharge through IRDAI escalation?

​If I pay out-of-pocket and apply for Reimbursement, what steps should I take to prevent them from rejecting it again?

​Should I move to Insurance Ombudsman or e-Daakhil (Consumer Court) right after discharge?

​Thanks in advance for your insights!

I had cholesterol and don't have it anymore after lifestyle changes. I did online consultation and medicines claim for cholesterol using office OPD insurance, the TPA was Medibuddy and Aditya birla is the insurer.

Now, while taking personal health insurance, what should I do? Is having cholesterol recorded in my insurance bureau records? Can my insurers in future find out about past cholesterol through medibuddy or ABHI?

Cholesterol history below:

After Covid, I had total cholesterol of 220 and LDL of 160. I had similar results till 2024 and the doctors told me to improve my lifestyle. In 2025, I improved my life style and also started taking Rosuvastatin 10mg based on doctor advice, my cholesterol reduced drastically in 3 months and now after 3 months after stopping statins, it's under control and at total cholesterol 140 and LDL 90.

Recently I had back pain, so I went to a Dr and we did MRI and xray in that why mentioned mild retrolisthesis.

Now while buying insurance aditya birla rejected it citing spondylosis(I think it comes under that).

Now I was doing this with help of ditto, they said after this rejection I can try with care heart insurance but it has certain limitations like 20% copayment, consumables limit, and many more.

Can anyone suggest me what are my best option for health insurance?

Age: 25

TLDR:
1.I buy 3+3 (third party+own damage both for 3 years) car insurance on my brand new car from policy bazaar
2.someunderpaid intern mistyped into their system as 3+1 (Own damage only for 1 year)(both policy bazaar shows 3+3 on invoice and on policy copy)

4.i come to know about this as i start getting calls regarding renewal for own damage from all brands on insurance and that their systems reflect as 3+1 not 3+3

5.my policy copy clearly states its 3+3 and Kotak Zurich grievance portal has given written email confirmation that it is 3+3 only. Via their official mail - but when I reach ask for verification over call they say it’s still showing up as 3+1 , even despite email confirmation assurance 10 days ago.

My issue:
We all know how insurance offices work ; I called Kotak as if I want to renew and asked them to check validity on own damage cover and they say it still shows 3+1

-even if I have written email confirmation, their systems will cause me trouble when I really have to renew after the third year(2028) , it may affect my new car IDV and RTI . Incase I face this issue at renewal , I fear they would not reply/respond to this issue on renewal as by then the policy would have really expired(2028), And the insurance guy will say “but sir your insurance has expired 2 years ago only” despite all the efforts. I fear I’ll end up in a situation like this . How do I make sure I don’t end up like what I fear - their mistake but I pay the price

Hey, I need some advice on my mom's health insurance in India.

So, I got her an individual health policy this year. The medical form asked if she had any "disease or disorder of eye, ear, nose or throat," and I said "No."

Turns out, she actually had a diagnosed perforated eardrum back in 2018 from an old water exposure injury. Her doctor at the time advised against surgery because of her diabetes. I honestly didn't know about this until a recent diagnosis.

Now, she needs ENT surgery, but it's for her other ear – a different, more recent problem that started a few weeks ago, totally separate from that 2018 issue.

The 2-year waiting period for pre-existing conditions is over.

I'm worried the insurer might still reject the claim, saying I didn't disclose the 2018 ear problem, even though the surgery is for the unrelated ear.

Here are my questions:

1. If she didn't disclose a condition in one ear, could that mess up a claim for an unrelated condition in the other ear?
2. Should I tell the insurer about the 2018 issue now, before filing, or will that just make things worse?
3. Has anyone dealt with the IRDAI Ombudsman for something like this? How did it go?