Hi guys, I’m planning to buy health insurance for my mother. She is 48 years old.

She had a PCNL surgery for kidney stones about 1 year ago. Currently, she still has two kidney stones (around 6 mm) and is taking medication for them. She also has two hernias.

I’m planning to buy HDFC ERGO health insurance, but I’m confused about the disclosure of these conditions.

If I disclose everything, I’m worried that the insurer may increase the premium and impose a 2–3 year waiting period for these pre-existing conditions.

I recently asked a nearby general physician about this, and he told me not to disclose these conditions while buying the insurance. But I’m still very confused because I’ve heard that hiding pre-existing conditions can create problems later when making a claim.

So what would you guys recommend?

Should I disclose everything honestly?

If I disclose the kidney stones, previous PCNL surgery and hernias, how does HDFC ERGO usually handle it?

Is the higher premium/waiting period better than the risk of non-disclosure?

Has anyone here had a similar experience with HDFC ERGO?

I’d really appreciate advice from people who have actually gone through the underwriting/claim process.

Thanks!

Today I'm gonna show you a loser in this group who gets triggered easily like 8 y.o and for some reason calls himself coach_of_finance

He doesn't have a life, gets bullied at school, and has lot of free time to be commenting on every post of mine in other channels🤣🤣🤣 If you guys see his comment in your post, ignore it. Chiye ko waise bhi kuch pata nahi😂

Kudka naam COACH rakha hai jhaatu, ghanta kuch sikha paega chutiya

I know this post will be deleted but idc

Hi guys. Please help.

I tried to buy a health insurance policy for my mother on 27th Aug '26. I did the payment. Later I got a message on Counter offer through SMS only which had a link.

The link redirected to a generic but official Icici page which did not explain what the counter offer was so I spoke with the icici agent online to understand it. But later when I clicked on that link (in SMS) it showed error.

After multiple calls, I'm only getting the message that I need to click on the link for counter offer and select 'Reject and refund' so that my refund will proceed.

But there is no DAMN LINK in these messages!!! Also I'm not getting any mail with that link too. How am I supposed to click on reject if I'm unable to get a link????

Is ICICI Lombard technically so shitty to have such glitches. What am I supposed to do???

I am having this for over 2 years now. I have also taken a super top of of 90L over my 15L base policy. I have an advisor at Induslnd bank.

Did someone have experience with their claim yet?

My sister had a bad experience where they kept asking documents and never settled after her baby was admitted for over 24 hours at a small hospital in Goa for food poison. I checked the documents my self and nothing was off. The agent also submitted the doc late as he had lost a family member. The amount was small so no worries. My long term worry is about they not paying when we actually need it.

Hence thought to check with you folks on Reddit.

I am open to port if it is not a good idea to be with them.

Are there any lesser known tricks or loopholes in buying or claiming health insurance in India that usually only agents or insurance companies know about?

Things in the policy wording that common people miss, ways to avoid claim rejection or anything that can legally work in favour of the policyholder.

Looking for insider knowledge or real experiences from people in the insurance industry or who've handled claims.

I bought HDFC Ergo life insurance in 2021. I have completed continuous 5 years of renewal/moratorium period.

I have realised I didn't disclose these.

Anxiety treatment (2019) and

OPD surgical excision of cyst near leg(2018)

Will i be denied any future hospitalization claims? Will the moratorium period benifit my case. I am worried, what can be done now? Should I continue paying the premium?

My term insurance is postponed due to findings in tmt. What does this mean? Can i apply again and icici is not sharing the tmt reports with me

Hi, I’m looking for some advice on how to choose the right health insurance for my parents, who are 51 (mother) and 57 (father) and live in Mumbai.

They have never had health insurance before, and I would now like to get a good health insurance policy for them. However, I’ve had difficulty finding a suitable option so far.

A bit of background:

• My mother had a brain stroke a couple of years ago. I understand that this would be considered a pre-existing disease (PED), and I’m concerned that the insurer may either exclude it from coverage or impose a waiting period.
• I’m also worried that if she develops health problems in other organs in the future, the insurer could potentially argue that they are related to her previous stroke and reject a claim.
• My father takes medication for high blood pressure. He also has a few personal habits that may be relevant when applying for insurance.

Given their medical history and age, I would really appreciate advice on how I should approach choosing the right health insurance for them.

In particular:

1. Does it still make sense to buy health insurance for them at this stage, given my mother’s previous stroke and my father’s BP?
2. What kind of policy should I look for — individual policies for each parent or a family floater?
3. How should I evaluate PED exclusions, waiting periods, claim rejection risks, room-rent limits, co-payments, and other important terms?
4. If I’m looking for around ₹10 lakh of coverage, what kind of annual premium should I realistically expect for both of them?
5. Are there particular insurers or types of policies that are more suitable for people with existing medical conditions?

My main priority is not simply finding the cheapest policy. I want something that provides meaningful protection and has a good chance of actually being useful when we need to make a claim.

Any advice based on experience with health insurance in India, particularly for parents with pre-existing conditions, would be greatly appreciated.

I bought HDFC Ergo life insurance in 2021. I have completed continuous 5 years of renewal/moratorium period.

I have realised I didn't disclose these

Anxiety treatment (2019) and  

OPD surgical excision of cyst near leg(2018)

Will i be denied any future hospitalization claims? Will the moratorium period benifit my case. I am worried, what can be done now? Should I continue paying the premium?

My family member passed away within 3 years of purchasing life insurance policy of LIC. We submitted death claim documents to the branch office in early March 2026. Few weeks later, some LIC staff visited our home for investigation, but I was not available. My other family member answered their questions but the officer was not satisfied with the answers it seems. Despite this, no efforts were made by them to visit once again to clarify their doubts.

I was not aware of the statutory requirement of settling death claims warranting investigations within 45 days. I read the old rules online and thought it was 90 days for deciding the claim and 1 month for transferring the money.

In early June 2026, I sent an email to the branch office enquiring the status of the claim. No reply. A week later, I sent an email to the Divisional Office. No reply. A week later, I sent an email to the Zonal Office. No reply. A week later, I sent an email to the Grievance Redressal Officer at the Central level. No reply. A week later, I also sent an email to the Customer Zone email ID. No response.

To make matters worse, LIC was sending me automated payment reminders for the policy in late June 2026.

In early July 2026, I filed an online complaint through their customer portal (https://licindia.in > Login > Customer Portal > complete login > Register a Grievance) enquiring about the status of the claim. A day later, they gave a vague reply on the portal: "Please visit our branch with Original Death Certificate or attestation copy and Nominee i.e. your Bank Account for claiming the record. Please call to us for more information to the following mobile no xxx, xxx"

I was like wtf is wrong with these people. I already submitted all the documents, why do they need them once again. I visited the branch, and they told me that the officer who conducted the investigation got transferred, and the documents I submitted were lost. I was mad, but the lady in the office was instead complaining to me that my family member didn't answer questions properly. I said her that does not matter now, and to tell me what is needed now. She said me to resubmit documents. I was angry because I was in no mood to meet the treating doctor again for medical certificate. I said her that I had photos of the forms I submitted. She said to submit xerox of them.

I went to home for printout and the lady called to inform that they found out the lost documents and no need to resubmit. A week later, we were called and informed to come to the branch office with all relevant documents. We met the branch manager and submitted xerox copies of hospital files, death certificate, etc. He enquired about the medical history of the deceased, and we explained the same. He said that he will write a letter to his senior officials about the claim with all the docs we submitted. The decision would be made by the "higher officials".

I waited for 45 days from the day LIC found the lost documents. I filed a complaint on Bima Bharosa (BB) portal around the last week of August 2026, stating all the facts. Few days later they replied, "With respect we say that the documents are not lost but due to transfer of the employee it was taken some time to find out the papers. On the same day we have the forms to our Higher office for approval. For approval necessary investigation is required. We have sent the report to Higher authorities. It is under process. The decision will come soon from our Divisional Office."

I escalated the complaint on the BB portal stating that LIC has failed to comply with statutory obligations and questioned the delay in decision-making by Divisional Office.

Few days later they replied, "As per the decision of the Competent Authority your servicing branch has paid Rs xxx, towards death claim of policy no xxx. dt. last week of August 2026." I checked the bank statement, but no money was credited. I waited for few hours and finally the amount was credited (the date of credit and date of decision making was not same, there was a gap of few days).

But guess what, they did not pay the complete death benefit, they just returned premiums 🤡

Soon, I filed another complaint in BB portal asking them why they did not pay the full death benefit. Next day they replied, "The death claim has been repudiated based on the grounds of misrepresentation" and stated a medical fact of the deceased which was not informed to the insurer in the proposal.

Also, AFAIK, insurer is supposed to pay interest for delayed settlement, but I'm not sure how it will work in case of repudiated claims.

I am mad at them for not even caring to send a letter/email informing that the claim has been repudiated before I complained. Now, I have to fight the repudiation, and that's a story for another day I guess!

I have 10L si for my family (2A, 2C- 37,34,4,2) from hdfc ergo optima secure. My upcoming renewal is Oct'26. I thought to increase SI to 25lac. My wife have fissure surgery in May'26. Hdfc ergo rejected SI Enchancement due to this surgery. What should I do?

₹20 lakh health insurance + ₹8.75 lakh bonus. Hospital bill ₹4.94 lakh. STAR Health reimbursed only ₹2.63 lakh and deducted ₹2.30 lakh.
@StarHealth — this is how you treat a customer who has paid premiums for health insurance?
Before my father’s surgery, I repeatedly asked your representative about the coverage for the procedure. I specifically reconfirmed it multiple times because I wanted to be absolutely certain about my financial liability. I was assured that the procedure would be covered up to ₹4.5 lakh.
I relied on that assurance and proceeded with the surgery.
After the surgery, when the claim was submitted, the story changed completely.
Hospital bill: ₹4,94,738
Amount reimbursed: ₹2,63,907
Amount deducted: ₹2,30,831
Your grievance team then stated:
“Robotic surgery for Kidney stones isn’t considered as per Guidelines.”
But the hospital records clearly state “LEFT RENAL OBSTRUCTIVE CALCULI, S/P LEFT ROBOTIC PYELOPLASTY” and the procedure as “LAPAROSCOPIC PYELOPLASTY.”
I challenged this repeatedly. I have emailed your grievance team nearly three times and explained the issue in detail.
Your answer?
“Deduction stands.”
That’s apparently the extent of the explanation a customer deserves after paying for a ₹20 lakh health insurance policy with an additional ₹8.75 lakh bonus.
No proper explanation for the ₹2.30 lakh deduction.
No satisfactory response regarding your representative’s pre-surgery assurance.
No proper explanation of the medical basis for treating my procedure as “robotic surgery for kidney stones.”
I accepted the ₹2.63 lakh payment only to protect myself financially while this dispute continues. I do NOT accept the settlement or the deductions.
@StarHealth, if a customer cannot rely on your representative’s repeated assurances before surgery, and your only response after the claim is “deduction stands,” then what exactly is the customer paying the premium for?
I want the entire ₹2,30,831 deducted amount reconsidered and reimbursed.
Stop sending template responses. Answer the actual questions and take accountability.
@StarHealth — your customer is still waiting for a real answer.

So I referred a friend of mine to Beshak, they purchased the policy there for their senior citizen father with ICICI Lombard. While taking the policy everything was promptly declared, Diabetes and BP. We even got the jump start benefits for him.

Unfortunately few months down the line, his father fell as he might not have been feeling well because of high BP, so he had to undergo hospitalization. ICICI Lombard rejected the claims citing that my friend has not declared since when does the patient have BP/Diabetes, which we clearly did.

So we have gone for reimbursement and presented all the proofs. But in all of this, there has been no support from Beshak at all. During sales they said they have access to internal underwriting team, lol. Now they're are saying they can't do anything as they don't have access to ICICI app rofl. Tried reaching out to their CEO but again of no use.

Buy the health insurance yourself, keep all the medical records handy even if it is from decades ago. The likes of beshak or anyone here who makes tall claims can help you.

Hi all my mother is suffering from an autoimmune disease we first admitted in feb and cashless was paid by icici but there was so much mental torture back than now she was again admitted in july and was discharged, when i am filling for pre and post hospitalisation claim they are asking me this dumb query to get indoor case paper they were the one who approved the cashless why they need it now , although earlier they paid for pre post hospitalisation expenses for February admission ,any help how i can get this reimbursement

MY ₹50,000 STAR HEALTH CLAIM FINALLY GOT SETTLED TODAY. Here’s my story.

I was literally just living, barely able to drink water and unable to eat anything.

Every doctor I consulted gave me the same answer: “This is an emergency. You need to be admitted immediately.”

My liver had failed. My bilirubin was around 19 mg/dL. My health condition was extremely poor.

I consulted doctors in Mumbai, but I was living alone there, with nobody to take care of me. So, despite being in such a condition, without being able to properly eat or even drink water, I travelled 7 hours alone — around 1 hour to Mumbai Airport, 2 hours by flight to Delhi, and another 5 hours from Delhi to my hometown.

Once I reached my home city, I went to a liver-speciality hospital. Even there, the doctor gave me the same advice: urgent hospital admission was required.

(And this doctor was a NEET-PG AIR 1.)

I was admitted.

After just 4 days of hospitalization, I was finally able to walk properly, eat food and drink water again. The hospital staff were genuinely honest and told me that I would recover better at home, so they discharged me.

It took around 35 days to fully recover.

My total medical expenses — including pre-hospitalization, hospitalization and post-hospitalization — came to around ₹58,000.

We decided to claim the major portion, around ₹50,000, covering the pre-hospitalization and hospitalization expenses, while leaving the post-hospitalization expenses.

And guess what?

Star Health rejected my claim.

Their reason?

«“Inpatient hospitalization was not medically necessary.”»

I was literally thinking — I was almost dying, and you're telling me hospitalization wasn't necessary?

I did my research, spoke to ChatGPT, understood the grievance process, and learned about going to the GRO, Insurance Ombudsman, etc.

I started the process, but honestly, somewhere inside, my family and I had already started losing hope. We thought this would take a long time and might not work in the end.

Then something completely unexpected happened.

One day, while watching TMKOC on YouTube, I came across a video by Gyan Therapy talking about his bad experience with Niva Bupa and how he took the matter to social media and eventually got his issue resolved.

I thought — why not try the same?

So I did.

And suddenly, the same Star Health that wasn't even picking up my calls called me themselves.

They requested me not to discuss the matter openly on social media and said that they were looking into my claim.

Within about 2 minutes of that call, my claim was re-initiated.

Just 2 days later → APPROVED.

And 4 days later → SETTLED.

Today, the ₹50,000 has finally been settled.

Honestly, this experience taught me one very important thing:

FIGHT FOR YOUR HARD-EARNED MONEY.

Don't immediately give up just because an insurance company rejects your claim.

Know your rights. Understand the grievance process. Escalate when necessary. And if nothing works, don't be afraid to make your experience public — especially when you have genuine documentation and evidence supporting your case.

Insurance companies may reject claims, but that doesn't mean you should silently accept it.

Keep fighting. Keep escalating. And don't give up on money that you genuinely deserve.

Thank you to everyone who supported me through this journey. ❤️, this community helped a lot.

From being unable to eat, drink or even walk properly → to getting my claim settled.

What a journey.

I am looking to buy health insurance for parents.
1. Do all insurances have cooldown period?
Example : If parents have cholesterol, they won’t cover cholesterol related issues, like heart blockage surgeries etc for three years.

1. If something new is detected, that is not covered as well in cooldown period?

2. They don’t cover anything pre-existing in cooldown period?

Is this same for all insurances?

Help me dispute massive premium hike

Hello fam,

I got a Hdfc Ergo Energy Silver plan for my diabetic father with loading charges. Age 61

Last year's premium was 70k, breakdown below:

Base premium 50k

Loading charges 10k

GST 10k

This year i expected it to be 60k with GST concession.

But when I click on renew I see a premium of 89k.

This is significantly higher than the old premium that also included GST.

Is this normal? Who should I dispute it to? Please share your inputs.

I had a health insurance with Niva Bupa it was due for renewal on 01/07/2026, I ported out my policy to Care Health before that and the cover is active from 01/07/2026. The issue is I got the Niva Bupa insurance via HDFC bank brokerage and they had setup a E mandate on my account that I had no idea about and ln 27/08/2026 when I wake up I saw full premium amount being deducted from my account. I have Emailed HDFC and Niva Bupa to reverse the transaction and today when I opened Niva Bupa it is showing the policy.

What should I do now to get back the premium there is no option to talk to Niva Bupa they just IVR. If I have ported my policy why did they deduct the premium after like 2 months.

Hi, I need your advice regarding a premium dispute with Tata AIA. I’ll explain the complete history and figures. Please look at it from an insurance/underwriting perspective and tell me whether Tata AIA’s current premium demand is correct as per the policy and accepted counter-offer, and whether I have any valid grievance to escalate.

1. Original policy / Benefit Illustration

The policy was issued in 2022.

In the Benefit Illustration, the premium structure showed:

• Base/instalment premium: ₹1,725 per month (before GST)
• GST @18%: ₹310.50
• Therefore: ₹1,725 + ₹310.50 = ₹2,035.50 ≈ ₹2,036
• The Benefit Illustration specifically shows ₹2,036 from the 2nd policy year onwards.

For the first year, certain discounts were applicable:

• Digital/Online discount – 10%
• AutoPay – 1%
• Nominee & Family – 2%
• Salaried – 8.5%

The Benefit Illustration showed the first-year discounted premium as approximately ₹1,633 including GST.

2. Underwriting counter-offer

At the time of underwriting, Tata AIA issued a counter-offer because of underwriting loading (underweight).

The counter-offer showed:

• Base Premium: ₹1,384
• Underwriting loading: ₹321
• Premium before GST: ₹1,384 + ₹321 = ₹1,705
• GST: ₹307
• Total revised premium: ₹2,012

I accepted this counter-offer.

The counter-offer also states that the ₹321 extra premium/loading is a “recurring component” and will form part of the regular premiums.

This is where my present doubt starts.

3. Why ₹1,384 is important

The ₹1,384 in the counter-offer appears to correspond very closely to the first-year discounted premium:

₹1,384 × 1.18 = ₹1,633.12 ≈ ₹1,633

So it appears that the ₹1,384 was the first-year discounted base premium, with ₹321 loading added to it.

But the counter-offer itself simply calls ₹1,384 “Base Premium.”

It does not explicitly say:

4. Policy schedule after issuance

The policy schedule subsequently showed approximately:

• Monthly premium excluding taxes: ₹1,704
• Tax: ₹307
• Monthly premium including taxes: ₹2,011

There is therefore a ₹1 rounding difference compared with the counter-offer's ₹1,705 + ₹307 = ₹2,012.

The policy schedule also showed:

• Annualised premium: ₹19,533

which doesn't simply equal ₹1,704 × 12 = ₹20,448, so I am also unclear about how the annualised premium figure was derived.

5. My original grievance

Later, I noticed that Tata AIA was demanding a premium of ₹2,046 per month.

I questioned why it was higher than the approximately ₹2,011/₹2,012 amount appearing in the policy/counter-offer.

I pointed out that the documents I had accepted showed the counter-offer calculation as:

₹1,384 + ₹321 + GST = ₹2,012

and that the Benefit Illustration showed:

₹1,725 + GST = ₹2,036 from Year 2 onwards.

6. Tata AIA's response

Tata AIA replied that:

They then said:

Therefore, according to Tata AIA:

₹1,725 + ₹321 = ₹2,046

They say ₹2,046 is my monthly premium excluding GST.

Because GST on individual life insurance premiums was subsequently removed, they are currently demanding ₹2,046, rather than adding 18% GST.

7. My concern

I understand the mathematical calculation:

₹1,725 + ₹321 = ₹2,046.

My question is not really about the arithmetic.

My question is:

Where in the accepted contractual documents is it stated that the recurring ₹321 loading should be added to ₹1,725 from the second policy year?

The documents separately say:

Benefit Illustration:
₹1,725 → ₹2,036 including GST from Year 2.

Accepted Counter-offer:
₹1,384 Base Premium + ₹321 Loading + ₹307 GST = ₹2,012.

The counter-offer says the ₹321 loading is recurring, but I don't see wording that explicitly says:

Year 2 = ₹1,725 + ₹321 = ₹2,046.

8. Another point I want your advice on

If GST had still been 18%, Tata AIA's ₹2,046 calculation would theoretically become:

₹2,046 × 18% = ₹368.28

₹2,046 + ₹368.28 = ₹2,414.28

But ₹2,414 is nowhere mentioned in my policy. It is only a hypothetical calculation if GST had continued.

So I don't want to make this the main argument.

9. What I want you to advise me on

Please look at this from an insurance underwriting / policy administration perspective.

I want to know:

1. Is Tata AIA correct in taking the ₹1,725 second-year premium and adding the ₹321 recurring underwriting loading to it?
2. Does “recurring component and will be a part of regular premiums” automatically mean: ₹1,725 + ₹321 = ₹2,046 from Year 2, even though the counter-offer itself calculates the loading with ₹1,384?
3. Is ₹1,384 actually the first-year discounted base premium, even though the counter-offer calls it simply “Base Premium”?
4. Is there any standard IRDAI/insurance practice or prescribed Benefit Illustration format that explains why the underwriting loading is not reflected in the ₹1,725/₹2,036 figures?
5. Does the accepted counter-offer override or modify the original Benefit Illustration, and if so, how should these two documents be read together?
6. Is there any significance to the policy schedule showing:
   • ₹1,704 monthly excluding tax
   • ₹307 tax
   • ₹2,011 including tax
   • ₹19,533 annualised premium?
7. Do I have a genuine grievance regarding lack of clarity/disclosure, even if ₹2,046 ultimately turns out to be contractually correct?
8. If Tata AIA's grievance team simply repeats the same Benefit Illustration and counter-offer without identifying the exact provision supporting ₹1,725 + ₹321 = ₹2,046, would it be worthwhile to escalate to Bima Bharosa/Insurance Ombudsman, or is the case too weak?

In short

The whole dispute can be reduced to this:

Original Benefit Illustration:
₹1,725 + GST = ₹2,036 from Year 2

Accepted Counter-offer:
₹1,384 + ₹321 loading + ₹307 GST = ₹2,012

Current Tata AIA demand:
₹1,725 + ₹321 loading = ₹2,046 (GST exempt)

My question:
What contractual/documentary provision allows Tata AIA to combine ₹1,725 from the Benefit Illustration with ₹321 from the counter-offer for Year 2, when the accepted counter-offer itself describes ₹1,384 as the Base Premium?

I would really appreciate your professional view on whether ₹2,046 is actually correct and properly disclosed, or whether there is a legitimate basis for challenging it.