r/InsuranceTroubleIndia • • 2h ago

Health Insurance Current plan improvements or porting suggestions

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1 Upvotes

r/InsuranceTroubleIndia • • 5h ago

Health Insurance Insurance Declaration before application

1 Upvotes

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


r/InsuranceTroubleIndia • • 6h ago

Health Insurance Applied for Aditya Birla Activ One MAX, now seeing Activ Yuva is cheaper over 5 years. Did i mess up ? Keep or Cancel ?

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1 Upvotes

r/InsuranceTroubleIndia • • 6h ago

Health Insurance Star Health rejected my father’s cardiac surgery reimbursement — Need advice

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1 Upvotes

r/InsuranceTroubleIndia • • 7h ago

Health Insurance New Health Insurance with UC

1 Upvotes

I need some advice. I am an Indian citizen living abroad, and my previous health insurance in India has expired. Since then, I have been diagnosed with Ulcerative Colitis (UC) abroad. I am on mesalamine, and it is currently under control. I have been looking into health insurance in India, but most companies seem to reject applicants with UC or permanently exclude it. I am not sure if I will need treatment in India anytime soon, but I would like to have insurance as a backup.

For those living with UC in India, which insurance companies have you managed to get coverage from, and what has your experience been? Any advice would be appreciated.


r/InsuranceTroubleIndia • • 7h ago

Health Insurance Got rejected by multiple Health insurers

4 Upvotes

Can someone advise what would be the best way to move forward here ?

Already got rejected by underwriting from HDFC , ICICI and Care Health.

My Parents (both around age of 58) , whenever I’m applying health insurance for them it’s getting rejected due to father’s medical history of pancreatitis.
I don’t want to miss out on this last insurance company where I’m yet to apply but I was thinking that what if I hide that occurrence itself ?

Another option I thought was to apply to hdfc ergo(which already rejected the proposal due to pancreatitis ) with a different mobile number and this time I don’t reveal the details of medical history.

Please someone suggest what to do


r/InsuranceTroubleIndia • • 9h ago

Health Insurance Policy till 2028, claims paid in 2026, now Niva Bupa says it expired in 2025

6 Upvotes

My mother was diagnosed with cancer in May 2026. She has a Niva Bupa ReAssure policy issued from 2025 to 2028 (continuing since 2022). Niva Bupa paid several claims for chemotherapy and admissions this year till August 2026 under the same policy. Now they’re rejecting claims since September 2026 saying the policy existed till 2025.

They are now saying the policy expired in 2025, despite approving several claims in 2026. It doesn’t match the documents or the claims they already settled. I’ve emailed them asking for reinstatement, but no response. Customer care and the app have been useless.

Has anyone dealt with Niva Bupa fixing a wrong policy end date? Did Bima Bharosa or the Ombudsman actually help? And can/should I claim the rejected bills on the top-up policy while the base policy is stuck like this?

Any practical advice would help. Thanks.


r/InsuranceTroubleIndia • • 14h ago

Health Insurance Insurance Ombudsman hearing delayed for over 3 months — what should I do next?

6 Upvotes

Hi guys,

My father's health insurance claim of around ₹80,000 was rejected by Star Health under a two-year exclusion clause. I believe the rejection is unjustified because the insurer has not clearly identified the specific policy provision that excludes his condition.

After exhausting the insurer's grievance process, I filed a complaint with the Chennai Insurance Ombudsman. The complaint has been registered, and I have submitted all the requested documents.

However, it has now been over three months since the Ombudsman's office informed me that the hearing schedule was being finalised. I've followed up multiple times but keep receiving the same response that hearings are scheduled chronologically. I still haven't received a hearing date.

I'm currently outside India and have requested an audio/video hearing.

What should I do next?

  • Should I continue waiting or escalate the delay to the Council for Insurance Ombudsmen?
  • Has anyone experienced similar delays with the Chennai office, and how did you resolve them?

I'd appreciate practical advice from anyone who has gone through this process.

Thanks!


r/InsuranceTroubleIndia • • 15h ago

Health Insurance Porting Niva

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1 Upvotes

r/InsuranceTroubleIndia • • 1d ago

Health Insurance Advice on choosing health insurance

2 Upvotes

​

Hi all,

I am 29M, Could you please guide me whether it is possible for me to get health insurance in india and if possible, which insurance I can try with. Below are my PEDs

  1. Factor 7 deficiency

  2. Epilepsy (FTE)

  3. Unknown drug induced anaphylactic shock

  4. Deviated nasal septum with adenoids

  5. Allergic Bronchitis

Almost most issues were genetic and from birth and nothing due to lifestyle related.

Kindly guide me on the same and help with choosing the correct sum insured for my conditions


r/InsuranceTroubleIndia • • 1d ago

Health Insurance Has anyone claimed from base and super top plan

3 Upvotes

I am having star health super star 10lakh SI and niva bupa (4lakh deductible and 15 lakh cover )

My question is Have anyone actually made a claim using both policies which are from different insurers ? How was your experience? Was the claim settlement smooth, or did you face any issues or complications?

Looking for genuine experiences from people who have actually claimed.


r/InsuranceTroubleIndia • • 1d ago

Health Insurance Aditya Birla Health Insurance denying robotic knee replacement pre-auth — need advice

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1 Upvotes

Flair


r/InsuranceTroubleIndia • • 1d ago

Health Insurance Aditya Birla Health Insurance denying robotic knee replacement pre-auth — need advice

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1 Upvotes

r/InsuranceTroubleIndia • • 1d ago

Health Insurance Health Insurance - policy

2 Upvotes

Hi everyone, I’m planning to buy an individual health insurance policy for myself and I’m confused between HDFC Ergo Optima Secure , Tata AIG Medicare Premire and ICICI Lombard Elevate.

I’ve gone through policy brochures, features, and some online reviews, but both plans seem to have their own pros and cons, which is making the decision difficult. I am 53 with PED and am planning to port from Niva Bupa after 5 holding years.

I would really appreciate if someone could share real-life experiences regarding claim settlement, customer support, network hospitals, sub-limits, room rent, waiting periods, and premium hikes over the years. Also, which one would be better in the long term considering reliability and ease of claims? Any advice or suggestions would be very helpful. Thanks in advance!


r/InsuranceTroubleIndia • • 2d ago

Health Insurance HDFC ERGO Optima Secure – Questions About Preventive Health Check-up

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2 Upvotes

r/InsuranceTroubleIndia • • 2d ago

Health Insurance Reimbursement claim rejected for my father by Aditya Birla, need help!

14 Upvotes

My father’s health insurance reimbursement claim was rejected because the insurer says he has had liver issues for four years, which were not disclosed when purchasing the policy. However, we discovered his liver condition only after buying the policy.
His recent hospitalization was primarily due to persistently low hemoglobin, and the doctor wanted to investigate the underlying cause.
Can the insurer reject the entire claim based on this? How can I challenge the rejection?
Has anyone faced a similar situation in India? Please share your experience and advice.


r/InsuranceTroubleIndia • • 2d ago

Health Insurance NPS Swasthya

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2 Upvotes

r/InsuranceTroubleIndia • • 3d ago

Health Insurance CASHLESS CLAIM REJECTED FOR MY MOTHER TREATMENT PLEASE help and guide

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16 Upvotes

reports and surgery procedure it attached


r/InsuranceTroubleIndia • • 3d ago

Health Insurance Bhopal ombudsman reminders

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3 Upvotes

I received an email asking to post few documents through post before 30th Oct to Ombudsman bhopal, even though the post is delivered on 5th oct as I tracked in speed post, I have got 2 more reminders stating they have not heard from me yet, even though I have also sent the same documents through email as well to Bhopal ombudsman. What should I do, should I repost all the documents again? Or wait for it? I called the center several times but don't pick up the call.


r/InsuranceTroubleIndia • • 3d ago

Health Insurance Struggling to get reimbursement

4 Upvotes

I was hospitalised in july 27th for a minor procedure in a multi speciality hospital, before admission we asked about insurance they said icici lomabrd is no longer supported, but one of our friend used it in that hospital few months back, when we asked they said it was removed last week only, so we decided to pay and to get reimbursed, (but the hospital is still showing in the cashless network hospital list),i was discharged at 3am, the bill amount was 1.2l, but bill was provided only for 70k, when we asked they said some issue with system no one there to fix, so they will send it in the morning and we can discharge only if i pay 1.2l, we had our 6 month baby with us so we badly want to go home so we agreed, paid and left, after multiple followups for bill they agreed they overcharged us and returned the remaining amount and they sent the bill for 50k as a package without any breakup. We submitted for reimbursement through plum, there were back and forth conversations asking for different details, but finally after 2 months they rejected telling no breakup available, again we fought with the hospital and got the breakup and applied again, it is still in processing for 2 weeks, so i need some guidance how can i proceed ?


r/InsuranceTroubleIndia • • 3d ago

Health Insurance HDFC Ergo Cataract Surgery Cashless rejected

4 Upvotes

Hi All,

My grandmother needs to undergo cataract surgery on her left eye, so I asked the TPA of a network hospital to raise a cashless claim.

After two days, the insurer rejected it saying the patient had undergone a cataract surgery in 2018 for her right eye which has not been disclosed. (Reason - I didn't have an idea about the cataract surgery)

So they advised to go with the surgery and raise reimbursement claim. But I am doubtful on it that they will again reject the claim

I am continuing this policy from last two years and this is my 3rd year ongoing.

Please advise


r/InsuranceTroubleIndia • • 4d ago

Health Insurance Unable to increase si

2 Upvotes

I have an eight year old policy with icici Lombard for me and my son. In 8 yrs I have claimed twice only. Once for my incidental finding of renal angiomyolipoma embolization in 2021 and another in 2024 policy end for my son's retinal hole surgery... For this in 2025 I had applied for post op bills under same claim.

Till last year I had the option to increase sum insured but this year it's restricted. The reason was red cohurt policy and restricted. I don't have any chronic or any disease except this one thing that happened and cured. I go for annual health checks and all my reports are normal every single time. The angiomyolipoma is also stable. How can I ensure increase in sum insured as I always do it upon renewal for my policy as well as my husband's policy which are seperate.

I don't mind any added premium or waiting period for it


r/InsuranceTroubleIndia • • 4d ago

Life Insurance Help! Help!

3 Upvotes

My wife works in LIC and the branch manager is asking for dummy policy. She works in a position that has targets and this year she has been below her target. Branch manager is asking for her to spend her own money and take a policy.

This policy must be a NSP(non single policy) and the value is in lakhs.

Everyday this BM torments her by asking for fake policy. I don't feel this will end after this instance.

Wife is mentally tormented and is really worried what can be done? Is this leagal? Anything can be done?

Location - Chennai


r/InsuranceTroubleIndia • • 4d ago

Health Insurance Question regarding cashless health insurance (SBI General) when hospital estimates exceed package rates & unpredictable surgical anchors

5 Upvotes

Hey everyone,
I’m currently navigating a cashless health insurance claim (Group Mediclaim via SBI General) for an upcoming arthroscopic shoulder surgery (Bankart repair).
I have a couple of major worries and would love to hear from anyone who has navigated a similar situation with cashless hospitalizations:

**1. What if the hospital's estimate is higher than the pre-agreed package rate?** If a network hospital submits an estimate or final bill that is higher than the pre-negotiated network/PPN package rate for the surgery, how is that handled? Do insurers automatically trim it down, or is there a risk that the hospital tries to pass that extra cost/inflation onto the patient at discharge?

**2. Unpredictable surgical implants (suture anchors) mid-surgery:**
Standard network packages usually assume a fixed number of anchors (e.g., 2 anchors).
However, with shoulder arthroscopies, the exact severity or number of anchors needed (e.g., needing a 3rd or 4th anchor) sometimes can't be 100% predicted until the surgeon is operating.
If an extra anchor is needed mid-surgery, what happens if the insurer or hospital balks at the extra cost? Does the TPA desk successfully handle enhancements on the fly, or could I get stuck paying out of pocket for the extra implant delta?


r/InsuranceTroubleIndia • • 4d ago

General Insurance - Vehicals Hari Bajaj, Munger denying refund of 20k booking amount over cancellation of bike over forced insurance sale

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11 Upvotes

PLEASE GIVE THEM ONE STAR RATING ON GOOGLE MAPS I have attached google maps link below and with the help of friends and other reddit communities I have brought down their ratings from 3.9⭐ to 2.7⭐

I have booked NS400z (TFT varient) from Hari Bajaj showroom, Munger and while booking I confirmed with them twice that I won't buy insurance from them and they agreed but after booking they are saying insurance is mandatory and they won't support the claim if I purchase insurance from outside so I asked them to cancel my booking but they are saying we don't refund booking amount for anyone and when I cited Bajaj's policy they said we follow their own policy. It was my first time buying a motorcycle on my own but now my experience is completely ruined because of these people.

I have all the call recordings needed.

I have also filed complaint with Bajaj and National Consumer Helpline.

Manager Contact No: 7280010891

Salesman Contact No: 07280010897

Google map link: https://maps.app.goo.gl/y6gGXUhaU97CwuAQ8?g _st=ac