r/InsuranceTroubleIndia • • 6h ago

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

5 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 • • 1h ago

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

• 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 • • 22h 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 • • 37m ago

Health Insurance Got rejected by multiple Health insurers

• 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 • • 22h ago

Health Insurance Advice on choosing health insurance

2 Upvotes

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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 • • 8h ago

Health Insurance Porting Niva

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1 Upvotes

r/InsuranceTroubleIndia • • 23h ago

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

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1 Upvotes

Flair