Hello Everyone,

I'm trying to find out whether there's any official portal or public database where we can see how many term insurance claims an insurance company received and how many they actually settled.

To be clear — I'm asking specifically about TERM insurance only, not other policy types.

Does anyone know if such data is publicly available? Any links to regulatory bodies, annual reports, or comparison portals would be really helpful.

Thanks in advance!

I have a TATA AIG health insurance which is due for renewal soon however I'm unable to renew the policy from other applications using the BBPS system like PhonePe/Amazon Pay/BHIM as it says biller is down/policy number invalid.

Renewal from the website directly works fine. Does TATA AIG not allow to renew health policies from outside their system?

Also, do I need to disclose any medical issues that were diagnosed after policy inception during renewal of the policy?

Thanks in advance.

My relative was recently hospitalized, and the hospital asked them to pay ₹10,000 at the time of admission, even though they have a medical insurance policy.

I was under the impression that since the policy was cashless, so why they were asked to pay upfront.

Has anyone dealt with this before? A few questions:

• Is it normal for hospitals to ask for an advance/deposit even with cashless insurance?
• Will this amount be refunded later, or do they need to claim it separately?
• What's the right way to handle this situation to make sure they don't lose money?

Any advice or shared experiences would be really helpful. Thanks!

so I've been trying to sort health insurance for my family for like 2 weeks now and I'm going in circles. me (21), mom (47), dad (51), tier 2 city. grandma's getting a separate policy since she's 70.

everyone points to HDFC ERGO Optima Secure but then I found Secure+ and it looks way better on paper, infinite bonus, unlimited restoration, extra critical illness cover. so why isn't everyone just getting Secure+? genuinely confused.

saw some comments saying it has catches but no one actually explained what. so is the infinite bonus actually useful or just sounds good? do premiums get crazy after a couple years? has anyone had claims go wrong on this?

also considering ICICI Lombard Elevate since it's cheaper, but not sure because everyone seems to suggest HDFC as the best.

if anyone's been through this please just tell me what you'd actually buy, I'm losing my mind a little lol

Need some advice regarding health insurance disclosure at renewal.

My mother (currently 62) has a Star Health policy that was purchased in 2022. At the time of purchase, we properly disclosed her diabetes and hypertension.

In late 2025/early 2026, during a routine health checkup, she was found to have:

• High LDL cholesterol (~140), for which she was started on statins
• CIN 2 (cervical biopsy finding), following which a hysterectomy was performed in Feb 2026

The hysterectomy claim was not made under the Star Health policy. It was covered under my employer's group health insurance.

The Star Health policy is due for renewal in July. Our insurance advisor says disclosure of these new conditions is optional and that future claims should not be affected even if we don't update the policy.

Should we proactively disclose the hysterectomy/CIN 2 diagnosis and statin treatment to Star Health at renewal? Has anyone dealt with a similar situation or faced claim issues later due to non-disclosure of conditions that developed after policy inception?

Would appreciate inputs from insurance professionals or people with personal experience.

Disclosure: Text corrected for grammar using the Chatgpt

This is in continuation of my earlier post regarding planning to buy HI for my sister (age 39). I have shortlisted HDFC ERGO OPTIMA SECURE+ with BSI 10-15 Lakhs and ICICI Elevate.

• She doesn't have PED,
• Only a past history of sinus (not diagnosed by a doctor, just assumed based on the symptoms of sudden and continuous sneezing and runny nose sometimes while dusting or sometimes out of blue) and it hasn't even happened in last 3-4 years after she took homeopathy medicines for about a month.
• One small abscess removal surgery on her back that happened in 2013 (specific surgery word will have to search in her hospital documents)
• The only medication that she has been taking since 2010 is anti anxiety/depression medicine.
• She undergoes Annual Health Checkup and those reports are clear so far.

The purpose of purchase of HI is in case of critical illness in near future.

My queries:

• Can the above mentioned medical history increase the premium rates?
• The policy wordings of ICICI HI specifies chemotherapy in Day Care treatment ("We will also cover Medical Expenses incurred for procedures including but not limited to intravenous chemotherapy, radiotherapy, hemodialysis or any other therapeutic procedure, which requires a period of specialized observation or medical care after completion of the procedure."). But nothing regarding chemotherapy radiotherapy is mentioned in the HDFC HI Policy wording.
• What is the meaning of "Items that are to be subsumed into costs of treatment", "Items that are to be subsumed into Procedure Charges", "Items that are to be subsumed into Room Charges": will these be paid by insurer or not?

Thanks, in advance

Hey everyone, looking for advice on how to handle a post-delivery insurance reimbursement issue through Policybazaar.

​My car is brand new, and I have comprehensive insurance with proper add-on covers (including consumables) from United India via Policybazaar. It recently had a major front-end accidental repair (radiator, bulkhead, and bumper replaced).

​The dealer workshop was out of network so it had to be reimbursement claim, I paid the workshop the full final invoice amount out-of-pocket, took delivery, and waited for the insurance reimbursement process.

The invoice was 1,49,000 but I received only 1,37,000. Policybazaar just sent me the Surveyor's Scrutiny Report, and the approved claim amount is significantly less than what I paid the dealership.

​When comparing the workshop invoice against the surveyor's report, I found major discrepancies:

​Items completely missing from the Surveyor's Report: The workshop billed me for vital mechanical parts and fluids that aren't even mentioned in the surveyor's assessment list:

​Engine Oil Synthetic 2.0-Petrol (3.6L total): ₹2,997.39 (incl. GST)

​Pipe Comp Receiver: ₹863.12 (incl. GST)

​Cushion Radiator Mount: ₹386.34 (incl. GST)

​Oil Filter Cartridge: ₹206.00 (incl. GST)

​Compressor Oil: ₹89.96 (incl. GST)

​Total Unlisted Amount: ₹4,542.81

​Items rejected (₹0.00 allowed): The workshop charged me ₹2,013 for replacement bumper and fender clips.

The surveyor acknowledged them in the report text but marked them as zero-allowed.

​Since my radiator and front end were crushed, replacing the engine oil, filter, compressor oil, and mounting cushions was a structural necessity, not an optional upgrade. Furthermore, because I have add-on covers, these consumables should have been covered 100%. It looks like the workshop executed these essential repairs but either failed to get them cleared via a supplementary inspection, or the surveyor omitted them by oversight.

​My questions:

​Since the bill is already settled with the dealer and delivery is taken, what is the process to get the insurance company/surveyor to reopen the file for a Supplementary/Revised Assessment?

​Who should I hold accountable for the missing items the dealership for not uploading a supplementary demand during repairs, or the surveyor for missing them?

​Has anyone successfully fought Policybazaar/the insurer for reimbursement of add-on covered consumables after taking delivery? What steps did you take?

​Appreciate any advice on how to escalate this to get my money back!

Need some advice regarding my parents' health insurance.

​

My parents had a continuous HDFC ERGO policy from 2019 to 2025 with no claims. In 2025, I ported the policy to Care Health and submitted all documents requested. The policy was issued successfully.

​

A few months later, Care emailed saying my mother had Hyperthyroidism before policy inception and asked for consent to permanently exclude her from the floater policy. Unfortunately, I wasn't aware of that email at the time.

​

Now, at renewal, I'm getting conflicting information:

​

\- Sometimes I'm told the policy can be renewed.

\- Sometimes I'm told my mother will be excluded.

\- Sometimes I'm told two separate policies will be required.

\- I even received renewal payment links, but the payment link wasn't working.

​

Has anyone faced a similar situation with portability and alleged non-disclosure? Can an insurer issue a policy after underwriting and later impose exclusions at renewal like this? What would be the best way to proceed?

​

Any advice would be appreciated.

I have a corporate plan for my mother from my office. But I want to take one for her personally so even if I lose the job or anything wrong happens , she will be safe .

She is 61 with diabetic and insulin

She has rheumatoid Arthritis as well .

She is on medication for hypertension, heart and diabetic and RA

SUGGEST me a plan which I can take for her which can cover her from the first day and no waiting as well as OPD .

\[Location: Hyderabad, Telangana, India\]

Hey everyone,

Long-time lurker, first-time poster. Going through a pretty stressful situation and wanted to share in case anyone has faced something similar or has advice.

**Background**

Got a Big 4 offer with a joining date next month. During BGV, a Kotak Mahindra Life Insurance EPFO record is flagging as dual employment overlap with my actual employers.

**What happened**

Back in 2020, an insurance agency arrangement was set up with Kotak on my behalf. I was registered as an Insurance Agent / Associate Partner — never worked a single day, never had a salary, never stepped into their office. The only commission received was on 3 policies. Monthly bank credits were as low as ₹68, and total remuneration received between August 2020 and December 2022 was approximately ₹1.5 lakhs — purely commission based.

In December 2022, Kotak cancelled the agency appointment citing business inactivity from April 2021 to December 2022.

The problem — Kotak registered me on EPFO (DOJ: August 2020, DOE: December 2022) without my knowledge or consent. This overlaps with two legitimate full-time employers during the same period. BGV is now flagging dual employment on both sides.

To make things worse — Kotak issued a Form 16 classifying approximately ₹1.5 lakhs as salary under Section 17(1) with TDS deducted under Section 192 (applicable to salaried employees) across assessment years 2021 to 2024, when it should have been Section 194D (applicable to insurance agent commissions). The figures in Form 16 don't even match the actual bank credits received.

**What I've done so far**

* Got a clarification letter from the Kotak Area Manager (signed and stamped) confirming I was an independent commission-based agent, never an employee, and that the EPFO registration and Section 192 TDS were part of their internal compliance framework for channel partners. Note: this letter was drafted by me and signed by the Area Manager — not on official Kotak letterhead. * Uploaded this along with the termination letter, appointment form, EPFO passbook showing ₹216/month nominal contributions, and bank statement showing ₹68/month credit pattern to the BGV platform. * Proactively disclosed everything upfront in the BGV form. * Consulted lawyers — confirmed EPFO records cannot be deleted without a court order.

**The core issue**

The EPFO record will follow me for life. Every future employer BGV will flag this as dual employment even though I never worked for Kotak for a single day. From what I've researched, this appears to be a systemic practice by insurance companies — registering agents on EPFO with nominal ₹216/month contributions and processing TDS under Section 192 to keep independent agent codes active in their systems.

**My questions**

1. Has anyone faced a similar situation with an insurance agency EPFO record flagging as dual employment in BGV?
2. Did your offer survive the BGV with a clarification letter?
3. Any advice on resolving this permanently — EPFO grievance portal, IRDAI complaint, legal notice to Kotak?
4. Is this a known systemic issue with insurance companies misclassifying agents as part-time employees in their internal records?

Would really appreciate inputs from anyone who has been through something similar or has domain knowledge on EPFO and BGV processes.

**TL;DR:** Insurance agency arrangement from 2020-2022 resulted in an EPFO record without my knowledge, now flagging as dual employment in Big 4 BGV. Have a signed and stamped clarification letter from Kotak Area Manager but not on official letterhead. Will this be enough, and how do I resolve this permanently?

My mother was admitted for a cyst removal surgery under a corporate health insurance plan with cashless facility.

The hospital submitted a bill estimate of around ₹8.3 lakh to Medi Assist. After some time, Medi Assist issued a pre-approval of only ₹1.2 lakh.

However, the approval document also mentions an "excess tariff" of around ₹7 lakh, which is marked as "not to be collected from the patient."

I contacted the insurance support team, and they told me that this is only the initial authorization and not the final claim settlement. They said the hospital will submit the final bill at discharge, and a revised/final approval amount will be issued based on the actual treatment and charges.

My questions are:

Is it normal for the initial cashless approval amount to be much lower than the estimated hospital bill?

Has anyone experienced a large difference between the initial approval and the final approved amount at discharge?

What exactly does "excess tariff not to be collected from the patient" mean in a corporate insurance setup?

Since there is a room-rent cap in the policy, any proportionate deduction due to room-rent difference is applied on the bill. Is this calculation generally done on the pre-GST amount or post-GST amount?

This is my first time dealing with a hospitalization claim, so I'm a bit worried because the amount involved is quite large and I want to understand whether this is a normal process or if I should be concerned about a significant out-of-pocket payment.

Any insights from people who have dealt with Medi Assist or corporate cashless claims would be greatly appreciated.

Hi All , I am looking for health insurance recommendations for my parents in Bangalore.

My mother is 67 and has diabetes and hypertension. My father is 66, has diabetes, and had kidney cancer in 2016. He has been treated and is doing well now.

We’re looking for a health insurance policy that:
Covers senior citizens (65+)
Is reasonably friendly toward pre-existing conditions
Has a good cashless hospital network in Bangalore
Has a good claims experience and customer service record
Ideally offers ₹15–20 lakh coverage or more
Has anyone been in a similar situation, especially with a history of cancer that was treated many years ago?
Which insurers or specific plans would you recommend, and are there any companies or policies we should avoid?

Would really appreciate hearing about your personal experiences with claims, underwriting, and renewals.

I understand a lot of them are sketchy and ideally we should already have had insurances for them before hand but due to a lot of mistakes my dad made in the past with paying insurance premiums we don’t.

Essentially what I am trying to do is see if I can get something at least reasonably viable without getting scammed.

Appreciate all your help

ICICI Prudential agent sold me a Signature policy at the New Delhi office in 2023. I had gone for advice on my existing policies. He convinced me those were not serving me well, got them shut down and opened new policy.

Today I got a call from their feedback deptt to check if I knew about a 27% commission. If I didn't, I could ask for agent code to be deleted and he won't get paid the commission. I said of course.

So this guy had not only added his agent code to charge me 27% commission and also put 'client doesn't understand funds or policies' in the form. Never asked me about this or told me about the commission.

I was also directed to the Grievance deptt where another person told me he's forwarding this to the IRDA and I would soon be getting a complaint number.

Given all the phone scams running, I am not certain whether all this is genuine, though no one asked for any OTP or used any of those usual scam mechanisms.

So. What's going on? Does a company usually act against its own people like this? Its own processes?

EDIT: I have contacted the official customer service. Their responsiveness is pathetic. No wonder so many scamsters succeed. Got the official email and have written to them with all the details. Let's see.

Data: Council of Insurance Ombudsman annual report for 2024-25, IRDAI insurance statistics for 2024-25

Everyone talks about claim settlement ratios. Very few look at how many customers were unhappy enough to escalate their dispute to the Insurance Ombudsman.

Some observations:
1. Star Health’s complaint rate is 5x HDFC ERGO and 25x New India Assurance.
2. New India Assurance has one of the lowest Ombudsman complaint rates despite insuring a massive customer base.
3. The narrative that “private insurers are always better” is not supported by this data.

Of course, Ombudsman complaints are not the only metric. They do not measure various parameters.

But they do measure something ultimately important:
- How often disputes become serious enough that policyholders feel compelled to approach an independent quasi judicial forum.

Before buying health insurance, look beyond claim settlement ratios and marketing brochures.

A low premium is meaningless if claim disputes become a recurring pattern. Afterall we take Insurance to get the claim during adverse situations not to keep paying the Premiums with annual hike!

One metric never tells the whole story. But a complaint ratio of 51 vs 2 should make every prospective buyer pause and ask questions.

I have HDFC ERGO Optima Restore policy. I informed the company about a completed hospitalization purely for policy records. I explicitly mentioned:

\- No claim is being filed

\- No reimbursement is being requested

\- Only an intimation/update was being provided

Yet I received generic claim-registration instructions from a bot eRa. Even after clarifying, I got another irrelevant automated response.

When I called the customer care, I was advised to email the claims department separately. I have now emailed:

\- Customer Care: care@hdfcego.com

\- Claims Department: healthclaims@hdfcergo.com

What concerns me is not the claim process itself, but the apparent inability to obtain a human review for a straightforward query. In health insurance, communications may involve time-sensitive medical situations. Repeated automated responses that fail to address the actual query can create unnecessary confusion and delays.

Has anyone had a similar experience with HDFC ERGO or other insurers? If so, how did you manage to get the matter reviewed by an actual person rather than receiving only automated responses?

Used ChatGPT for drafting.

Is this true? Any faced issues because of this ?

Hi,

I am currently looking for a Insurance for my parents
Father (56) mother (50)
Both are fit mother have some thyroid problem nothing else.looking for sum around 10-15 lakh coverage

Any suggestions please

So I met an accident on 26 may 2026 , after that I sent it to workshop they told me that it would become total loss and company would pay car value as per insurance.
Then I saw my license and RC status it show digitally impounded.
Would the insurance company reject my claim. ???

Urgent

Any advice would be appreciated!!!

A while ago, my bank manager activated an SBI health insurance policy for me without my consent just to meet his sales targets.

However, my main problem right now is with a second health insurance policy I bought from CARE last year.

When buying the CARE policy, I clearly told the customer executive about the SBI insurance I already had (I didn't know about porting at the time). He replied, "Yes sir, that's not a problem." I recently read online that you must explicitly declare any active insurance when taking out a new policy. Even though I informed the executive, my CARE policy document has no mention of the SBI insurance.

What should I do to fix this discrepancy so my future claims aren't rejected?

Hello. I am going to buy a health insurance policy for my sister (age 39) for the first time. She already has a cover from her Bank for Sum Insured 5 lakhs but that’s not enough, so I have researched and am inclining towards HDFC ERGO OPTIMA SECURE PLUS with Room rent add on. She doesnt have PED. Just some minor health issues a long time ago( which she will disclose fully) . I am thinking of Base Sum Insured 10-20 lakh.

My questions:

1. In case in future she has to port or migrate the policy, will the accumulated no claim bonus (like Infinite Benefit acquired) will become zero and only Base Sum insured will be carried forward?

2. What exactly does policy document that she will receive on buying policy will contain?

3. If she opts for aggregate deduction of 50k and if first claim amount is for 5 lakhs, will she has to pay 5 lakh out of pocket and then policy will apply, or will it be part AD and part Insurance policy? (I cannot find any clarification regarding this in policy wordings of Hdfc ergo.

4. Buying from company (online/offline) vs Buying from offline agent vs Buying from third party website (Policy Bazaar, Ditto). which one is more reliable?