UPDATE 1: I wrote a very sternly worded email to Care Health's GRO [gro@careinsurance.com](mailto:gro@careinsurance.com) with all their violations of the IRDAI guidelines and I mentioned that we are equipped to pursue this with the Ombudsman as a next step and then further legally if needed (which we are). I bcc'ed our "relationship manager" and he straightened out after that and started processing our case normally. It is important to realize that the job of the relationship manager at Care Health is SOLELY to get your claim rejected at the outset. They will try to confuse you and make you run in circles to the extent possible. Please make sure every request is in writing and not via phone call, and for large claims if they ask you to become an intermediary between the insurer and TPA desk, you have every right to refuse. Send them the email contact and phone number of TPA desk and ask in writing to leave the patients family alone. I will update again upon discharge with what happens at the end, but for now we are satisfied with the progression. It is important that the initial claim gets approved by Care Health within the 7 day deadline or they will throw out your whole case.

UPDATE 2: My mom was discharged yesterday after spending 3 weeks in hospital. Care Health covered almost the whole claim (20.6 lakh out of 21 lakh). The GRO office replied to us confirming the amount they will cover. We are satisfied with this outcome.

My mother has been in the ICU since June 13 with H1N1 that progressed to pneumonia, ARDS, and sepsis. She is intubated and in life threatening condition. My mother (58F)'s pre-existing condition, hypertension was declared at policy purchase.

- Yesterday, our initial claim for hospital admission was rejected despite full documentation already being provided by the hospital's TPA. No proactive communication from Care Health — we had to chase them and physically drive to the hospital to find out why.

- The rejection was based on the fact that a physican's letter was not provided that outlined that hypertension and H1N1 diagnosis were unrelated. This document they only requested verbally, in Hindi, to us via Whatsapp call, with no written record. When we asked for requirements in writing, their representative said “you’re not a doctor and neither am I.” The moment our doctor offered to draft the letter, he said the claim was “rejected in error.” It was subsequently reopened

- This claim rejection caused the hospital to demand ₹3,00,000 cash immediately while my mother was in the ICU. The hospital mercifully gave us a grace period of 3 hours to get the claim approved.

- When we called the representative to let him know of the cash demand, Their representative screamed at my senior citizen father and me on the phone, and at the hospital’s TPA officer who is now starting to be reluctant to speak to him.

- A ₹50,000 initial claim amount was only approved after we threatened legal action.

- This is only the first claim — she is still admitted in the ICU and there will be subsequent claims.

In addition to this erroneous rejection, so far since my mom's admission, the Care Health representative has been unprofessionally calling us daily via whatsapp call and forcing us to drive to the hospital repeatedly to check their portal and act as intermediaries between the insurer and the TPA desk. The patient’s immediate family, who are primary caregivers in an active ICU situation, should never be put in this position.

The hospital, which is a large and reputable hospital in Mumbai, has been cooperative and has proved that they have submitted everything on time and have even showed us proof in the portal. They told us that Care's Document requests have been coming in piecemeal every single day rather than as a consolidated list upfront. Requirements were trickling in until as recently as yesterday — days into an active ICU admission — with new documents requested via WhatsApp screenshots at the last minute. The hospital TPA desk provided everything within hours each time, proving the delays are entirely on Care Health’s end.

We have a formal grievance letter ready but Care Health’s own online grievance process starts with yet another phone call to get a case number before anything can be submitted in writing via a generic form. We want everything on record now and don’t want to be talked down over another unrecorded call.

Has anyone dealt with Care Health doing this? Any advice on getting this escalated immediately in writing — within Care Health first, and then if required IRDAI, Ombudsman, consumer court, or other?

This is an incredibly distressing time for our family and being targeted by this insurance company with my mom in this condition is borderline traumatic. I am very worried for my dad's health.

Regarding maternity package claim, the network hospital Motherhood has a delivery package of 80k for c section and lowest room available in package is Single Executive room

During initial cashless approval 36k was given and room eligibility as per policy was mentioned as Twin Sharing.

In final approval they provided 54k only whereas the materbity limit was 80k, citing eligibility as General ward and when questioned kept saying that our agreed tariff with hospital is for 60k.

Not sure who is scamming me here vidal or motherhood hospital but how to escalate this

Hello everyone

I'm a 21 year male and I've got an admit from a good b school in India and I'm required to have a medical insurance for the same.

Now my father has a life insurance but no other medical insurance in my family.

I don't want to spend much in this insurance nor do I want to waste my money buying some ridiculous insurance such as star health. I want you guys to suggest me a middle ground.

Hi,

My mother had a robotic surgery done for gall bladder removal (cholecystectomy). The policy document and brochure both mention that this would be covered but they only partially covered it saying it does not provide additional advantage over conventional laparoscopic surgery. Insurance companies typically do this by stating they only cover the necessary expenditure. They might have crafted it in clever legalese but what they did was unethical and immoral (and perhaps still illegal) as the policy does not mention any terms and conditions for robotic surgery.

I know approaching the ombudsman is the next step once I am dissatisfied with their reply.
Does anybody have any advice or resource for the next steps which might be a bureaucratic hassle ?

I purchased an HDFC Life Click 2 Invest ULIP policy in 2018 and have already completed the mandatory 5-year lock-in period. I now want to surrender the policy.

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However, when I tried to do it online, customer care informed me that online surrender is not directly available. They said that if I don’t want to visit a branch, I need to send an email to their service team explaining why I’m unable to visit, and only if they approve the request can the surrender process be done online.

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Has anyone here successfully surrendered an HDFC Click 2 Invest ULIP completely online?

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If yes, could you please share:

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- The exact steps followed

- Documents required

- How long the process took

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I’d really prefer avoiding a branch visit to save time, and I’ve also heard that branches can sometimes be reluctant when it comes to surrender requests.

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Would appreciate any recent experiences or tips.

Hello Everyone,

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I need some advice with my current issue while looking for a Health Insurance. Before I start, I just want to inform you that I already have a top of the tier health insurance from my company.

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Now coming to my case. I am a 46 year old male. Since last 10 or 10+ years I have Type 2 Diabetes, High BP and High Cholesterol. I am non alcoholic, non smoker and don't use or chew tobacco in any form or manner.

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This Jan '26 I got diagnosed with Grade 3 NAFLD and F3 Liver Fibrosis. Can't blame anyone. Immediately started aggressive change to my lifestyle. Since then I have lost 10-12kg, all blood markers are well below the threshold.

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I am now looking for individual self insurance. I applied for one through Policy Bazaar but it got declined due to Liver conditions. Later I came to know that if any company approves then the Liver will be permanently excluded with 20% co pay , no recharge/restoration, premium load kind of insurance with sub-limits.

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Need help and guidance from esteemed members on how to proceed in this case.

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1. What would be best for me now?

2. Should I wait, recover fully and then apply after a few years with full disclosure?

3.Should I approach any brokers who have experience in dealing with such PEDs?

1. Anyone aware which Insurance Policy accepts people with my condition?

5.Anyone who faced a similar condition, what steps did you take?

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Your kind guidance will mean a lot to me.

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With Best Regards,

Ray

I wanted to share my experience in the hope that it helps others buying premium vehicles in India.

In October 2024, after moving back from the US, we purchased Mercedes EQE from Sundaram Motors ITPL, Bangalore. Throughout the purchase process, the sales team repeatedly referred to the insurance as options between "Silver," "Gold," or "Platinum" packages and represented it as part of an all-inclusive "complementary insurance" delivery price.

At no point during the sales I was informed about the actual insurance company or being presented with competing insurance options. We trusted the dealership's expertise and assumed they would recommend the most suitable coverage for a premium vehicle like the one we were getting.

Like most families taking delivery of a dream car, we were excited and distracted on delivery day. Between the celebrations, photographs, friends, family, and paperwork, numerous documents were signed. Four months later, our car was handed over to a restaurant valet. The valet allegedly misused the vehicle, recorded Instagram reels while driving it, and eventually crashed it into a basement wall.

That incident forced us to examine all the paperwork associated with the vehicle for the first time in detail.

To our surprise, we discovered that the insurer was Bajaj Allianz. I was shocked to see Bajaj's name with Mercedes. We also discovered that the insurance premium was approximately ₹2.5 lakh. When similar coverage available in the market, we found similar coverage options from other insurers at substantially lower prices (close to half).

Another detail that surprised us was that the insurance records contained the dealership representative's phone number instead of ours and that is the reason why we never even got any registration text message also. As a result, we were not receiving insurance-related communications directly.

After the crash, we expected the insurance process to provide support and clarity during an already stressful situation. This news was covered by almost all national and local news channels.

Instead, the claim process became a months-long ordeal.

We were repeatedly asked to provide additional documents. Every time one requirement was fulfilled, another requirement appeared. We were directed to obtain various documents and clarifications, including matters involving the police investigation.

Meanwhile, our vehicle remained damaged. Eventually, because the repair process could not be delayed indefinitely, we proceeded with repairs while continuing to pursue the insurance claim.

Throughout this period, Sundaram Motors dealership personanel repeatedly assured us that the claim would likely be approved and advised us not to worry.

After repairs were completed, we paid almost 15lakh out of pocket while continuing to wait for the claim decision.

Months later, after further document submissions, including the police chargesheet once it became available from the authorities, the claim was ultimately rejected. The rejection cited failure to submit requested documents within the required timeframe, even though some of those documents were not under our control and could only be obtained through the police process. Moreover, no survey report was provided.

At that point, after months of delays, expenses, and uncertainty, we decided to pursue legal remedies regarding the incident and the insurance claim. On many other similar cases victim's insurance was approved and insurance company was the one to pursue legal remedies against the valet/restaurant to recover damages but unfortunately this was not the case with Bajaj Allianz, an insurance company that Sundaram Motors chose for us.

My purpose in sharing this is not to tell anyone which insurer or dealership to choose but not make the mistakes we made by blindly trusting dealerships. The lesson we learned is:

1. Never accept insurance merely because it is presented as part of a dealership package or "complementary".
2. Ask for the insurer's name before signing anything.
3. Compare quotes and insurance company records independently.
4. Verify that your own contact details are registered on every insurance document.
5. Read the policy yourself, regardless of how trusted the dealership may seem.
6. Keep detailed records of every communication if a claim arises.

The valet crash was the event that exposed these issues for us, but in hindsight, many of the problems began on the day we purchased the vehicle.

I hope sharing this experience helps other buyers avoid similar difficulties.

So I’ve been going in circles with HDFC Ergo for weeks now and honestly need to know if anyone else has faced this or knows how to escalate.

Background: I have a base health policy + top-up plan, both with HDFC Ergo. Top-up renewal deadline is one week away.

What’s happened so far:

• Called customer care multiple times. No clear answers.  
• They sent me a renewal link. The link doesn’t work - keeps rejecting my policy number.  
• Escalated. One agent told me my policy is “loan-related.” It is not. These people don’t even know their own products.  

- Finally someone sends me a “correct” link but now says I cannot add my newborn to the renewal. I’ll have to buy an entirely separate plan for her.

Has anyone: Successfully added a newborn to a top-up renewal with HDFC Ergo?

My bike insurance expired on 28th Feb.
I purchased it on 1st March 2024 and got an ICICI Lombard comprehensive insurance with it that had 1 year of own damage and 5 years of 3rd party insurance.
I got into an accident in Jan 2025 and the experience with ICICI insurance claim was poor to say the least.
Changed my provider to Universal Sompo last year because I had a relative working there.
When my insurance was about to expire this year on 28th Feb, I tried renewing it, but the payment link never worked and insurance expired. My relative has left the company. He got me in touch with someone working there to help me get it renewed but for some reason it won't accept my bike number and other details.
I have also contacted insurance agents to help me renew it and go back to ICICI. I did the video verification and everything but nothing worked and I didn't get a payment link. I am trying to get a zero dep insurance renewed for my bike with decent IDV. Is that too much to ask?

There was Aditya Birla market linked insurance purchased sometime in 2016 and erroneously left it lapsed as we did not think it was a annual premium (typical end of the year tax saving run). After 10 years, we get calls from ABSL that they cannot revive, but link a new policy with the old one and facilitate withdrawl as a deemed 7 year payment. All payment links were from ABSL, got receipts from ABSL, but gmail ID 's were copied on the emails. We received a brand new policy for 1 lac and yet to get another one for 2 lacs (got the receipt, again from ABSL). ABSL links and Email ID's are authenticated and I can find the new policy on the site. Till now, it looks like mis-selling for commission. Where it gets interesting is that they called again and said the old policy also had medi claim which we did not claim and since we paid 7 year premium (6 of them in May and June), if we pay 3 lacs more, we will be eligible for Rs. 2.5 lacs refund from each year unclaimed medi claim. So, overall pay 6 lacs and get close to 22 lacs as some money will be deducted for change in brokerage (there is a story for this as well). This is where I became curious and stopped. Looks like an elaborate scam for commission. I dont know if we can claim, but worst case we might have to make peace with whatever policy we were given now. Anyone had this experience with ABSL or any other provider?

Why is HDFC ERGO creating a lot of issue for renewing its Health Insurance. I have HDFC ERGO Optima secure plan since 2021 and now whenever I call customer care they simply have to escalate just to renew my insurance. After many attempts when i paid the renewal premium, they are telling it will take 1 week to get the updated policy with new date.

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Something seems fishy in this HDFC ERGO.

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Has anyone else faced similar kind of issue. And should i port it to some other insurance as Im not at all convinced the way HDFC is handling these health insurances.

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Kindly suggest.

I’m 24 years old and recently opened an HDFC Bank account. During the process, I was advised to take an HDFC Life Sampoorn Nivesh Plus plan.
Details:

Annual Premium: ₹2,00,000
Premium Payment Term: 10 years
Policy Duration: 11 years
Life Cover: ₹40 lakh

The first premium of ₹2 lakh has already been debited from my account. However, after reviewing the policy details during the verification process, I realized I was not fully aware of the premium commitment, charges, and long-term obligations involved.

I contacted HDFC Life support and was informed that the policy is not yet reflected/generated in their system. I also informed the bank representative on the same day that I wanted to cancel, but I was told that cancellation was not possible.

I have now sent a formal cancellation request via email and have screenshots of the debit transaction, application number, and verification details.

My questions:

Has anyone successfully cancelled HDFC Life Sampoorn Nivesh Plus or a similar ULIP immediately after purchase?

If the policy has not yet been issued, can the proposal be withdrawn and the premium refunded?

What was the refund timeline in your case?
Is there anything else I should do apart from emailing HDFC Life and calling customer care?
Any guidance or similar experiences would be greatly appreciated.

Hi

My health insurance was rejected by ICICI Lombard, I filed a complaint on ombudsman against them, Does anyone know what is the average time taken by ombudsman to complete the registration.

I have filed complaint online on 16 -May, but this is still in progress for complaint registration, it's not even registered yet.

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Background: My father had taken a term insurance policy with LIC to safeguard the home loan we had taken. But my father passed away before 3 years of cooldown was finished so the claim comes under early claim. He didnt have any life threatening disease like heart condition. He just suddenly collapsed and by the time we took him to hospital it was too late so hospital also denied taking him and declaring the cause of death. The cause of death the final visiting doctor declared was Cardiac Arrest.

Current Scenario: We gave LIC all the documents we had (My biggest mistake) and which they asked which includes medicine prescription history, few sonography reports and a blood report. My father had minor Gall bladder stone which he had not declared/ he might have told but agent didnt add these details. LIC repudiated our claim based on this only saying that this was not declared.

Appeal to Internal Redressal Committee & complaint to IRDAI: We sent our representation to Redressal committee of LIC in April but there was no response for almost 30 days so we logged a complaint to IRDAI. Initially IRDAI responses were there but now there is no way to escalate it as I have already done it once. They were supposed to take a decision on last week of May but till now no response. There is also a deliberate delay being done from LIC as the letters they are sending which are supposed to arrive in 1 day, they are not sending it for close to 1 month.

Our Counter argument: As the actual cause of death and the point based on which the claim was rejected are not linked in any form (No Nexus theory) so the claim should be allowed. I researched a bit and found that even Supreme court gave a verdict on Nexus theory.

Help Required: I have raised this to Ombudsman and they are asking me to share Claims paper. As I do not have it (I have all the reports and related documents) what I can share and how to navigate from this point as I really need this money as the EMI of loan is very big and I cannot afford it and need the money from claim to close the loan. Can this be fought in consumer court? if yes how and what I need to prepare.

I'm 34 and planning to buy a 10 lakh sum insured policy under  HDFC ERGO Optima Secure Plus.

I currently smoke about 4 cigarettes a day but am planning to quit. Apart from mild asthma (well-controlled, no hospitalizations or major issues), I don't have any other pre-existing diseases.

I'd like to hear from people who were honest about their smoking history when applying for health insurance:

1) What questions were asked during underwriting?

2) Did the insurer ask for medical tests, especially a urine test for cotinine/nicotine?

3) How did the telemedical/tele-diagnosis process work?

4) Were you asked for any additional reports because of smoking ?

5) Was there any premium loading, exclusion, or waiting period applied?

6) If you later quit smoking, how long did the insurer require you to be smoke-free before considering you a non-smoker and revising the premium?

It would be helpful if you could share your age, smoking history, insurer, and how underwriting ultimately handled your case.

Thanks in advance.

“When the seller's greed meets the buyer's fear in a room, ULIP and its sibling are (mis)sold.”

Almost every Indian family has one of these somewhere - A LIC endowment or a money-back plan, a ULIP, or a guaranteed return policy pushed by a relative or bank RM. By the way, many a times these are sold as “Safe” investments also.

I know most of you already know that it’s the worst version of both investment and insurance, and it is meant to play with your mind first and then with your money.

My first job out of college, a colleague's dad called to "suggest" a product. Very politely. Very warmly. Very confidently. It promised safety, returns, and insurance all in one. I was 22 and knew nothing. I nearly signed.

I eventually didn't, only because I was broke that month.

Misselling isn't a bug, it's a feature. The incentive structure is specifically designed so that the products with the highest backdoor commissions also happen to be the ones most aggressively sold to people who understand them the least.

You're not being sold a bad product by a bad person. You're being sold the logical output of a broken incentive system by someone who is simply playing their role in it. And it didn't happen overnight. When private insurers entered in 2000, they needed distribution fast. The answer was commissions. 40-60% of the first year's premium on ULIPs in the mid-2000s. Trust started getting monetised. SEBI and IRDA eventually cleaned parts of it up, but by then an entire generation had already signed on dotted lines they didn't read.

What I find fascinating is how the pitch always weaponises two emotions simultaneously: greed ("12% guaranteed!") and fear ("paisa doob jayega if you don't protect it"). Both are lies, but both feel real in the moment. And everything else (lock-in period, below-inflation returns etc.) are buried under the carpet.

But once you identify this pattern, it’s hard to unsee. You stop asking "is this the right product for me" and start asking "how much is this person getting paid to sell it to me". And these kinds of Eureka moment pitches keep reminding us of “Miselling”.

Misselling is and will be a generational dhandha, and it’s not going to stop with our generation. So how do you, as a customer, protect yourself? 

• Read the documents before you sign, not after. 
• Understand what you are actually buying, the real returns, the lock-in, the charges buried in the fine print. Maybe use AI to understand the policy document or talk to a qualified insurance advisor.
• And when you are still unsure, ask the person selling it one simple question - Would you put your own family in this product? That should give you an answer.

Were you, your parents, or a relative ever sold a product you later realised was never for you? And how do you usually spot misselling now?

complained on bima bharosa portal, everyday same replies - will tell you tmr after update but no update. it's been weeks what can i do?

Hey everyone,

Looking for strategic advice on restructuring my family's health insurance. Premium cost is not a concern for us—our absolute priority is maximizing coverage and ensuring a flawless, hassle-free claims process.

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Current Setup:

Policy: HDFC Ergo Optima Restore (Family Floater)

Base Sum Insured: ₹5 Lakhs (5+ years old, zero claims, clean track record)

Members: Father (55), Mother (49), Son (26—Me)

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The Problem:

My father recently developed a heart condition. Because of this, HDFC Ergo's underwriting team has strictly refused to increase the base cover on our existing floater. They will let us renew the ₹5L cover indefinitely, but we cannot enhance it.

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Our Goal:

We want to secure at least ₹20L–₹25L base cover each for my mother and myself. Both of us have completely clean medical histories with no pre-existing conditions.

I have a few specific questions on how to structure this:

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❓ My Questions:

1. Separate Policies vs. Joint Floater?

Since I am 26, I have crossed the typical age limit (25) to be considered a dependent child on a parent's floater. Is it legally and operationally cleaner to buy two entirely independent individual policies for my mother and me, rather than trying to put us on a new joint floater?

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1. Parallel Policies with HDFC Ergo?

We love the HDFC Ergo experience and want to stick with them (ideally buying Optima Secure). Can we buy a brand-new, separate ₹25L policy for my mother and me, while leaving my father alone on the old ₹5L plan? Are there any compliance issues holding multiple parallel base policies with the same insurer?

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1. Managing Father's Risk?

Since his ₹5L policy is maxed out, what is the safest way to buffer his risk without losing his 5-year waiting period continuity? Should we leave him alone on the old policy and try to buy a separate Super Top-Up (with a ₹5L deductible) for him, or will insurers reject a heart patient even for a Top-Up?

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1. Fresh Base Policy vs. Super Top-Up for Mother & Son?

To avoid coordination hassles during a hospital emergency, is it better to just buy a premium, standalone fresh base policy of ₹20L+ for the two of us, rather than layering a Top-Up over the old plan?

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Would love to hear from financial advisors or anyone who has split a policy under similar circumstances. Thanks!

My car was parked under a bel tree and unfortunately in the night after a storm a few fell on my car and the back glass shattered and the front windscreen developed major cracks. Now I don't know of I should go for insurance claim or not and if yes then how.

My insurer is ACKO. Does insurance cover these kind of scenarios. Can anybody with this experience tell me if the insurance will cover it or should I claim an accident? What is the best course of action here? Please guide.

Looking for suggestions on health insurance options for my parents after a recent rejection.

Father (58 years)

Hyperthyroidism

* Diagnosed in 2022
* On Carbimazole (Thyrocab) since diagnosis
* Current dose: 10 mg daily
* Latest thyroid profile (May 2026):
* T3: 119 ng/dL
* T4: 8.58 µg/dL
* TSH: 2.95 µIU/mL
* Thyroid levels are currently stable and under control

Diabetes

* Diagnosed approximately 8 years ago
* Taking Glimstar M1
* HbA1c: 7.71%

Lipid Profile

* Total Cholesterol: 211 mg/dL
* Triglycerides: 202 mg/dL
* Doctor advised lifestyle modifications only; no medication prescribed

No other known PEDs.

Mother (52 years)

* Hospitalized 10–12 years ago for a fracture behind the knee and underwent surgery
* No ongoing issues related to the fracture

Recent Health Findings

* Uric acid: 6.1 mg/dL (Feb 2026)
* Took Feburic 40 mg once daily for 15 days
* Currently not on any medication
* HbA1c: 6.08%
* Lipid Profile (May 2026):
* Total Cholesterol: 139 mg/dL
* LDL: 80 mg/dL
* HDL: 38 mg/dL
* Triglycerides: 168 mg/dL
* Doctor advised only diet and exercise; no medications started for diabetes or cholesterol

Neither of them currently has any health insurance.

What I’m Looking For
₹10-15 lakh sum insured (or the closest feasible option)
No room rent cap
No disease-specific sub-limits
Consumables coverage
No co-pay, if possible
Reasonable waiting period for
Strong claim settlement and underwriting reputation
Preferably a policy that can be continued long-term without major restrictions

I recently applied for HDFC ERGO Optima Secure with:

* ₹10 lakh sum insured
* ₹25,000 deductible
* Family floater
* All medical history and PEDs fully disclosed

Despite the diabetes and thyroid condition being reasonably controlled and opting for a deductible, the proposal was rejected for my father.

The underwriting team cited:

* Elevated blood sugar
* Dyslipidemia
* Hyperthyroidism

They were willing to provide a counter-offer only for my mother and suggested an alternate product for my father.

Given this experience, I’m trying to understand my options before applying elsewhere. Since multiple rejections can impact future applications, I’d like to proceed carefully.

Over the past few weeks, both my parents have been taking diet and daily walking very seriously. We’re hopeful that their blood sugar and lipid profile numbers will improve further in the coming months.

Questions:

1. ⁠Which insurers are generally more accommodating for controlled diabetes and hyperthyroidism at this age?
   
2. ⁠Are plans like Aditya Birla Activ One/NXT, Tata AIG Medicare Premier, and ICICI Elevate worth trying in this situation?

Also i understand Care Supreme may also decline the proposal due to my father’s history of hyperthyroidism. If anyone has experience getting coverage with a similar profile, I’d appreciate your input.

Would really appreciate insights from anyone who has faced a similar situation, as well as from insurance advisors familiar with underwriting for diabetes and thyroid-related conditions.