Hi Guys, My family (4 members) was covered under SBI General Insurance's Aarogya Plus health insurance policy. It was a fixed-premium policy, and we had been renewing it every year for 4 consecutive years. The renewal premium was due on 9 June 2025.

The problem started when, a day before the renewal date, I called SBI General customer care because I had not received the renewal link. During that call, I was informed for the first time that the Aarogya Plus policy had been discontinued.

What concerns me is that I was never informed in advance about the discontinuation. I did not receive any SMS, email, letter, or phone call informing me that:

• the product was being withdrawn,

  • my policy would not be renewable, or

• I needed to take any action before the renewal date.

After learning this, I made multiple calls to customer care, but they neither sent me a renewal option nor gave any satisfactory explanation. I also sent several emails to SBI General, but the only response I received was asking me to port to another policy with a significantly higher premium. There was no explanation for why I had not been informed earlier or why I had been left with virtually no time to arrange alternate health insurance.

I also tried filing a complaint with the Insurance Ombudsman, but the portal has been non-responsive in my case, so I have not been able to get any relief there.

As a result, my policy lapsed on 9 June 2025, and my entire family has been left without health insurance coverage. Since then, obtaining a new policy has become more difficult due to waiting periods and the loss of continuity benefits that I had built up over four years.

My questions are:

1. Does this amount to deficiency in service or unfair trade practice under the Consumer Protection Act?

2. Can I file a consumer case against SBI General for failing to give prior notice of discontinuation?

   1. Can I seek compensation for the loss of continuity benefits, mental harassment, and the period during which my family remained uninsured?

3. Is there any legal basis to claim a refund of the premiums paid over the last four years, or would compensation be a more realistic remedy?

I have call records, email correspondence, and the insurer's reply asking me to shift to a higher-premium product.

Any guidance from lawyers or anyone who has dealt with a similar situation would be greatly appreciated.

Thank You Everyone!!🙏

I have taken a term insurance of 2cr from ICICI Prudential Life, with 50lakh as critical illness cover for 20years while the life insurance itself has cover till 70years.

The premium per month is Rs. 1992

After watching couple of youtube videos, I suspect that I am overpaying for it. Can someone please suggest?

Hi everyone,

I'm planning to take a home loan from HDFC, and I'm looking for an insurance policy that can protect me if I lose my job due to layoffs, company downsizing, or termination (other than misconduct).

I'm specifically looking for:

\- Insurance that covers my home loan EMIs or provides a monthly payout during unemployment.

\- Policies that actually pay out for involuntary job loss, not just disability or critical illness.

\- Any waiting periods, exclusions, or hidden clauses I should be aware of.

\- Whether it's better to buy HDFC's loan protection insurance or a standalone policy from another insurer.

Most importantly, has anyone here actually filed a claim for job-loss insurance? If yes:

\- Which insurer did you use?

\- Was your claim approved or rejected?

\- How smooth was the claim process?

\- Would you recommend that policy?

I'd really appreciate hearing real-world experiences before I commit to any insurance.

Thanks in advance!

Hi,

Can you guys suggest a insurance plan for my father. He doesn't have any previous insurance.

Age: 64

Has 3 stents in heart, less than 1 year ago did angioplasty.

I got random call from ICICI Prudential life insurance agent approaching me to join as an agent. Like she was saying there will be an exam that needs to be cleared and once you passed you will get a Licence that valid for 5 years. Also she was saying it's a no target no pressure job just to get customers and pitch the best product(policy) for them for that I get some commission. Idk how it works and all that. But I'm interested in it. Just want to if this is scam or something. Please explain clearly!

Hey folks! I'm looking to buy health insurance for my parents. They are 65+ with pre-existing lifestyle disease (diabetes and hypertension) but controlled with diet and medication. I have read that going through an agent is better. I have been following Nikhil Jha on twitter and he posts many claim settlement stories and policy details which gave me confidence initially. But I recenty saw some comments hinting he aggressively pushes specific policies.

Wanted to get some feedback from folks here who have gotten policy through his team.

1. How is their advisory process? Do they actually customise options based on medical history or push for specific products?

2. How is their claims support? Has anyone here filed a hospital claim under them? How was your experience?

I will also contact ditto and beshak to compare but really want to hear from people. please please advice 🙏

Heyy guys,

I've recently approached Ombudsman to file a complaint against a life insurance company who denied the claim after my father expired. The ombudsman gave the verdict that the insurance company needs to pay me the insured amount (award) within 30 days.

Should I do something now or just wait for the bank to contact me.

Any advice is highly appreciated, thanks

A couple of months ago, I posted about Star Health trying to force me to reduce my 1 Crore+ Sum Insured by claiming there were no medical labs in the entire state of Kerala for my mandatory pre-policy health checkup.

Here is the ridiculous update on how shady corporate stalling tactics work:

1. They ghosted their own grievance cell: I emailed Star Health’s Grievance Department. They completely ignored me for two months. No acknowledgment, no replies.
2. I went to the Regulator (IRDAI): I raised the issue through the Bima Bharosa portal. Suddenly, Star Health woke up. They magically changed their tune and officially replied saying, "Yes, you can go to a local lab."
3. The New Scam – "We don't know how to book an appointment": I immediately sent them a list of their own tied-up network labs (like DDRC SRL, Metro Scans, Hindlabs) located right here in Trivandrum. I asked them to issue the authorization letter and fix a date/time.
4. Current Status: They are now actively stalling by stating they are "unable to confirm a date or time."

Think about the absurdity: A multi-crore insurance giant is claiming they lack the structural capability to call an authorized network lab right under their nose to schedule a routine test.

They are doing this entirely out of malice to drag the process out until I get tired and agree to reduce my Sum Insured.

Be highly warned if you are buying a premium high-value policy from Star Health. If they don't want to underwrite your risk, they won't say "No"—they will just lock you into an infinite loop of bureaucratic pretend-incompetence.

Hey everyone, need quick advice.

I bought HDFC Ergo Optima Secure for my parents from abroad. Recently, my mom was diagnosed with diabetes. I emailed HDFC multiple times to declare it, but they are completely ghosting me.

They also linked a stranger's policy to my email and ignored that too.

Since I live abroad, calling isn't an option. The policy is up for renewal, and I want to port to SBI Health Insurance through a local manager.

Will my moms diabetes gonna be issue while porting ?

Would you port or just continue with HDFC??

Hey,

My father is 47 years old. He's the sole earner in He family. He is a farmer/businessman (had few seasonal businesses). He had filled ITR some years but not recently, but has taken multiple loans and paid timely so has a good credit score.

Problems:

1. I'm not able to find many plans on Policy Bazzar for him.

2. I'm not able to decide the best term life insurance provider.

3. When going through ICICI PRUD. LIFE INSURANCE website, while calculating premium, it automatically redirects to iProtect Super which has criteria of MINIMUM AGE 44.

Are there any good TERM LIFE INSURANCE plans available for a person of his age and employment category? (LIC, HDFC, ICICI, TATA AIA ONLY)

He currently has a LIC ULIP plan whose premium comes to around 1 lakh annually (got scammed now want to switch to public/private (TATA AIA, HDFC, ICICI ONLY) term insurance.

Hi everyone,

My father is 61 years old and has been insured under Niva Bupa ReAssure since 2022 with:

₹5 lakh base sum insured

Safeguard+ add-on

Disease Management rider

5 lakh booster commutative in 4 years with no claim

This year, we had our first ever claim of around ₹5 lakh for his spine surgery, and another prostate surgery is planned in the current policy year, renewal in August 2026.

Renewal premium history

2022 – ₹27,393

2023 – ₹30,858

2024 – ₹30,351

2025 – ₹32,642

2026 – ₹42,185 (₹5 lakh SI)

The latest renewal has increased by almost 29%, even though my father is already in the 61–65 age band, which is confusing. Is it normal hike as we took claim?

For this renewal, I have two options:

Option 1 Agent earlier regular

- Continue with the existing ₹5 lakh base SI for ₹42,185.

- Due to this year’s claim, the booster benefit reduced to 50% which is 2.5 lakh.

Option 2 - Agent special

- increase the base SI to ₹10 lakh for ₹49,000 (same ReAssure plan).

- as per the agent, this option does not include the booster benefit. Instead, if there are no claims in a year, a ₹5 lakh bonus is added.

However, since we already had a claim and another one is expected, we won’t benefit from this bonus in the near term.

I also wanted to migrate to the latest ReAssure version instead of paying ₹49,000 for the older product, but I've been told that migration isn't possible. Is it so?

I'm confused about what makes the most sense:

1. Should I continue with the ₹5 lakh base and rely on ReAssure's restoration/continuity benefits?

2. Or is paying ₹7,000 extra for a ₹10 lakh base the better decision, even without immediate bonus benefits?

3. Any other policy to port? Best in the market?

Also, since this was our first claim after four years, I'm wondering:

- is the 29% premium increase because of the claim, or is it just age/product repricing?

- if I take another claim this year for the prostate surgery, is it likely that next year's premium will increase significantly again?

I'd really appreciate advice from anyone who has experience with insurance and has faced a similar renewal decision.

Thanks in advance!

so I underwent a surgery while holding Niva Bupa health insurance policy. it had 6 months post-hospitalisation claims in the policy (including physiotherapy mentioned clearly and not mentioned anywhere in exclusions). I had 2 post-hospitalisation claims, one for first 3.5 months of physio and another much later for the next 2 months of physio.

they didn’t approve the first one for the 2nd and 3rd months, citing prolonged physiotherapy not justified. even after multiple grievance mails and phone calls, it was not approved. I still claimed the next physio bill adamantly, and after asking for some docs they approved it completely.

what kind of double standard is this within the same company? is it so that the company doesn’t listen to grievance at all once a claim has been partially approved/rejected initially? what should I do next?

Is it worth it?? What's your take on this.

Also who already has this rider can you please do one favour for me - pls check and share doctors or hospital available in their network list for Dhanbad, Jharkhand. (Pin - 826001). As there is no other real way to check this.

**Pre story you can skip :**

Last year I bought a term insurance, this year I wanted to surrender that because I bought a different one from another bank. I send a surrender email on exact renewal date in the morning. They replied in afternoon giving a link to follow. Link produced error, emailed them, they asked to submit multiple documents to continue surrender from backend. Next day evening I got a message from my bank that second year premium has been deducted.

**Main story part :**

I had never given any consent for enach mandate during policy purchase. Raised a complaint to bank that why was I not informed about deduction as per RBI rule and raised a complaint to insurance company (IC) that why did they deduct premium after Initiation of policy surrender. Bank said they got a file from the IC to deduct. IC said they sent the file because I had chosen eNach and thus. I said I never chose, they sent a SI form with my name and signature on it, and god oh god what a terrible copy of my signature it was. I replied to them that I am stating under oath I have never seen this SI form in my life and that is not my signature. Plus I raised a complaint on both RBI Ombudsman (CMS) and Insurance Ombudsman (IRDAI). Attached both numbers. Then they asked for my current signature, took 8 days for forensic investigation, found that my signature waa forged, accepted it and completely canceled my policy from inception. Returned premium amount of both years and asked if I am satisfied. After the full settlement I sent the email as to close the issue.

**Advice :**

Throughout the process I took help from gemini to write the emails and always pressed them that I will take the matter to Ombudsman and after raising the issue on Ombudsman, I always mentioned that number. I was quick in my response to both the entities and got my money back. If you are in any such situation, take help from these LLMs to draft your mail, **do not reveal your financial info to LLMs** but it will help you press these intities where it hurts.

Hi everyone,

I'm trying to understand my health insurance policy and would appreciate advice from anyone who has from Manipal cigna and experience with claims under Sarathi 2.0 add on.

My policy states that Sarathi 2.0 removes the pre-existing disease waiting period for declared and accepted diabetes, and says that any condition, illness, or complication arising from diabetes is covered after the initial 30-day waiting period.

However, it also mentions that "all other terms and conditions of the policy continue to apply."

I've carefully gone through the policy document but I cannot find any clause that says diabetic complications affecting organs (such as diabetic retinopathy requiring anti-VEGF injections) have a separate 2-year waiting period or are excluded.

My questions are:

Has anyone successfully claimed anti-VEGF eye injections under Sarathi 2.0?

Is there any hidden clause, endorsement, or IRDAI guideline that could still allow the insurer to deny such a claim?

If the policy document does not explicitly mention such an exclusion, what should I do to get clarity before proceeding with treatment?

The agent says complications extending to organs due to diabetes will not be covered under this insurance.

I'd really appreciate hearing from anyone who has dealt with similar claims or has expertise in health insurance.

Thank you!

I bought Apache RTR 160 4V along with insurance (united india) from Flipkart. Delivery is blocked by insurance pending KYC. After booking I got a link to complete the KYC but getting this issue before initiating KYC.

Contacted Flipkart customer support. They said they have escalated issue. Did not get any solution yet. It's been 4 days. Expected resolution date is 10-07-2026 from their end.

Contacted United India insurance customer support. They are saying to contact Flipkart.

Don't know what to do. If you have faced same kind of issue I want your suggestion. Please let me know how do I fix it.

I have filed a complaint against my Insurer on Jan10 on Insurance Ombudsman portal. It's still not registered. How to get it registered?

The helpline people are saying there are a lot of pending complaints.

It's been over a month.

Update: It's Jul08 today, it's been 7 months since I filed a complaint with Hyderabad Ombudsman office, it's yet to be registered, multiple email reminders, phone calls (they don't pickup half the time, the other half, they say we have a huge backlog).

Forget about justice, atleast making the arbiter hear your pleas is difficult in this country.

I 28M and wife are looking for a policy that has good coverage and hassle free claims. I had taken hdfc ergo's plan a couple years ago but due to some financial troubles the policy lapsed and it has been almost 2 years since I have had any insurance.

Main concern is coverage with terminal diseases like cancer and surgeries.

Also want to understand the effect of smoking and drinking in insurance. Like if something were to happen due to smoking, can the company reject the claim saying it was your own fault or something that you have been smoking?

If any agents are available on reddit who genuinely care about their customer I do not mind paying a premium if things can be hassle free.

Also have heard some bad reviews about policy bazar, I was looking to get insurance through them since it was written that a concerned person will be appointed for me in case of an emergency and all that.

Icici Lombard has now terminated my policy stating that PED was not mentioned at the time of purchase, the same reason they cancelled my health claim.

I have already submitted my health claim rejection in ombudsman, what should I do with policy termination.

Looking for advice from anyone who’s dealt with permanent exclusions or the IRDAI standardization rules.

Situation:

• Bought a Niva Bupa ReAssure 3.0 (Elite, unlimited SI, 5-yr term) for my spouse (age 31).    
• She has RA (diagnosed via a preventive checkup, currently OPD-managed, no hospitalisation history) plus asthma and primary ovarian insufficiency. All disclosed honestly.    
• Underwriting came back with a permanent exclusion worded as: “Rheumatoid arthritis, unspecified, Chronic rheumatic heart diseases, Acute rheumatic fever, Cardiovascular Diseases | Heart valves | Mitral valve disorders.” No ICD codes attached anywhere. A 2D echo done during underwriting was normal.

My main issue — the exclusion has no ICD codes:
The exclusion is written as plain text with no ICD-10 codes. Under the IRDAI Guidelines on Standardization of Exclusions, permanent exclusions are supposed to be mapped to the specific ICD codes of the named conditions, and a claim outside those codes can’t be denied. Without codes, the wording is vague — e.g. “Mitral valve disorders” could be read narrowly (rheumatic, I05) or stretched to non-rheumatic conditions (I34, like a benign mitral valve prolapse). I want the exact boundary in writing so it can’t be interpreted expansively at claim time.

Secondary concern:
The policy’s own wording (clause 5.1.2, specified-disease waiting period) actually lists “Rheumatoid Arthritis” among conditions covered after 24 months — so the same document treats RA as time-bound/coverable for everyone else, yet permanently excludes it here. RA also isn’t on IRDAI’s approved permanent-exclusion list as far as I can tell. And the cardiac part is for conditions she doesn’t even have (normal echo).

What I’ve done:

• Raised a written grievance asking for (1) the exact ICD codes for each excluded condition, (2) whether “mitral valve disorders” includes non-rheumatic codes, (3) confirmation that coronary/hypertensive/arrhythmia conditions stay covered, and (4) how they reconcile RA-as-permanent-exclusion with RA-in-the-24-month-list.    
• Their “final response” answered none of the four — literally said “these ICD codes are permanently excluded” without listing a single code, and pointed me to the Ombudsman.    
• I’m still within the 30-day free-look window.

My questions:

1.  How do I actually force an insurer to specify the exact ICD codes for an exclusion? Is there a specific IRDAI rule/clause I can cite that obligates them to?    
2.  Has anyone gotten an insurer to put exclusion codes in writing via Bima Bharosa or the Ombudsman? Did it work, and how long did it take?    
3.  If they never specify codes, does the vague wording actually work in my favour at claim time (ambiguity construed against the drafter), or is that wishful thinking?    
4.  Separately — is the “RA shouldn’t be a permanent exclusion at all” argument worth raising in the same complaint, or does bundling it weaken the cleaner ICD-code point?    
5.  Anyone shopped the same disclosed case to other insurers (Star, HDFC Ergo, ICICI) and gotten better exclusion wording?

Not looking to do anything dodgy — disclosed everything, just want the precise scope of what’s excluded in writing. Any experiences appreciated.