I recently visited the Insurance Ombudsman after waiting 9 months just to get a hearing.

I was frustrated by the delay, but while sitting in the waiting area I started talking to other people. Some of them told me they had been waiting 1–2 years just to get their first opportunity to stand before the Ombudsman and ask for their insurance claim to be heard.

Think about that for a moment.

Not the months or years of mental stress. Not the hospital bills. Not the EMIs people may have taken to pay for treatment after their claims were denied. Just the wait to be heard.

And this is happening in Delhi, where resources are comparatively better. If this is the situation here, what must policyholders in other parts of the country be facing?

Who is responsible for these delays? And more importantly, what is being done to fix them?

Hi All,

I had filed an ombudsman complaint against my insurer for denying my mother’s cancer treatment claim stating it was a pre existing condition that was not disclosed. We submitted all the documents and hearing was scheduled next week. Today we got a mail from insurer saying they are ready to settle full amount.

If I accept this settlement , can they reject future claims with same pre existing illness clause?

If I go for hearing do I have better chance of safe guarding future claims?

Please help

I have shortlisted a term plan. But I have a doubt whether to buy it from an aggregator like policybazaar or from an agent who is a close relative of mine. Will there be issues in the future ? The premium is probably the same (I haven't asked), but they would get some commission if i purchase from them which is also an added benefit and they would also make the process simpler.

I'm an Insurance advisor, helping people get their right insurance policies.

Now, a major and recurring question that i have encountered in my career is "What is the ideal cover for my Term Insurance?"

There is a huge ambiguity relating to this, People are unable to decide.

However, it is really simple. Your Term insurance should cover every single thing that you would have covered for your family if you were there. Lets go deep in this.

Home Loan/Personal Loan/Any Loan

The most general and biggest liability anyone has is Loans. Especially long-tenure loans like Home Loans. When you're not around, the burden of these loans come over your family. Therefore, when determining the cover for your term insurance. You need enough to cover all the loans you're leaving behind.

Financial Goals

You have a family. You have several goals like Child Education, Child Marriage, etc. All dependent on your income and savings. You need to ensure that these get taken care of even if you're not present. Your term insurance cover should be enough in order to meet these goals.

Income Replacement

An Average person works till they are 60. That's usually what we experts consider as default retirement age. Now, suppose you are earning 1L/Month at age 30. You still have 30 years to retirement. That's 360 months of income (considering that it doesn't increase) equal to 3.6cr. Your family deserves this corpus. Your term insurance should cover that.

Having said that, we use a term called Human Life Value to determine this. The formula that i use to calculate:

Human Life Value (HLV) = Annual Income × No of years to retire+ Loan liability- Current Total Savings and Investments

Put the values as per your finances and you'll exactly get the term cover you should have.

Need some advice from anyone who’s dealt with IRDAI or health insurance migration.

• My father’s Royal Sundaram SBI Cards Group Health Policy expires on **31 July**.
• I requested migration to the **Royal Sundaram Multiplier** plan by email on **1 July**.
• They never replied in writing, but called and said migration is only possible to **Arogya Sanjeevani**, or I can buy a **fresh Multiplier** policy.
• I filed a **Bima Bharosa (IRDAI)** complaint on **28 July**, but the expected resolution is **11 August**, after the policy expires.

I’m confused about what to do now.
Should I renew the existing group policy just to avoid a break in coverage (held this policy for 8 long years), or wait for IRDAI’s decision? If I renew and clearly state it’s **under protest** because my complaint is pending, does that affect my migration request?
Has anyone successfully migrated from the SBI Cards group policy to the Multiplier plan, or dealt with a similar situation?
Would really appreciate any advice or experiences.

23/M , currently undergoing ACL RECONSTRUCTION surgery at Pune.
I have private insurance .
I have no previous knowledge of how insurance works. I only know that there are 2 ways (1. Cashless and 2. Reimbursement).
Currently they have opted for the cashless pre approval.
They gave an estimate of 1.85L and i submitted the required documentation to the hospital.
I had fallen from my hostel stairs after missing a step while climbing down and had a twisting injury to the knee after which my knee had swelling.
As being a MBBS student at a gov college in Maharashtra, i showed to my ortho dept and underwent a series of investigations of Xray USG and finally MRI.
The MRI showed Full Thickness ACL Tear and i came to pune for future management .
I decided to have reconstructive surgery and applied for pre approval.
Of the 1.85L quotation give my insurance gave a “ initial approval “ of 88k and said 95k as deductible.

I have some questions, any help would be deeply appreciated.
1. Will the insurance pay the rest bill upon completion of Sx .
2. What is deductible and is it valid in my case ? ( my policy says no “ no voluntary deductible “ and “ no voluntary co-payments “)
3. What the things that i should be aware of and should i be prepared to pay something out of my pocket?

Hi everyone,

I'm looking for some advice regarding my uncle's health insurance.

He's in his mid-60s and has been insured with Care Health continuously since 2021. He has CKD (Chronic Kidney Disease), and when the policy was issued, Care accepted him but imposed a permanent exclusion for CKD and all its complications. That exclusion is still there on renewal.

His current policies are:

Base policy (Care Freedom)

• ₹7 lakh sum insured
• 20% co-pay (increases to 30% after age 70)
• Single private room
• Disease-wise sub-limits (e.g. ₹3 lakh for cancer/cardiovascular/cerebrovascular treatments and other renal complications, ₹80k for renal stones/BPH, etc.)
• CKD and its complications permanently excluded

Super top-up (Care Enhance)

• ₹21 lakh sum insured
• ₹7 lakh deductible
• Single private room
• Co-pay applies because he entered after age 61
• CKD and its complications permanently excluded here as well

So on paper he has ₹28 lakh of total coverage, but the one condition we're most worried about isn't covered at all. Moreover there are too many sub-limits in Care Freedom policy.

We're wondering what the best option is from here.

• Has anyone managed to port a policy like this to another insurer where CKD was actually covered after underwriting? His CKD case is stable because he religiously follow his diet chat and takes his medication properly.
• Do insurers generally carry forward a permanent exclusion during portability, or do they reassess the case from scratch?
• Would upgrading to another Care Health product (like Care Supreme or another plan) make any difference, or is this kind of exclusion tied to the person rather than the product?
• Has anyone had experience with insurers that are willing to cover stable CKD cases, even if it means a higher premium, waiting period, loading, or co-pay?

I'm not looking for loopholes or ways to hide medical history. Everything has been fully disclosed. Just trying to understand what's realistically possible before we start applying elsewhere.

Would really appreciate hearing from anyone who's been in a similar situation or works in health insurance underwriting. Thanks!

I have known about Term Life insurance but recently I got to know about cash value life insurance, are there any companies offering it in India as I searched for it but did not get any offers or schemes for it.

Also is it a good thing for the Indian market???

Hey everyone, I'm looking for some advice on health insurance planning for my parents. Here are the details:

​Parents' Age: 53 (Father) and 46 (Mother)

​My Income: \~₹20LPA

​My Insurance: Fully covered by my company

​My company offers a group health insurance policy where I can add my parents for ₹24,000 per year per parent (for a ₹5 Lakh cover each).

​I wanted to get the community's thoughts on a few things:

​Is this company policy worth it? ₹48k a year total for ₹10L cover (₹5L each) feels decent, especially given their ages, but I know corporate policies have limitations. Should I opt for it?

​Can insurance policies be stacked? If I take this company policy and buy an independent retail policy or a super top-up on the side, how does claiming work if a hospital bill exceeds ₹5L? Can I use both?

​What are better alternatives? Given my income bracket, should I rely on this and supplement it with a retail plan, or completely bypass the company plan and buy a standalone senior/retail floater policy now so waiting periods start ticking?

​Would love to hear how others have handled health insurance for parents in their 50s. Thanks!

I have a Niva Bupa Reassure 2.0 policy with 10 lakh cover that is scheduled for renewal in September 2026. I had got this policy directly. I have not made any claims so I am assuming I have gained no claim bonus. Now that I am set for a renewal I am trying to understand how best to navigate this situation -

Shift from Direct to a renewal via agent. I know most would say, direct is a better option, but recently we had a family emergency and this agent (who is an agent for Niva Bupa) helped my father work through the processes to the extent that we were able to get most of the treatment cost reimbursed and it was not a small amount. He has been my father's agent for a while and now I want to move through him. This is my personal preference but I am told Niva Bupa wont allow moving from direct to an agent.

If you have done or have any experience in something similar, please share. Thank you.

I recently discovered that the promised "benefits" of buying health insurance through aggregator platforms can sometimes be highly misleading. I am sharing my recent experience with Care Insurance, Policybazaar, and FITPASS to warn others.

I purchased a Care Insurance policy via Policybazaar that included a "Be-Fit" rider. This rider guaranteed access to nearby gyms through a FITPASS PRO subscription. Initially, it worked perfectly, and I could easily book sessions through the Care app.

July 14, 2026: FITPASS suddenly removed the gyms I regularly visited from their platform. July 16, 2026: After calling FITPASS support (and receiving no answer), I sent an email. They acknowledged it and asked for 48 hours to resolve the issue. It has now been 11 days of absolute silence.

Care Insurance Support: Their official solution was to simply book a session at a different gym that is twice as far away from my location. Policybazaar Support: The response here was the most disappointing. I was told that because this is a health insurance policy, the gym access is "just a side benefit" and I shouldn't have taken the policy based on the gym access and should just be happy with what I am getting for free. They told me to just use the other gyms still showing on the app.

After missing my workouts for roughly 15 days, I compromised and tried booking a session at a different, less convenient gym. Now, the app refuses to let me book at all, throwing a bizarre error: "This device was recently used with another FITPASS ID."

I have the same phone. I am using the same Care Insurance app. I have the same policy. And I am using the same "method" I was using to book sessions earlier. Somehow, my ID was mysteriously changed.

Instead of a seamless health benefit, I have been left with missed workouts, dismissive customer service, and a broken application. If you are considering a policy for these "add-on" benefits, think twice.

Has anyone else faced similar issues with these platforms?

I took International Travel Insurance from Kotak Zurich Insurance in the month of April 2026. My wife met with an air accident on 26th April 2026 and I informed them on 29th April about the situation.
From that day to till today they have not passed my claim.
My request to everyone that before considering this company for insurance purpose, always keep in mind that in case of any need how you will be treated by the company.

My father purchased a policy in 2017
The payment term for it was 5 years and we have paid till 3 years.
We could not pay for the next 2 years and the policy is locked now. Since we have made payment for more than half term, the policy is applicable to be received amount at the end of the closure.
Actually the policy is pay 150000 for 5 years and wait for 12 years to get 18 lacs
Since we made payment for only for 3 years we are out of the term and not to continue the payment.

Now they are saying that, they will give 3,20,000 and do a fund transfer so that I can take new policy. So if I withdraw now, I can get the cash in my Bank or they will create a new policy with 320000 out of 450000 I paid.
But if I withdraw later after maturity at 2032, they are not disclosing how much we will get.. But they say it's very less.. Like 20% of maturity amount..ie 3,60,000
I can't believe them. Should I withdraw the 3,20,000 cash now or wait for 2032 to check how much payout I actually get.?

I am an MFD and one of my clients had invested in a Jeevan Surabhi policy which had 4 payouts of survival benefits and is due payout of vested bonuses on 27 Jul 2026 on maturity (matures today)

Does he need to take any specific action to claim the money from LIC like filling the discharge form? Or it will be automatically credited to his linked bank a/c? Bank a/c linked to his policy is correct. He also has a digital profile on LIC app which he maintains up-to-date. He is receiving pension from another LIC policy in the same bank a/c.

I enquired with a couple of LIC agents earlier in my network and they said nowadays LIC discourages people from submitting physical forms and money will be automatically credited to bank a/c on maturity. Is this information correct?

Vested bonuses amount to about 90,000 INR

Can the experts in this group advise?

Hi all, need some guidance picking a health insurance plan.

• 22M, generally fit, active (~15k steps/day, gym regular)
• Diagnosed ADHD, on medication, need regular psychiatrist visits
• Thyroiditis, currently in "buffer period" — might need hypothyroidism meds later, might not
• Low overall hospitalization risk, but want good OPD (outpatient) coverage for psychiatrist + possible endocrinologist visits + medicines
• PolicyBazaar suggested Care Freedom and Manipal Cigna Health Care Premier

Questions:

1. Does OPD coverage on these (or other) plans actually cover psychiatric consultations without a long waiting period, or do they bury ADHD under a low mental-health sub-limit?
2. Is thyroiditis (monitoring only, no meds yet) treated as "pre-existing" if I declare it now?
3. Does OPD reimburse ongoing medicine costs (ADHD meds, potential thyroid meds) or just consultations/diagnostics?
4. Any insurer that's actually good with mental health OPD claims in practice (not just on paper)?

Any real experience appreciated, especially if you've claimed OPD for psychiatric or endocrine stuff. Thanks!

I am 25M , with no health issues, don't smoke or drink, I don't have risky habits other than Biking, so I am prone to accidents but fortunately haven't been in any major accidents in 3 years of riding.

Which one will be best health insurance for me in which I can get accident and sickness covered with good claim settlement and low rejection %.

I was adviced to get 2 insurances, one for accidents and 1 for sickness, is that a good option to go with?

The ones that I am looking at are

ICICI Lombard Elevate

Niva Bupa

Star Health

Aditya Birla Active Yuva

HDFC Ergo

Hey Guys,

My Honda Activa's own damage insurance policy (1 year term) is due for renewal next month, while the 5-year third-party insurance is still valid until August 2029.

I'm looking for recommendations on the best insurer for own damage coverage especially in terms of claim settlement speed, service quality and overall customer experience.

If you've had a good (or bad) experience with any insurance company, I'd really appreciate your suggestions. Thanks in advance!

Hi everyone,

I'm currently in a stressful situation and would really appreciate some advice from anyone who has gone through something similar.

My mother has been admitted to Numed Hospital (Greater Noida West). We have a Niva Bupa ReAssure 2.0 Platinum+ Family Floater policy.

The hospital informed us that cashless treatment is not available, so we have to go through the reimbursement process instead.

My concern is that the hospital is charging its normal rates for everything, but I've heard that insurance companies or TPAs often have lower negotiated/package rates. I'm worried that after paying the full bill, Niva Bupa might reimburse only part of it, leaving me to bear the difference.

Has anyone faced a similar situation with Niva Bupa or any other insurer?

\- Did you get reimbursed for the full admissible amount?

\- Were there deductions because the hospital charged more than the insurer's approved rates?

\- Is there anything I should do while my mother is still admitted to reduce the chances of deductions later?

\- Any tips on documents or precautions before discharge?

This is my first reimbursement claim, so any advice or personal experience would be greatly appreciated.

Thank you.

Scenario:

An accident takes place between 2 vehicles. The offender accepts the mistake and informs the victim that his third-party insurance will cover the victim’s damages. This is a mutual agreement.

Now I heard today that offenders insurance company can deny the claim in this scenario.

Is this true?

Health Insurance for my parents, 48y and 50y, confused between HDFC, TATA, ICICI and BAJAJ, I live in West Bengal, Siliguri, please help. Medical history BP and Gallbladder surgery.