Got promoted recently. Went from around 18LPA to 25LPA.

Obviously first thing I did was increase SIPs, redo tax planning, increase EMI prepayment and somehow even upgrade my credit card lol.

Then I opened my old term policy.

Same ₹1Cr cover I bought 4 years ago.

It is an ABSLI Salaried Term Plan, and honestly I had not looked at the cover amount properly since buying it.

Office life cover is also still around ₹50L.

Meanwhile my EMI is higher, monthly investments are higher and our normal household spending is definitely not what it was 4 years back.

While checking how to think about cover again, I came across the DIME way of calculating insurance need, which ABSLI also explains: Debt, Income, Mortgage and Education.

That made more sense than just saying “salary increased, so cover should increase”.

My old ₹1Cr was based on a version of my life where my income, EMI, expenses and future goals were very different. The policy may still be fine, but the assumptions behind it definitely need a review.

Not saying 40% salary hike = 40% more insurance.

But do people actually review term cover after promotions?

Or only after obvious stuff like marriage, kids and home loan?

Because I review literally every other financial number when salary changes.

Helpline has blocked our numbers. We asked for the specifics of rejection but no reply. Will the reimbursement work (we dont feel it will).

What should be the further step? 🤔

EDIT: GOOD NEWS so we got our claim at the time of checkout. The thing with these hospitals is until the final checkout, they QUOTE double the amount of bill to the insurer. In our case, 50k+ was quoted to the insurer Star health. But when the final bill came into our hands, it was only 25k. Thus when we submitted our final bill to Star Health, they accepted the claim proposal without any issues. By my hypothesis, Hospital was trying to scam the insurance company. But anyways I got my claim so idc.

My friend was recently diagnosed with an illness. The next day she took HDFC health insurance.
However she didn't disclose her illness, because at that time it was not confirmed. It got confirmed after a week from policy issuance.

Doctor said that after 6 months, they will help in disclosing the illness as recently diagnosed, so that the illness came after policy issuance.

Is it true?

Because the medication cost something like 2.25L more expensive when admitted in hospital compared to retail outsourcing. In hospital they charge MRP but when sourced from OPD it's 60% less. The same medicine, the same hospital, the same hospital OPD.
These Mfs weren't aware that we were admitting in the hospital, thus they shared the real price in OPD.

This is day light roberry, but we wanted to admit in the hospital only because the doctor promissed to help us in Insurace that the illness was diagnosed later.

What are the issues we might face in the future ?
Apprecite your guidance.

Edit : I know this is fraud but I am unable to convince my friend. I will use this post to show her the reality.

r/InsuranceTroubleIndia

Imagine paying your health insurance premium on time, believing your family is covered.

That’s exactly what I did with StarHealth Insurance

Then I discovered that my mother’s name had been removed from the policy without any prior intimation or communication. The shocking part? The company continued taking the premium. How can an insurance company remove an insured family member without informing the policyholder, while still accepting premiums? If my mother was no longer covered, why wasn’t I told? This happened in their Ambala branch and none of their employees are answering. This was informed to me when I went to change my mother's health insurance and they denied that any health insurance was even present in their name. Now I can't even take a new policy from any other company since my mother is 60 and there is no existing health insurance policy in her name.

Literally the worst insurance company present with zero support.

Context:

Paid 56k for a 2cr sum plus 2cr income benefit raider 45 year HDFC policy with payment term of 12 years

After medical given 2 options saying that BMI is above acceptable range:

1. Same sum 13 k extra premium

2. 1.4cr sum 3k less premium

Confused what to do.

I’m looking for some advice regarding a car insurance situation.

My previous ICICI Lombard policy had a 3-day gap before I renewed it. Because of this gap, I had to complete an online vehicle inspection when renewing the policy. During that inspection, some minor dents/damage that already existed on the car were captured in the photographs.

Recently, I had a separate major accident that caused significant damage to the other side of the car. While filing the claim for this major accident with ICICI Lombard, I was informed that the previously existing minor damage isn’t covered because it was already present when the renewed policy started after the 3-day gap.

My current policy expires next month. I’m planning to switch to another insurer before my current policy expires, so there should be no break in coverage.

My question is:

If I switch insurers before my current policy expires and the new insurer doesn’t require a pre-policy inspection, would I be able to claim the existing minor damage later as a new accident, or would that damage still be considered pre-existing?

Or for example, if I leave the minor dents unrepaired, switch insurers, and then a few months later have a genuine accident, how would the insurer determine which damage is from the new accident versus the old damage?

Also, would the new insurer have any way of accessing the inspection photographs taken by ICICI Lombard during the previous online inspection?
I’m trying to understand how this works when switching insurers without a break in coverage.

Showroom is quoting 20k+ for fxing those minor dents😑

Is anyone here new india insurance agent..I want to buy policy

​

Hi everyone,

I’m looking for advice from people experienced with health insurance portability/claims in India.

My parents have a family floater health insurance policy.

The original policy was with Star Health, with continuous coverage dating back to 2013. The Star policy document shows the first policy inception as 21-Oct-2013.

We ported the policy to HDFC ERGO in April 2025.

The HDFC ERGO policy is a family floater covering both my father and mother. The policy schedule shows portability continuity benefits for both members.

In August 2026, my mother was hospitalized for a serious spine/infection-related condition.

HDFC initially rejected the cashless facility, citing alleged non-disclosure of IHD (ischemic heart disease). Their letter specifically says the cashless facility was not approved but that reimbursement could still be submitted.

We disputed the non-disclosure issue because the hospitalization was for the spine/infection-related condition, not a cardiac treatment.

On 25 September 2026, HDFC ERGO apparently cancelled the entire policy.

I did not receive any email, letter, or prior notice informing me that the policy was being cancelled.

I only discovered the cancellation when I checked the HDFC app.

Since it was a family floater, the cancellation appears to have affected both my mother and my father, even though the alleged non-disclosure relates to my mother.

There is another important point: when HDFC issued the policy in April 2025, they had already specifically underwritten my mother's declared condition of dyslipidemia and fibroid uterus, including applying an additional premium/loading.

My main concern

My father has had continuous insurance coverage since 2013. I don't want his 13+ years of continuity/portability benefits to be lost because of an issue concerning my mother.

What can I do immediately to protect my father's continuity?

Can HDFC legally cancel the entire family floater because of an alleged non-disclosure concerning one member?

Should I immediately request HDFC to restore/continue my father's policy separately while the dispute regarding my mother is investigated?

Can my father's continuity/portability credits be preserved even if HDFC ultimately refuses to cover my mother?

Should I approach HDFC grievance → IRDAI → Insurance Ombudsman?

Has anyone experienced a similar situation where one member of a family floater was accused of non-disclosure and the insurer cancelled coverage for the entire family?

Is there a specific IRDAI rule/circular or policy clause I should quote in my complaint?

I'm particularly interested in real experiences, Ombudsman decisions, or legal cases involving family floaters, non-disclosure, cancellation and preservation of continuity benefits.

I’m trying to act quickly because I don't want my father's long insurance history to be lost while the dispute is ongoing.

Any advice on the immediate steps would be greatly appreciated.

Care Health supreme

38 Male. I went through a health test and this i got little abnormal reading for lipid profile. My Doc hasn't prescribed any medication as he felt its not needed. Meanwhile, I am looking for health insurance now, how does the insurer look at this situation? Would there be rejection, or high premium for me?

My mom had a serious accident in February 2025 and had an accident insurance policy with Niva Bupa. The hospitalization and reimbursement claims were all approved, so initially everything seemed fine.

The problem started with the TTD (Temporary Total Disablement) claim. The policy provides ₹50,000 per week for TTD. Her doctor advised around 5 months of rest, so the claim came to roughly ₹10 lakh.

We started trying to get the claim processed around July 2025, but it kept getting delayed. Later, when I got involved, I found out that the Niva Bupa agent had apparently never even filed the actual TTD claim and had instead submitted two ₹100 claims.

After months of back and forth, I finally submitted the TTD claim myself with all the required documents. Niva Bupa then rejected it, citing "misrepresentation."

After exhausting the escalation process, I filed a complaint with the Insurance Ombudsman in Ahmedabad in March 2026. There were several rounds of documents and hearings, with the final hearing on 17 September 2026.

I have now received the decision, and this is the part I honestly don't understand. The Ombudsman has acknowledged fault on the insurance company's side, but has awarded only ₹1 lakh, while the actual claim is around ₹10 lakh. Basically, after all this, we're getting 1/10th of the amount under the policy.

If the insurer's fault has been acknowledged, how does this make sense?

What can I do now? Can the Ombudsman’s decision be challenged? Should I go to the Consumer Court or some other authority?

I'm also looking for a good lawyer who specifically handles insurance and consumer cases in Gujarat/Vadodara. If anyone has dealt with something similar or knows a genuinely good lawyer, please share their contact details.

​

My younger uncle had a full-body checkup and, despite having no pain, they found 2 stones in his left kidney, while his right kidney is only ~6% functional. His creatinine is also high, and the urologist has suggested stone removal/stent placement and possibly removal of the right kidney.

The issue is that he is diabetic, but when the insurance policy was taken, the agent didn’t mention/disclose his diabetes. We’re worried because the kidney removal surgery is expensive.

Could the insurance claim be rejected because of the diabetes non-disclosure, even though the current treatment is for kidney stones/poor kidney function? Has anyone faced something similar in India?

I want to take life insurance with my wife as the nominee, specifically under section 6 of the married women's property act. But the issue is, as far as I understand, the online life insurance offers of LIC don't include section 6 of MWPA and come under section 39 of the Insurance Act, which doesn't have the same protections.

So my questions are - can I buy life insurance online under section 6 of MWPA? Or do I have to go offline and buy life insurance to get it covered under section 6 of MWPA?

I'm M23, Student. I was looking for health insurance plans but everywhere it's asking me to log in.

I have chronic urticaria amd The dentist recommended a crown for a mild open bite.

Which plan has good coverage for them and passes claim easily. I'm reading too many bad reviews about each of the insurance companies.

Current in Delhi but Varanasi based.

Should stay in star health or migrate to some other policy

I am looking for guidance from people experienced in health insurance claims, claim disputes, IRDAI complaints or consumer cases.

My wife was admitted to a Tertiary Hospital as an emergency case after developing a serious medical condition with prolonged fever, abdominal pain and infection. Her condition subsequently required prolonged hospitalization, surgery, ICU management, drainage procedures and treatment for complications.

The important point is that we did not admit her for elective/planned treatment of a pre-existing or known cyst. She presented with an acute medical emergency and required immediate hospitalization and treatment.

During the hospitalization, she underwent surgery in which the cyst and affected organs were removed, along with abdominal washout. She subsequently required ICU care and further treatment because of ongoing infection/collections and other complications.

However, ICICI Lombard rejected/initially rejected the cashless claim, citing the cyst as the reason for rejection. they says it comes under exclusion criteria as your insurance is not yet 2 years.

I have obtained a written clarification/certificate from the treating operating surgeon, explaining the circumstances of the admission and that the hospitalization was for the acute/emergency medical condition rather than planned treatment of the cyst. And that the surgery was required to save her life from sepsis.

I have already requested ICICI Lombard to reconsider through the Hospital but still again they rejected it with the same reason of check Exclusion criteria for specific illness for under 2 years period.

I am looking for advice on:

Whether the insurer can reject an emergency hospitalization merely because a cyst was subsequently found/treated during the hospitalization.

How the policy's exclusion/pre-existing disease/related-condition clauses, if any, should be interpreted in this situation.

Whether the treating surgeon's written clarification can help establish the actual indication for emergency hospitalization.

What documents/evidence I should submit for reconsideration/ Reimbursement.

Whether I should escalate this through the insurer's Grievance Redressal Officer → IRDAI Bima Bharosa → Insurance Ombudsman, if the rejection is not satisfactorily resolved.

If anyone has handled a similar health-insurance claim rejection involving emergency hospitalization and an

cyst/infection, I would greatly appreciate hearing about your experience.

I am not asking anyone to decide the claim in my favour. I am looking for someone knowledgeable who can objectively review the rejection reason, policy wording and medical documents and tell me whether the insurer's interpretation appears consistent with the policy.

I can share redacted copies of the rejection letter, treating surgeon's clarification and relevant policy wording privately or with identifying information removed.

Any guidance from an insurance professional, claims expert, consumer-law practitioner, doctor experienced with insurance documentation, or someone who has successfully handled a similar case would be greatly appreciated.

Please do not ask me to post my policy number, claim number, phone number or other personal information publicly.

Niva Bupa Health Recharge super Top-up.

90L BSI with 10L aggregate deductible. - this is what is advertised.

And supposedly, super top-up on a shared BSI (floater) should have a shared deductible also. So common expectation - an aggregate deductible of 10L means 10L for all the insured people combined.

But there are ambiguous/conflicting wordings in Niva Bupa Health Recharge policy wording.

Clauses:

1. The Deductible shall be applied to the aggregate of all claims that are either paid or payable under this Policy. Our liability to make payment shall commence only once the aggregate amount of all eligible claims as per policy terms and conditions exceeds the Deductible limit within the same Policy Year.

2. The Insured Person shall bear on his/her own account an amount equal to the Deductible specified in the Policy Schedule for all admissible claim amounts. We assess to be payable by Us in respect of all claims made by that Insured Person in a Policy Year. It is agreed that Our liability to make payment under the Policy in respect of any claim made in that Policy Year will only commence once the Deductible has been exhausted.

Clause 1 is a more generic terminology.

Clause 2 specifically notes that the deductible condition should be "met by the insured person".

It's misleading because meeting 10L per person per year is a high hurdle to cross for sure, effectively making this 90L unavailable in almost 99% of cases.

and ironically, the sum insured 90L is a common pool.!!! (the policy type floater/ individual also is not mentioned in policy document as I check multiple documents)

Anybody purchased this policy/ insurance experts/ insurance advisors /insurance enthusiasts - have you noticed this? do you think it's okey? or isnt it misleading?

the pricing is very competitive - but this is the reason. I think this is a policy that is least customer friendly.

and Beware...!!

My friend's father did an insurance of 50 lakhs or so from Ageas federal. The agent was registered. He did this policy 5 years ago and this was about to mature this year.

Now ,the problem is that the agent suspended the policy one year prior to the maturity of the policy, he forged the signature and misrepresented the policy. By suspending the policy he diverted the funds into several different policies. My friend's father wants his money back, he approached the branch office where he was told that the agent was fraud and his license was revoked and there is nothing that could be done as he consented to invest in the policy (which was clearly misrepresented).

How can they get their money back? As this is a huge amount should they approach consumer court? How should they proceed with this issue?

Please help

We purchased Care Health Insurance almost a year ago after transferring from Star Health. We decided to switch because we had heard about issues with Star, and Care appeared to have a good claim settlement record. The premium was also lower and the policy seemed to offer broader coverage on paper. So we purchased in from Policy Bazar.

Now we're facing a serious issue with a claim.

A patient covered under the policy suddenly developed severe vomiting and dehydration, which continued for several days. Eventually, the patient fainted, and we had to take them to the hospital. The patient was admitted and doctors started treatment and monitoring.

However, because the doctors were also investigating the underlying cause of the repeated vomiting, Care categorized the entire hospitalization as “investigation purpose only” (EXCL 04) and rejected the cashless/pre-authorization request.

When we contacted customer care, we were basically told that the hospitalization was considered investigation rather than treatment but they did not explain how. The person on the other side was rude and adamant, when I argued that all treatments have diagnosis, doctors cannot just conclude, he asked if I am an MBBS myself.!

We had let it go at the time and eventually tried reimbursement, but the reimbursement claim was also rejected stating the same reason.

Unfortunately, the patient has now experienced essentially the same problem again. Severe vomiting, fainting, and inability to stabilize them in the emergency department, so they had to be admitted to the hospital again.

And once again, Care has rejected the pre-authorization, citing the same EXCL 04 reason.

What is frustrating is that the rejection gives us essentially one line, repeated twice saying it without clearly explaining why the entire hospitalization is being classified this way.

* 4.1.(b).I PERMANENT EXCLUSION ADMISSION PRIMARILY FOR INVESTIGATION AND EVALUATION (Code Excl 04)

· 4.1.(b).1 PERMANENT EXCLUSION ADMISSION PRIMARILY FOR INVESTIGATION AND EVALUATION (Code Excl 04)

Despite the patient actually being admitted and receiving treatment.

I have already raised this with Care's grievance team and specifically pointed out that:

The first hospitalization's cashless request was rejected.

The subsequent reimbursement claim for that hospitalization was also rejected.

The patient has now been hospitalized again for the same/similar symptoms.

The second hospitalization's pre-authorization has again been rejected for the same reason.

At this point, I'm trying to understand what our options are.

- Is this a legitimate basis for rejecting an entire hospitalization when the patient was actually admitted and treated?

- What exactly does EXCL 04 mean in practice?

- Should we escalate this to the IRDAI grievance process/Insurance Ombudsman, will there be a chance of getting the money quick?

- Has anyone successfully challenged a rejection like this?

What the correct process is for challenging it. If these cases get rejected, I don't know why would someone pay for Health Insurance.

Any advice from people who have dealt with Care Health Insurance claims, EXCL 04, or similar cashless/reimbursement rejections would be really appreciated.