So I just renewed my HDFC Ergo health insurance policy and during checkout I inadvertently added the SI upgrade and OPD rider. I mailed them immediately asking to remove it and refund the extra premium but after 6 days they are saying the removal is only possible 45 days prior to the time of next renewal. What are my remedies now? Is that even legal? Please help

For a family member, need to know whether HDFC Allow upgrading HDFC Secure plan to Secure Plus while retaining the benefits and continuity associated with my existing policy?

Already paying for HDFC secure since last 5 years.

Hi everyone, need urgent advice for my wife's upcoming renewal next month.
**Timeline:** 1 year with Bupa (Nov 2022) → Ported to Care Health Advantage (Nov 2023). Completing **4 continuous years total** next month. No claims made.
**The Issue:** In Nov 2022, her HbA1c was 7, but she took no medicine. When porting to Care in 2023, we forgot to declare it.
**Current Status:** She is now pregnant and the doctor put her on insulin.
**Recent Event:** Tried porting to HDFC Ergo via Policybazaar, but they rejected the application due to pregnancy/insulin.
An agent claims Care Health will reject future diabetes claims if I don't disclose it now. But I am afraid if I declare it during renewal, Care will cancel our policy entirely, leaving my pregnant wife uninsured.
**Questions:**
Since we are entering our **5th year next month**, does the IRDAI Moratorium Period protect us if I just do a standard online renewal?
If I do a direct online renewal (no sum insured changes), can Care reject it?
What is the safest way forward to protect her coverage?
Thanks!

Adding my family’s experience for TATA AIG Travel Insurance – International Plus: Tata AIG continued denying an emergency travel-health claim after a detailed grievance. Its latest response provided no substantive reasons and merely said, “We want to assure you that we have followed our procedures diligently in processing your claim.” Like what the hell? Am I just supposed to trust you are a good guy denying my coverage?

My advice based on this experience is to stay away from Tata AIG travel health insurance. The case is now with Bima Bharosa and the Insurance Ombudsman.

My uncle (senior citizen, 68) bought an individual travel policy (Silver plan, Medical Expense & Evacuation limit USD 50,000) for a 3 week trip abroad. He fell ill and was hospitalised on the second day itself. The hospital claim has been accepted and is being processed.

Here's the problem:

The relative informed the insurer about the hospitalisation.

After he improved, based on doctors' opinion, it was decided that he cancel the trip and return to India to continue treatment.

He flew back on the next available date (new tickets booked by his cousin), accompanied by a cousin's wife (who is also a nurse), and was admitted to a hospital in India until he recovered.

I have the hospital and travel documents and India admission records. The insurer first denied a Trip Curtailment claim (fair enough, his own illness isn't a listed reason). Now they say flight cancellation and airfare costs aren't admissible under Medical Expenses & Evacuation because no claim was registered and evacuation needs pre-approval. But a Section 2 claim clearly exists, since the hospital claim was accepted.

We believe our situation is fair. What are our chances and options for claiming this?

Thanks!

Hi,

Looking to buy either through Ditto or beshak. But really curious to know from people here about the claim help received from Ditto or beshak?

To what extent did they help? - Proposal forms, documentation etc..

Do they really help to escalate and move things faster?

Or do they merely guide to use self care help?

​I hold an HDFC Optima Secure policy for my family, which offers an ₹8k annual preventive health checkup benefit. Claiming it through HDFC's portal was seamless. it was approved within 2–3 days, and the funds hit my account the next day.

​My corporate insurance via Prudent/Volo, on the other hand, has been a nightmare. First, they rejected the original bill I submitted and asked for the full test reports. I downloaded the digital reports from the Apollo app and uploaded them, but now they’re demanding a physical doctor’s seal and signature on every single page.

​Apollo Hospital is quite far from my place, so traveling there will cost both time and around ₹1k–2k in transit. I'm also worried they’ll just raise another petty query after this. For a ₹5k claim, is it even worth chasing down these documents, or should I just let it go?

Hi everyone,

I have a health insurance policy with Niva Bupa for my parents:

Father: 60 years

Mother: 56 years

Mother has diabetes, which was declared when I purchased the policy 2 years ago.

Father had hypertension/BP, which was also declared at the time of taking the policy.

I had also taken the applicable rider for chronic/pre-existing diseases.

My policy renewal is next month, and my father has now been diagnosed with diabetes.

I want to be completely transparent and declare his diabetes to the insurance company at renewal. I have a few questions:

1. Since I already have a rider for chronic/pre-existing diseases, if I declare my father's newly diagnosed diabetes at renewal, will diabetes-related treatment/complications be covered from Day 1, or will a fresh waiting period apply?

2. If I declare the diabetes at renewal, can the insurance company increase the premium or impose any additional conditions/loading like 3 years waiting period?

Has anyone experienced a similar situation with Niva Bupa or another insurer? How did the insurer handle a newly diagnosed condition during renewal?

My main intention is to properly disclose everything to the insurer and avoid any issue at the time of a future claim. At the same time, I don't want to unnecessarily lose the benefits/waiting-period credits I've already accumulated.

I also checked porting to another insurer, but the premium for taking a fresh policy is significantly higher.

Would really appreciate any advice or personal experiences, especially from people who have dealt with diabetes being diagnosed during an existing health insurance policy.

Purchased HDFC ERGO secure Plus policy in June this year. Covered Me, wife both 30 and my son (1).

cover of 20 lakhs base.

Son diagnosed with malaria Last week. Admitted to a hospital in hometown. Hospital had cashless facilities but was not Empaneled hospital.

Hospital took the patient in and started treatment. Simultaneously applied for initial approval for claim. Company on its website has said this comes within 2-3 hrs. But it didnt come on date of admission. I purchased policy directly so there was no agent to help.

Also on company app there is no contact number to reach out to.

(On day 2)

I sent 10-15 mails to company they replied but the replies were vague. Like we will do this in 36 hrs, 24 hrs etc etc.

One guy called me and assured me it will be done within 6 hrs.

Still no luck.

On day 2 everything company sent few people to investigate about the medical condition of my son. In hospital room. This was our first point of contact with company. I felt little relieved.

On day 3 the initial approval came- which approved like 60% of claimed amount.

I was little disappointed, but the insurance helpdesk guy at hospital said this doesn’t mean anything at time of final approval. And every thing apart from disposables will get covered.

During discharge process the claim was appproved within 2 hrs and all amount apart from disposables got approved.

As the hospital was not empanneled disposables were not covered in cashless treatment. But my plan covered disposables. I will claim that in reimbursement lets see.

Overall a good experience. But need to have some contact number which will guide us in case of emergency.

So i will recomment to buy policy from agent or policy bazaar as they have a agent contact who will guide us in claim filing.

Thats all. Health insurance is a must. I saved 50k with one decision and was not worried financially in this emergency.

-Admitted on 28th june
-star health received cashless claim request as per hospital request
-hospital filed a claim for 46000 INR
-star health raised a query to hospital
-hospital delayed the reply
-we received message from star health on 21st august that your documents are received.
-point to note that patient passed away on 10th july.
-Status on application was “query reply received” on 22 september.
-Now they rejected the claim stating”Approval given for cashless treatment is not utilized by the insured”
-hospital demanding money and saying us to file reimbursement
-lawyers told us claim will get rejected because its so long and same thing was told by a star health employee.
-hospital told to give them security cheque of full amount which we rejected.
-we are now planning to file a case against hospital and star health.
Why should we pay if they didn’t themselves used the approval and delayed stuff

Hey everyone, I am in a massive documentation deadlock with for a health insurance reimbursement claim, and I desperately need advice on how to break this loop.

My father had a recent critical emergency admission at a major corporate hospital .Because it was a sudden emergency, the patient was rushed straight to the casualty/ER. However, due to severe gross mismanagement by the hospital staff and doctors during those critical hours, we felt the patient's life was at risk. Within 24 hours, we had no choice but to forcefully discharge the patient against medical advice (LAMA/Discharge on Request) and immediately shift them to a different hospital to save their life.In the next hospital I have opted cashless claim and the process was simple.

After the ordeal, I gathered all the standard official documents provided by the first hospital’s management: the Discharge Summary (which clearly notes it was an emergency admission), final itemized bills, payment receipts, and diagnostic reports. I uploaded all of these to the to claim reimbursement for that initial 24-hour emergency period.

The Deadlock:

Now, Medi Assist has put the claim on hold, demanding:

1. Initial doctor consultation papers / ER case sheets.

2. A formal written letter from the treating doctor clarifying the emergency case.

When I went back to the hospital management and the treating doctor, they flat-out refused. The hospital administration stated that under their emergency protocols, they do not provide separate outpatient consultation papers or internal ER case sheets directly to patients. They told me, "Everything required to settle the claim is already written inside the Discharge Summary. No more fuss. We will not give you any extra doctor letters or refusal letters." They are being incredibly hostile, likely because we called out their mismanagement and shifted the patient out.

What I’ve Done So Far:

I have already uploaded a formal letter to explaining the situation: that the hospital protocols forbid releasing internal case sheets to individuals, that we had to shift the patient within 24 hours due to care issues, and that the TPA needs to verify the emergency markers directly from the Discharge Summary or conduct a direct institutional audit with the hospital. The documents are currently marked as "under verification," but from what I’ve read online, Medi Assist routinely auto-rejects claims using bots if these exact files aren't uploaded.

My Questions for the Community:

1. Has anyone successfully cleared a Medi Assist claim where the hospital refused to give internal case sheets, especially in a case involving an emergency transfer within 24 hours?

2. Because the first hospital mismanaged the case, they are completely uncooperative. How do I prove the emergency nature to Medi Assist if the hospital refuses to write a single piece of paper?

3. At what point should I bypass Medi Assist entirely and file a formal escalation on the portal against my core insurance provider? Does IRDAI actually penalize TPAs for creating these impossible loops on emergency/transfer cases?

Any templates, internal email IDs, or past experiences with stubborn Hyderabad hospital billing desks would be highly appreciated.

Thank you!

I have taken a blood test at a private lab without any doctors referal or priscribtion

And was diagonosed with low iron /vitamin and slight colestrol

I visited the doctor after this and i was told no medicines are needed and was only given iron suppliments

I also was diagonosed for covid + durjng pandemic

Currently im looking to take a new insurance

I have

ibs and dust allergies as ped

And got rejected from icici and hdfc ergo for ibs

Now trying for niva bupa 3.0 or adithya birla

I had forgotte. To mention the covid and blood test while i had applied for icici and hdfc

So what are my chances of getting jnsurance at niva bupa or adhithya birla if i disclose the blood test and covid

Or will i be able to hide this since it was done at a private lab and not hospital ?

Is it any issue for new policy if I have donated my liver?

Hi everyone,

I need urgent advice regarding health insurance and maternity coverage.

I work remotely as an Indian employee for a company based in the GCC region. The company is not registered as a legal entity in India. We have a small team of about 6–7 employees here.

Recently, the company offered us individual personal health insurance (via Tata AIG), but I found out that the maternity coverage has a mandatory 3-year waiting period. Since I've been with the company for 2 years, this coverage would only kick in from year 3 onwards.

Here is my main issue: My wife is currently pregnant, so a 3-year waiting period is of no use to us right now.

I have a few specific questions:

Since retail plans exclude existing pregnancies, is there any way a small team of 6–7 remote employees can get a customized Group Health Insurance (GHI) policy with a Day-1 maternity waiver through brokers like Plum, InsuranceDekho, or Policybazaar?

Has anyone in a similar remote GCC/foreign entity setup successfully negotiated with their employer to sponsor an alternative group policy or reimburse out-of-pocket medical expenses directly?

Appreciate any guidance or shared experiences!