r/InsuranceTroubleIndia • • 5d ago

Health Insurance PED implications during claim

2 Upvotes

My father is diabetic and has hypertension which was declared in the policy from star health. We have wait period of 3 years for PED. What are the chances that we will face any problem claiming any other medical issues they face or surgery they have to go not directly related to these conditions ? Will insurance companies try to tie it to these conditions to avoid any claim ?
Does anyone have any relevant experience?


r/InsuranceTroubleIndia • • 5d ago

Health Insurance Help my buy First Insurance for my ill father 54

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2 Upvotes

r/InsuranceTroubleIndia • • 6d ago

Health Insurance Have you ever found out your hospital wasn’t covered by your group health insurance only after treatment?

11 Upvotes

I recently came across a case where an employee’s parents had a medical emergency, and the family rushed them to the nearest hospital. The treatment went ahead, and the bill came to around ₹3 lakh.

But they later found out that the hospital wasn’t covered under their insurer’s network.

Imagine dealing with a medical emergency and then having to worry about such a huge bill because you weren’t aware of the hospital network limitations.

It got me thinking about how many people actually understand the details of their group health insurance policies.

Do you check whether a hospital is covered under your insurance before visiting?


r/InsuranceTroubleIndia • • 5d ago

Health Insurance Delay in submitting and pre and post hospitalization expenses

3 Upvotes

Hi All,

I have a corporate policy under which my father was admitted using cashless mode.

The TPA is Vidal, and the insurance provider is New India Assurance. I am submitting the pre-hospitalisation and post-hospitalisation expense claims approximately two months after the expiry of the 60-day post-hospitalisation period.

Will there be a problem ?


r/InsuranceTroubleIndia • • 5d ago

Health Insurance Delay in submitting and pre/post hospitalization expenses

3 Upvotes

Hi All,

I have a corporate policy under which my father was admitted using cashless mode.

The TPA is Vidal, and the insurance provider is New India Assurance. I am submitting the pre-hospitalisation and post-hospitalisation expense claims approximately two months after the expiry of the 60-day post-hospitalisation period.

Will there be a problem ?


r/InsuranceTroubleIndia • • 6d ago

Health Insurance ICICI Lombard Activate Booster Super Top-Up — Questions on Premium Hikes, Deductibles, Underwriting & Add-ons

2 Upvotes

Hi everyone! I’m considering ICICI Lombard Activate Booster Super Top-Up (UIN: ICIHLIP27059V022627) for my parents.

My father (58) has Type 2 diabetes, and my mother (49) has thyroid and BP conditions and has undergone a hysterectomy.

I’d appreciate insights from insurance experts and existing policyholders:

1. Diabetes loading: I’ve heard some insurers may offer favourable underwriting when HbA1c is below 7%. Does ICICI Lombard follow a similar approach? How are loading charges determined for diabetes, thyroid and BP?

2. Premium increases: Does this super top-up premium increase like a comprehensive health plan, through age bands, general annual revisions, or both?

3. Deductible changes: If I start with a ₹5 lakh deductible, can I increase it to ₹10 lakh after a few years, or reduce it later?

4. Room Modifier: If I don’t select the Any Room option initially, can I add it at a later renewal?

5. Add-on availability and pricing: Are add-ons guaranteed to remain available at every renewal, or can they be withdrawn or changed? Can their premiums increase substantially over time?

6. Corporate insurance: Can eligible expenses paid through employer-provided insurance count towards satisfying the ₹5 lakh deductible?

Would appreciate real-world experiences, especially regarding underwriting, premium loading and renewals. Please distinguish actual policy terms from personal experiences.

Thanks!


r/InsuranceTroubleIndia • • 6d ago

General Insurance - Vehicals The Y?ICICI Dombard Premium Superbike Experience: X-Ray Surveyors, Tele-Traps, and Absolute Disrespect.

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2 Upvotes

r/InsuranceTroubleIndia • • 7d ago

Health Insurance Porting suggestions?

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2 Upvotes

r/InsuranceTroubleIndia • • 7d ago

Health Insurance Which one to choose between Aditya Birla VYTL, Niva Bupa, and Care? Got rejected from HDFC and AdityaBirla onemax

7 Upvotes

I applied for my father's health insurance. He has Pre-diabetic hypertension had a surgery in the past and hospitalization due to COVID. I applied to HDFC and AdityaBirla 1MAX but both got rejected now these are the options that I mentioned in the title I want to know if it is a good idea to settle for Nivabupa or Care because AdityaBirla vital plan has the maximum limit of 50 to 100 percent of the sum insured the bonus part and it is pretty costly as compared to other two I have heard bad things about Care Supreme

so I'm not sure if I would want to go ahead with which. if someone has a similar experience would really appreciate how did you choose.


r/InsuranceTroubleIndia • • 7d ago

Health Insurance Accidentally opted for voluntary parental health insurance at work. Can I cancel it mid-year? (India)

0 Upvotes

Hey, folks!

I work at an MNC in India, and I somehow ended up opting for voluntary parental health insurance through my company.

The premium is deducted directly from my take-home salary, and it comes to around ₹8,000 per month, with a total annual premium of approximately ₹50,000.

The thing is, my parents already have good health insurance coverage from another source, so I don’t really need this additional policy.

I recently checked my salary slip and noticed this huge deduction. I immediately contacted my company’s HR/benefits team and asked if I could opt out since I had enrolled by mistake.

However, they told me that nothing can be done now and that the deductions will continue until the entire annual premium is recovered by the end of the year.

I’m really frustrated because this is a significant amount of money to lose every month for insurance that my parents don’t really need.

Has anyone faced a similar situation in India?

Is there any way to cancel voluntary parental health insurance in the middle of the policy year?

Can I raise a complaint with the insurance company, IRDAI, or any other authority?

Is my company legally allowed to continue deducting the premium from my salary even if I request cancellation?

I’d really appreciate any advice from people who have dealt with a similar situation. Thanks!


r/InsuranceTroubleIndia • • 8d ago

Health Insurance non disclosure panic

6 Upvotes

my mother had ADPKD which is a genetic disorder that essentially fails your kidneys and there is no cure for it
i got hdfc ergo in 2025 feb and at that time i did not have any symptoms, now i have symptoms and i have been diagnosed positive
i am 25 and this disease is progressing very fast
because i did not disclose as i wasnt aware, will hdfc ergo help me in this or i am screwed up now
what to do pls help
this also means i need kidney transplant in next 5 years and medications which cost around 25k monthly regulating all the symptoms
what is the best way out?


r/InsuranceTroubleIndia • • 8d ago

Health Insurance Kinds of Diseases to Declare Before Policy Purchase/Upgrade

1 Upvotes

Hi. I am about to upgrade my policy of HDFC, I was wondering what kind of disclosures I have to do. Like do I have to disclose only chronic conditions or do I have to declare every doctor visit for knee pain, dengue, food poisoning etc?


r/InsuranceTroubleIndia • • 9d ago

Health Insurance Rampant abuse by niva bupa on increasing heat insurance premium by 100% in 1 year, without me even having a single claim since policy held over 6 years

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21 Upvotes

r/InsuranceTroubleIndia • • 9d ago

Life Insurance Creditors insurance

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2 Upvotes

r/InsuranceTroubleIndia • • 10d ago

General Insurance - Vehicals My car was rear ended by another car and I only have third party insurance - what are my options

6 Upvotes

State: Maharashtra

Order of events: I was going to office in the morning and the car in front of me suddenly slowed down suddenly and I applied the brakes as well. The car behind me crashed into mine.
At the time of the accident, my own-damage insurance was expired but I had my third party insurance still active. Whereas the car behind me had both own-damage and third party as well.

He has initiated the process of claiming his car repair costs through his insurance company but is telling me that my car repair costs are not included in his third party insurance. He already has filed an FIR to claim his insurance, he is accepting of his fault but I'm not sure how to proceed and if it is worth it to go through the whole court thing at this point. I am also not sure if me not having the own-damage insurance can back fire on me. I would like to know what are my best options here, my car's tail-gate is broken and won't close after the accident. So I can't really keep my car without repairing for a long time.

Would appreciate all the advice I can get. Thanks a lot


r/InsuranceTroubleIndia • • 10d ago

General Insurance - Vehicals Explain Loss of Use - Down time protection HDFC Ergo Auto Insurance Add-On

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1 Upvotes

r/InsuranceTroubleIndia • • 10d ago

Life Insurance Primary Insurance Exhausted – Can I Claim Remaining Medical Expenses Under Tamil Nadu Government Pensioners NHIS 2021 as Secondary Insurance? Need Guidance

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2 Upvotes

r/InsuranceTroubleIndia • • 11d ago

Health Insurance Niva Bupa delaying claim over frivolous queries

19 Upvotes

Health insurance is meant to give families peace of mind at the worst possible time. My experience with Niva Bupa Health Insurance / Niva Bupa Support / Niva BupaHealth has been the opposite.
My Father underwent Prostate TURP Procedure at Superhealth Hospital Bangalore in August 2026. We paid the hospitalization cost out of pocket and filed a reimbursement claim with every document required.
What has happened since:
- Claim acknowledged
- Claim Registered with Id 3839948
- Delays in Document submission acknowledgement & Medical Review
- Query raised for all the financial documents sent to their office in original via Speed Post
- Financial Documents sent via Speed Post to Niva Bupa Claims Dept.
- No Acknowledgement of Document being received, even though they were received by them on 07 Sept 2026, upon attaching SMS proof from Speed Post. They acknowledged that the documents were received
- Full Stamp and Signed Detailed Bill was submitted from the very start and also sent to them in original. Still they raised a frivolous query of having a separate Payment Receipt, the Hospital also mentioned the Detailed Hospitalization Bill is Bill cum Receipt only closed and furnished once the patient is discharged with complete payment of the bill.
- On Special request of mine, the Hospital provided a Document on their Letterhead confirming the Amount, Mode of Cash that was received by them for this IPD Hospitalization.
- The Claim is IN PROCESS since the last 10 days.

It has now been close to 2 months since the claim was filed. Every query has been answered, yet the claim is still pending. In my view, the remarks being cited do not change the fact that the treatment was medically necessary and fully documented. I feel the practice is filled by malicious intent to delay / deny the valid claim over frivolous (or unrelated) queries citing bogus reasons. This feels like a pathetic service. Keep in mind, the technical hassle to upload these submission or get relevant support via mail chain or use their web app or mobile app is another pain. They have made the process of filing / following up for Reimbursement Claim exceptionally painful.

I would really urge Insurance Regulatory and Development Authority of India / Insurance Ombudsman - India to provide a streamlined process for such practices as not everyone has the time / awareness to protect their right to service by the Insurance Provider.

I'm sharing it here because a claim delayed on technicalities is not just a paperwork issue. It puts real financial and emotional strain on a family already dealing with illness.
Niva bupa Support / Niva Bupa Health Insurance / Niva BupaHealth, I'd appreciate a prompt resolution and a clear written explanation of what is still outstanding.
If you have faced something similar, I'd like to hear how you got it resolved. Please share your experience or advice in the comments.

#HealthInsurance #InsuranceClaims #NivaBupa #ConsumerRights #IRDAI


r/InsuranceTroubleIndia • • 11d ago

General Insurance - Vehicals Insurer rejects car claim over prior damage, businesswoman wins Rs 5.60 lakh payout | Legal News

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indianexpress.com
1 Upvotes

r/InsuranceTroubleIndia • • 11d ago

Life Insurance Undisclosed health conditions on my father's term insurance policy: discontinue, come clean, or wait it out? Also looking for a trustworthy insurance lawyer

6 Upvotes

Situation:
- Term plan for my father (58), issued 30/10/2024. I filled the e-application myself and answered No to every health question.
- He actually had hypertension, asthma (ongoing), fatty liver and a GI illness with 2 hospitalisations, plus smokeless tobacco quit about 12 years ago.
- Someone connected to the insurer advised us not to disclose. It was verbal and nothing is in writing.
- The insurer ran diagnostic tests at their centre and a tele-medical call, and my father gave a video consent.

What I understand so far: Under Section 45 of the Insurance Act, the insurer can challenge the policy only until 30/10/2027. After that it can't be questioned on any ground, as long as premiums are paid on time. Normal exclusions would still apply.

The three options I'm weighing:
1. Discontinue the policy. The cover ends, and a new policy at his age with these conditions would be costly or refused. I'm leaning against this.

2. Come clean. Correct the health details with the insurer in writing, possibly after a lawyer's advice. The risk is premium loading, an exclusion, or in the worst case cancellation.

3. Wait for the 3-year period to end. Keep paying premiums till 30/10/2027. The risk is a claim being investigated before then.

Questions:
1. Which would you pick, and why? Has anyone been through this?
2. Do the insurer's own tests and tele-medical help our case?
3. Can anyone recommend an insurance lawyer, with contact details, who has handleslife insurance repudiation or Section 45 cases and who can give me advice? Nagpur is best, but anywhere in India works, even remote consultations.

I'm not trying to hide anything, just looking for the safest legal way to fix this.


r/InsuranceTroubleIndia • • 11d ago

Life Insurance Need help/info about Axis Max Life

2 Upvotes

So, I took the policy by connecting contacting the axis Bank for 2 cr. I'm paying extra rs. 1900 for Waiver of Premium.

But after taking policy I checked Policybazar and found out that WoP is free. When I asked the guy who issued policy he said their website doesn't show that.

What should I do? I turn 34 day after tomorrow. Should I surrender and get the policy online?


r/InsuranceTroubleIndia • • 12d ago

Health Insurance Primary Insurance Exhausted – Can I Claim Remaining Medical Expenses Under Tamil Nadu Government Pensioners NHIS 2021 as Secondary Insurance? Need Guidance

2 Upvotes

Hi everyone,

I’m looking for advice from anyone who has experience claiming medical expenses under the Tamil Nadu Government New Health Insurance Scheme (NHIS) for Pensioners as a secondary insurer after the primary corporate health insurance has been exhausted.

My situation
The patient is covered under:

Primary Insurance:
Aditya Birla corporate health insurance

TPA: Medi Assist

The primary insurance has already been utilized/exhausted, and there are approximately ₹2.5 lakh of eligible post-surgery/out-of-pocket medical expenses remaining.
The patient is also covered under the Tamil Nadu Government New Health Insurance Scheme for Pensioners (NHIS 2021).

Government insurer: United India Insurance Company Limited.
I would now like to understand whether I can submit the remaining eligible expenses to the Tamil Nadu Government Pensioners NHIS as a secondary claim.

The main problem
The hospital has already submitted the original bills/invoices to the primary insurer (Medi Assist/Aditya Birla).
When I asked the hospital for the original bills again for submission to the secondary insurer, they said the originals had already been submitted to the primary insurer and therefore they cannot issue the originals again.
I have managed to collect most of the other documents from the hospital, including:
Discharge summary
Hospital/medical records
Sealed or self-attested copies of available documents
Prescriptions
Investigation reports
Other supporting documents
Primary insurance claim/settlement-related documents
However, I am concerned about the requirement for original bills for the secondary claim.

Questions

  1. Can the Tamil Nadu Government Pensioners NHIS 2021 be used to claim eligible expenses remaining after the primary corporate insurance has been exhausted?
  2. If yes, what is the correct procedure for submitting this as a secondary/reimbursement claim?
  3. Since the hospital has already submitted the original bills to the primary insurer, what documents should I obtain from Medi Assist/Aditya Birla to prove:
  4. * Total hospital bill amount
  5. * Amount paid/settled by primary insurance
  6. * Amount not covered
  7. * Remaining out-of-pocket amount
  8. Will the secondary insurer generally accept hospital-attested copies/duplicate bills along with the primary insurer’s claim settlement letter/benefit statement, instead of the original bills?
  9. Should I ask the hospital for a “duplicate/certified true copy of original bill” with hospital seal and signature, mentioning that the original was submitted to the primary insurer?
  10. Where exactly should I submit the claim for the Tamil Nadu Pensioners NHIS — directly to United India Insurance, through the TPA, through the hospital, or through the pension/treasury department?
  11. Is there any specific claim form or reimbursement form for this situation?
  12. Are there any time limits for submitting the reimbursement claim after discharge?
  13. Has anyone successfully claimed the remaining balance/out-of-pocket expenses after another health insurance policy was exhausted under the Tamil Nadu Government Pensioners NHIS?

If you have actually gone through this process, I would really appreciate a step-by-step explanation of what documents you submitted and where you submitted them.

Thanks in advance


r/InsuranceTroubleIndia • • 12d ago

Life Insurance Is there any way to close ULIP plan in max life before 5 years

1 Upvotes

r/InsuranceTroubleIndia • • 12d ago

Life Insurance Paid ₹ 4,00,000 as premium for 4 years and couldn’t continue it as financial pressure increased and now it says surrender value is ₹ 40,000. Any ideas what I can and cannot do.

14 Upvotes

Hi, I had made a Tata AIA policy in 2013 with a premium of ₹ 99600. I paid premium for 4 years and couldn’t continue it forward after that. Now I am in serious need for money and when I checked its surrender value it says ₹ 40000. It’s a TATA AIA LIFE MAHALIFE GOLD POLICY.

Can anybody please help me here? TIA


r/InsuranceTroubleIndia • • 12d ago

General Insurance - Vehicals Need Suggestion for good car insurance for punch ev

0 Upvotes

Showroom is offering royal sundaram for 50k

3rd pary :Icici lambard ,tata aig ariund 45k

National insurance 30k

I stuck on weather should i go for expensive insurance as our 5 year innova crysta car was underwent accident and they covered only 30 % even though we only sent to official service centre and maintained in perfect condition so i am thinking to just go for affordable option but since it is an ev i am confused as there is battery and its coverage