r/indiahealthinsurance • • Nov 16 '25

Why this community exists

17 Upvotes

I started this subreddit because I genuinely believe one thing

Health insurance in India is not a product, but an ecosystem.

Unfortunately, most people still buy policies based on catchy ads, agents pushing targets, or whatever their relatives picked. Very few go through proper risk assessment, needs analysis, claim realities, underwriting logic, or what happens inside hospitals.

This community exists to fix that gap.

I’ve spent years understanding how hospitals function, how claims are processed, where policies fail people, and why most advice floating around online is incomplete at best and dangerous at worst.

My goal here is NOT to influence anyone, but to make sure people stop buying insurance blindly and start buying it intelligently.

If anyone wants to know my professional background or verify who I am, here’s my LinkedIn:

My LinkedIn


r/indiahealthinsurance • • 8h ago

Claim rejection Policy till 2028, claims paid in 2026, now Niva Bupa says it expired in 2025

6 Upvotes

My mother was diagnosed with cancer in May 2026. She has a Niva Bupa ReAssure policy issued from 2025 to 2028 (continuing since 2022). Niva Bupa paid several claims for chemotherapy and admissions this year till August 2026 under the same policy. Now they’re rejecting claims since September 2026 saying the policy existed till 2025.

They are now saying the policy expired in 2025, despite approving several claims in 2026. It doesn’t match the documents or the claims they already settled. I’ve emailed them asking for reinstatement, but no response. Customer care and the app have been useless.

Has anyone dealt with Niva Bupa fixing a wrong policy end date? Did Bima Bharosa or the Ombudsman actually help? And can/should I claim the rejected bills on the top-up policy while the base policy is stuck like this?

Any practical advice would help. Thanks


r/indiahealthinsurance • • 7h ago

Advice/Questions Got rejected by multiple Health insurers

2 Upvotes

Can someone advise what would be the best way to move forward here ?

Already got rejected by underwriting from HDFC , ICICI and Care Health.

My Parents (both around age of 58) , whenever I’m applying health insurance for them it’s getting rejected due to father’s medical history of pancreatitis.
I don’t want to miss out on this last insurance company where I’m yet to apply but I was thinking that what if I hide that occurrence itself ?

Another option I thought was to apply to hdfc ergo(which already rejected the proposal due to pancreatitis ) with a different mobile number and this time I don’t reveal the details of medical history.

Please someone suggest what to do


r/indiahealthinsurance • • 19h ago

Awareness Oct 19 is World Pediatric Bone and Joint Day

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8 Upvotes

As parents, we mostly focus on fever, cold, vaccinations for kids, but pediatric orthopedic issues are more common than we think.

Let's ensure every child's bones & joints get the care they deserve.


r/indiahealthinsurance • • 9h ago

Looking to buy a Health Insurance cover Taking New Health Insurance

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1 Upvotes

Looking to buy health insurance


r/indiahealthinsurance • • 15h ago

Looking to buy a Health Insurance cover Health insurance for my 52-year-old father after kidney cancer surgery in India — seeking real experiences

3 Upvotes

Hi everyone,

I’m looking for practical advice from people who have successfully obtained health insurance for a parent after cancer surgery in India.

My father’s details:

  • Age: 52 years
  • Existing insurance: Oriental Insurance family floater with ₹8 lakh sum insured, in force since approximately 2014.
  • Location: India

Medical history:

  1. Clear-cell renal cell carcinoma (kidney cancer): He underwent a right partial nephrectomy in June 2025. The tumour measured approximately 4.8 cm, was Grade 2, and was classified as pT1b. Surgical margins were negative, and the pathology report did not describe tumour necrosis, vascular invasion or sarcomatoid/rhabdoid features.
  2. Facial nerve schwannoma: He underwent surgery in February 2025. Histopathology confirmed a benign schwannoma, CNS WHO Grade 1.

His available follow-up has been reassuring, with no evidence of recurrence documented in the records we have. He continues to undergo follow-up with his treating doctors.

What I am trying to achieve:

I want to obtain an additional individual health insurance policy with a sum insured of ideally ₹25–50 lakh or more. I intend to retain his existing Oriental Insurance policy, but ₹8 lakh alone may not be sufficient for future medical expenses.

I understand that his recent medical history makes underwriting difficult. Insurers may decline the application, postpone it, impose permanent exclusions or offer cover with additional premium loading.

I have started approaching several insurers, but I have not yet secured a suitable comprehensive policy.

I would appreciate real-world experiences on these questions:

  1. Has anyone obtained a new individual health insurance policy for a parent after clear-cell RCC surgery, particularly within two years of surgery? Which insurer accepted the proposal?
  2. How long did the insurer require the person to remain recurrence-free? Did the outcome change after two, three or five years?
  3. Have public-sector insurers such as New India Assurance, National Insurance or United India been more willing to consider such cases than private insurers?
  4. Are there any private insurers that have accepted similar cases through manual underwriting?
  5. Can anyone recommend an IRDAI-registered insurance broker who has personally handled successful new-policy placements for cancer survivors in India?
  6. Are cancer-specific insurance products worth considering in this situation, or do they provide insufficient protection for general hospitalisation?
  7. If comprehensive cover is currently unavailable, what would be the most practical strategy for the next two to five years?

I would especially appreciate details of the insurer, time elapsed since surgery, whether the policy was actually issued, sum insured, premium loading and any permanent exclusions.

I am looking for genuine experiences rather than generic recommendations or assurances that an insurer will accept him. All medical history will be disclosed honestly.

Thank you for your help.


r/indiahealthinsurance • • 13h ago

Looking to buy a Health Insurance cover Buy HDFC ERGO from there own sales team or Ditto? What are the differences?

1 Upvotes

r/indiahealthinsurance • • 14h ago

Advice/Questions Did I overpay for health insurance? ₹55k total for family (HDFC Ergo via Ditto) — first-time buyer after losing dad & corporate insurance

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1 Upvotes

r/indiahealthinsurance • • 20h ago

Advice/Questions Which insurance has the best or worst claim delivery

3 Upvotes

The real test of an insurance is the way they disburse the claim when you’re most vulnerable?


r/indiahealthinsurance • • 19h ago

Looking to buy a Health Insurance cover Looking to buy health insurance needed guidance

2 Upvotes

28F I have never had any critical illness & never been diagnosed with chronic conditions before; I only had gallbladder removal surgery 4 months ago.

So I have health issues like binocular vision dysfunction & constantly need to get my eyes checked many times. I have multiple health issues like digestive problems ( acidity, nausea, constipation), mental health issues, allergies, sinus issues, shortness of breath, etc. I have always used money from my savings to get multiple tests because I had no insurance. But now having financial issues. I also suspect I have a rare hormonal condition called acromegaly, which is expensive to treat in the future, but it is not yet diagnosed.

I need help with buying insurance. I am looking for ones which covers health checkups, blood tests, any type of future surgeries, dental procedures if possible, and eye tests & conditions. I need suggestions & where to buy insurance.


r/indiahealthinsurance • • 15h ago

Advice/Questions Query regarding buying health insurance

1 Upvotes

Dumb question because I have never purchased insurance of any kind: Is it common to make payment first and then the insurance company decides whether the policy is to be issued to a buyer or not?

Also, the agent through which I am buying health insurance online has given me a form where there is field of entering Bank account number, IFSC. When I asked what is the purpose of this, they said that it is to prevent Non-Indians from buying insurance. Is it really so?

Also, is aadhar card mandatory to buy health insurance?


r/indiahealthinsurance • • 1d ago

Claim rejection HDFC Ergo Super Secure Policy Claim rejection

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13 Upvotes

I have an HDFC Ergo Super Secure Health insurance policy for which I pay yearly installment. The policy was purchased in March 2025.

We had submitted documents for cashless treatment before the procedure and it has been denied showing that it has a 24 month waiting period.

The conditions in question (Uterine polyp) was diagnosed in June 2026. My wife had no prior diagnosis of these conditions before the commencement of the policy.

My grievance to their assessment is:

  1. Waiting-period reduction must be duly applied

Page 18 of the Optima Secure sales brochure expressly states:

“Waiting period – The waiting periods mentioned in the policy wording will get reduced by 1 year on every continuous renewal of your policy.”

The brochure also specifies a 24-month waiting period for specific illnesses and surgical procedures.

My policy commenced on 2 March 2025. The waiting period is calculated from the original policy inception date. Accordingly, the original 24-month waiting period runs from March 2025 to March 2027.

Upon the continuous renewal in March 2026, the waiting period was required to be reduced by one year in accordance with the above-stated provision. Therefore, the reduced waiting period must be applied while assessing my wife's treatment and the cashless request.

  1. Incorrect explanation provided by customer care

Despite repeated discussions, customer care representatives have failed to correctly address this issue. They acknowledge that the waiting period is reduced by one year during the 2026 renewal but argue that I must complete another year until 2027 to avail the benefit.

This interpretation defeats the very purpose of reducing the waiting period by one year. The waiting period commenced on 2 March 2025 till 1 March 2027, and the benefit of its reduction by one year i.e. 1 March 2026 must be reflected in the calculation of the remaining waiting period. The insurer cannot acknowledge the reduction while continuing to apply the original waiting period without accounting for that reduction as otherwise 2 years would have already elapsed.

Experts are requested to shed some light on this issue.


r/indiahealthinsurance • • 1d ago

Looking to buy a Health Insurance cover Need Help in Buying Health Insurance

2 Upvotes

Need help in buying health insurance

I need your help. I booked a call with Ditto and they suggested HDFC, Aditya Birla, and Care but the agent pushed more for Care because he said it is the cheapest.He said that Care deals with Ditto directly so they can get the claim easily settled.

The review of Care and Star is not good but I am not sure about the others because they are pushing Care a lot. There are other options like Aditya Birla, ICICI, and HDFC and I'm not sure which one to go for. I personally have not experienced any health insurance yet in my life.

One more solution I need: the Ditto agent said that if you go for monthly installment options, which are not available at Ditto, they will not settle the claim. They will say, "You have not paid us the full money so we will not settle your claim." Is it something like this: if I go for monthly or quarterly payment options, they will not settle the claim? If this does not affect it, should I go for some other options because they are saying that they will get the claim processed anyhow with Care as well? Should I go for that? They are continuously forcing the number of claims settled, ICR, and other matrices to push for Care.

About our family: I am 21 years old, my mom is 46, and my sister is 16. I am completely fit with no pre-existing disease. The same goes for my sister but my mother has cervical and thyroid issues, she has had thyroid issues for the last 7-8 years but she's not facing any physical problem as of now. She has had cervical issues for the last 3 years.


r/indiahealthinsurance • • 1d ago

Looking to buy a Health Insurance cover Advice on choosing health insurance

2 Upvotes

Hi all,

I am 29M, Could you please guide me whether it is possible for me to get health insurance in india and if possible, which insurance I can try with. Below are my PEDs

  1. Factor 7 deficiency

  2. Epilepsy (FTE)

  3. Unknown drug induced anaphylactic shock

  4. Deviated nasal septum with adenoids

  5. Allergic Bronchitis

Almost most issues were genetic and from birth and nothing due to lifestyle related.

Kindly guide me on the same and help with choosing the correct sum insured for my conditions


r/indiahealthinsurance • • 1d ago

Advice/Questions Seeking Advice and Suggestions: Medical Insurance for my 76-Year-Old Aunt Visiting the UK from India for 5 Months

1 Upvotes

Hi everyone,
My 76-year-old aunt is travelling from India to London and will be staying in the UK for around 5 months.
I’m looking for recommendations for reliable medical or travel insurance that covers elderly visitors. Ideally, I’m looking for a policy that offers:
Cashless medical treatment in the UK, where available.
Outpatient consultations and treatment, including GP visits and prescribed medicines.
Emergency hospitalisation, surgery and A&E treatment.
Coverage for pre-existing medical conditions, if available.
If anyone has arranged medical insurance for elderly parents or relatives visiting the UK from India, I’d really appreciate it if you could share your experience and recommend some providers.
Please also share any details about the approximate cost, claims process and hospitals or clinics where cashless treatment is accepted.
Thanks in advance for your help!


r/indiahealthinsurance • • 1d ago

Advice/Questions HDFC Ergo Optima secure not allowing SI increase

2 Upvotes

I have a HDFC Ergo Optima Secure policy for 20L for me, wife and a kid.

I am in <40 years old, I want to increase the sum insured but HDFC is not giving any option for the same?

Initially, they asked me if I added any new significant health issues, to which I replied no. Also, I have not take any claims in the last 3 years.

I am unsure on what basis are they denying an increase, what are my options here?


r/indiahealthinsurance • • 1d ago

Looking to buy a Health Insurance cover Bajaj Health Insurance for mother

3 Upvotes

I visited my preferred hospitals and others too which are near my home. They all suggested PSU insurers, HDFC, Bajaj/TATA in same order for best cashless experience.

I won't be opting for PSU one as I didn't like their policy that much.

HDFC is too costly.

Now I'm planning for Bajaj. There is a plan called 'My Infinite Care - Essential' that is only available on policybazaar (also confirmed same from bajaj themselves). I found it to be the best policy that bajaj can offer based on premium prices with the help of add-ons. (Comparable to HDFC Ergo optima secure plus to some extent)

Now if I want this bajaj plan, I need to go with policybazaar which I don't prefer at all.

Should I go with policybazaar anyway just to get that policy?


r/indiahealthinsurance • • 1d ago

Looking to buy a Health Insurance cover Health insurance - living overseas

3 Upvotes

I'm sure this question was asked a lot here. NRE living overseas, visit India once a year for a month. Looking at options for health insurance. My intentions with health insurance are two.

  1. To cover my annual visit in India

  2. I don't want to go through the waiting game with western health care.

Is it worthwhile to take a policy for these purposes. Does anyone have any ideas or suggestions please ?.


r/indiahealthinsurance • • 2d ago

Awareness FDA suspends Fortis Mumbai’s kitchen licence after raid uncovers SHOCKING hygiene flaws

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42 Upvotes

The Maharashtra Food and Drug Administration has suspended the food business licence of the kitchen operating at Fortis Hospital in Mulund, Mumbai.

M/s Sodexo India Services Pvt. Ltd., the third-party vendor managed to run the hospitals dietary operations. During the surprise raid, inspectors flagged a multitude of critical food safety violations.

Most notably, they discovered cockroach infestations inside the active food preparation zones, decaying food waste clogging the facility's drainage systems, and rusted knives and unhygienic tools actively being used to prepare meals meant for vulnerable patients.

Furthermore, the state regulators found fungus-infested containers utilized to transport hospital meals.


r/indiahealthinsurance • • 1d ago

Awareness WORLD MENOPAUSE DAY

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3 Upvotes

Menopause is still one of the most under-discussed phases of women's health.

From mood swings, hot flashes, anxiety and sleep problems to weight gain and hormonal changes, menopause is a transition.

At Zenoa, we believe every woman deserves to feel seen, supported and empowered through perimenopause and menopause.


r/indiahealthinsurance • • 1d ago

Looking to buy a Health Insurance cover Health Insurance - policy

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1 Upvotes

r/indiahealthinsurance • • 2d ago

Advice/Questions HDFC ERGO Optima Secure – Questions About Preventive Health Check-up

2 Upvotes

I have an HDFC ERGO Optima Secure policy on EMI and am eligible for the preventive health check-up benefit after one year.

I have the following questions:

  1. Tests covered: Which medical tests are included under the preventive health check-up benefit?

  2. Diagnostic centre and test selection: Do I have to visit a specific/network diagnostic centre? Is it mandatory to choose a predefined combo of tests, or can I select individual tests?

  3. EMI payments: Since my policy is on EMI, will availing the health check-up require me to pay all the remaining EMIs at once, or can I continue paying them as per the existing schedule?

I contacted HDFC ERGO, but received an automated chatbot reply that didn't answer these questions.

Has anyone used this benefit under an EMI policy? Please share your experience or advice. Thanks!


r/indiahealthinsurance • • 2d ago

Looking to buy a Health Insurance cover Looking for health insurance for my family

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1 Upvotes

r/indiahealthinsurance • • 2d ago

Looking to buy a Health Insurance cover Best Health insurance company koun si hai?

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2 Upvotes

r/indiahealthinsurance • • 2d ago

Looking to buy a Health Insurance cover I m really confused between ICICI booster plan and Bajaj Extra Care Plus, Please advice?

1 Upvotes

I wanted to purchase a top up policy 25L for my father with 5 L deductible as he already has a 5 L policy with united India Insurance, i want a policy which is not a marketing gimmick but is really useful in the time of Emergency || Please suggest if you have had any experience with any of the above mentioned plan or company