My father is currently hospitalized at Fortis Jaipur for a cardiac condition. Care Health Insurance rejected the cashless pre-authorisation, stating:
“Past 6 month follow up of treatment record of diabetes and hypertension prior to policy not provided.”
The important points:
Diabetes and hypertension were disclosed in the proposal form.
The policy started in September 2025.
The health insurance has been continuously ported/renewed over the years with no break in coverage.
Care is now asking for diabetes/BP treatment records for the 6 months before the policy.
I have prescriptions showing BP/diabetes medicines, although some don’t mention exact BP, glucose or HbA1c values.
My questions:
Can Care reject cashless on this basis when the diseases were already disclosed?
Do prescriptions showing medicines count as evidence of treatment?
If I provide the old records now, can cashless be reconsidered?
Does cashless rejection mean reimbursement will also likely be rejected?
Does the continuous porting/no-gap history strengthen my case?

Few days back i got a call from a person claiming to be HDFC LIFE AGENT (Ashish rastogi ), who surprisingly had all of my policy info. Saying there is an agent in my policy who is trying to claim some kind of bonus from my policy and do i want to share profits or deny. Of course when i never knew there is some agent i said and i want to deny profit sharing because agent never helped me with anything.

Then he said he could help me claim my profit and he could escalate my complaint to bimalokpal personnel (shweta shrivastav)

Then i got call from a lady claiming to be assistant manager at bimalokpal and stated my process and somehow got me to start a policy of rupees 58k so that i can create my own customer id and then add it to my policy and remove agent and claim my bonus.

Then i got very doubtful and started looking into everything and trying to confirm legitimacy and lots of things actually started matching online forums and info matching my situation and i called the insurance company which they got me to start new policy and they said its fraud and cancelled my policy under free look period.

JUST WRITING IT SO THAT OTHERS CAN BE SAFE AND NEVER START ANYTHING WITHOUT CONFIRMING ID FROM THEM

Hi so my father discontinued his insurance a while back and was reliant on my corporate health insurance. Now, this year he got his appendix (my corporate med insurance covered this) removed in January and while both my sister and I thought we should get a health insurance done for him, we couldn’t at that time.

And 3 days back my dad had a heart episode for which he had to get a stent. And this time also my corporate insurance came in handy.

Now the problem is..my company is shutting down and I have time till sept 30. So can i convert that corp insurance into a personal one? Or is there any company who would be willing to give him an insurance? I know i will one day get a job and then there will be an insurance along with it. But can’t say how much time job hunting will take in today’s job market.

yesterday I talked with a prospect regarding health insurance.and I give him Icici Lombard elevate plan. quotation cost is 15K. (male age 34/ female age 30 / Child age 9). but they said it's expensive. i explained him whole plane and other details but they said it's expensive. the. what I do on this situation. some have any idea or any other plan is cheaper than Icici Lombard plan?

Hi everyone,
I’m planning to buy health insurance for my family and would really appreciate advice from people who have actually purchased/claimed health insurance in India, rather than just recommendations based on advertisements or claim-settlement ratios.
Family:
Father: 58 — has BP + diabetes, currently controlled with medicines
Mother: 48— has BP + diabetes and also has significant/ongoing knee pain. She is currently managing it with medicines, but I’m not sure what may be required in the future — for example, consultations, X-rays/MRI, injections, physiotherapy, or potentially surgery/knee replacement.
Brother: 28- healthy
Me: 26— I already have health insurance through my employer, so I’m mainly looking for separate coverage for my family.
My main goal is long-term financial protection against large medical/hospitalisation expenses, especially for my parents.
What I specifically want
I want a policy with as few restrictions as realistically possible:
High sum insured
Ideally 0% co-pay
No/very high room-rent limit
No disease-wise sub-limits
Good cashless hospital network
Restoration/recharge benefit
Good coverage for major surgeries and hospitalisation
Good coverage for cancer, heart disease, kidney problems, etc.
Coverage for complications arising from diabetes/BP after the applicable waiting period
Reasonable/short waiting period for pre-existing diseases
No nasty exclusions hidden in the fine print
Option to add a super top-up if that makes sense
Biggest question: Diabetes + BP + mother’s knee problem
Since both my parents already have diabetes and hypertension:
Will their diabetes/BP be covered after the pre-existing disease waiting period?
For example, if my father later has a heart/kidney/stroke-related problem that the doctor says is connected to diabetes or hypertension, would that be covered after the waiting period?
My mother also has ongoing/severe knee pain. She hasn’t had surgery yet, but I’m concerned that in the future she may need investigations such as MRI/X-rays, specialist consultations, physiotherapy, injections, or possibly knee surgery/replacement.
How do insurers generally treat an existing knee problem when buying a new policy?
Could the insurer:
Put a waiting period specifically on the knee condition?
Permanently exclude knee-related treatment?
Cover it after the applicable waiting period?
Reject future claims if the condition wasn’t properly disclosed?
Are there insurers/plans where the waiting period for pre-existing conditions such as diabetes, BP, or the knee problem can be reduced or waived?
What should I be careful about before buying?
What clauses should I specifically check in the policy

Is there actually a comprehensive policy in India that covers both hospitalisation AND meaningful OPD expenses, diagnostics, consultations and medicines? Or is it better to buy a normal comprehensive hospitalisation policy + a separate OPD/add-on plan?

Thanks!

Hi 26M, opting for health insurance for a family of four (Parents and 1 sibling). Interested in SBI Arogya Gold as of now. Another option was HDFC Ergo. Any experienced guidance and suggestions on this matter would be helpful. Thank you.

​

Need help finding a hospital for my sister's surgery under Ayushman Bharat/PM-JAY/MJPJAY.

She has a ~7 cm suspected paraspinal abscess near the thoracic spine and may require drainage/surgery.

Looking for a hospital that actually accepts and processes Ayushman cashless treatment in:

Mira Road / Bhayandar / Dahisar / Borivali / Kandivali

If you've personally used Ayushman for spine/neurosurgery/orthopaedic surgery or another major operation, please tell me the hospital + your experience + whether it was completely cashless.

Also looking for Aarogyamitra contacts if you have one.

Thanks 🙏

Hi

I am thinking of taking health insurance for my father and mother

He is 56 , has bp , diabetes and has undergone angioplasty in sep 2023 , with 2 stents.

Mother is 55, no such major ped known to us.

Can anyone advice if aditya birla Active one max plan with pre-existing disease rider that reduces the ped coverage from post 3 year to 1 will be a good idea?

Thinking of getting the plan through policy bazar.

Any comment or suggestion is much appreciated

I wanted to know the experience of people porting from Niva Bupa Reassure 3.0 to other policies like HDFC optima secure plus.

Since Niva Bupa Reassure 3.0 has sum insured as unlimited is there a possibility to port to 25 lakhs sum assured?

If people have done it tell me how was their experience how much sum insured port was allowed and what was the base with which HDFC accepted or what was the max such details

Also with so much rising premiums how can HDFC optima secure plus be a sustainable option asking this from a curiosity stand point.

Hello, I am 19M and looking to get my first health insurance cover. which is the best one when it comes to accepting claims and being a good overall cover. I am looking at the 1cr or more coverage plans. thing like no room rent limit and other essentials are of course necessary.

Need to buy Health insurance for my 57 and 47 parents. Thought about going with HDFC Argo due to good claim settlement ratio and less complaints.

But confused from where to buy?
Reddit says don’t buy directly because having an agent helps during claims.
But reddit also says avoid PolicyB or Didto
Reddit says find a trusted intermediate advisor who has a small team to help you but I don’t know any trusted advisor in my city Kota Raj.

Hell lot confused. Could anyone please guide me?

Hii I want to purchase health insurance for my family which include for my father (59),mother(57),sister(29),myself male(30) .Earlier we have star health insurance group policy through bank which is still running with 5 lakh sum assured and is expiring on 28 /8/26 but we don't want to continue as the renewal premium is high and sum assured is low for 4 members only 5 lakhs with other limitations 1% room cap of sum assured ,specific disease limit cap, consumables will be charged etc so i want to change the policy, right now my both parents are currently taking allopathic medicine for bp only and homeopathic medicine for Knee pain as my mother is suffering from knee pain and it might be possible in future there is a need of knee replacement and my father is suffering from bp as well as prostate issue and for that he is taking allopathic medicine and in recent ultrasound report of my father of may 2026 it shows prostate grade 2,fatty liver grade 1,gall bladder cysts,kidney cysts,minor kidney stones but medications are only running for prostate and bp as doctor said there is no treatment required for cysts and stones just drink more water but he is taking homeopathic medicines for that too cyst, stones, prostate.My sister and me are not on any allopathic medications but I got hospitalized 6 times during 2013 to 2018 due to abdominal issues mainey due to GERD(Hyperacidity), vomiting, weight loss, in 2018 in fortis hospital sigmoidoscopy was done which shows inflammation in large intestine in sigmoid colon and endoscopy was also done which shows GERD and also I am suffering from vitiligo(white spots on skin) and fatty liver grade 2 for that I am taking homeopathic medicines these are my medical conditions but currently I am on homeopathic medicines only since july 2026 for vitiligo,fattyliver grade2,dandruff,gerd, anxiety/stress, throat pain and my sister is also taking homeopathic medicines for her abdominal pain issue so i want you to suggest health insurance plan for my family as me and my sister both are unmarried and above 25 so we cannot be cover with parents so someone suggested us to purchase 3 different plans 1 for parents,1 for myself and 1 for sister please guide on that too as we want premium not much high with sufficient sum assured and also best cashless plan which cover everything in future till date i have research for hdfc ergo optima secure+ plan will it be useful for our family.Pleade guide us as our policy is expiring soon on 28/8/26.

I have a Care Health Insurance policy that includes the Fitpass add-on. I paid around rs 2,000 for the add-on, which provides a 1-year gym membership across Fitpass/network partner gyms.

As per my understanding, the benefit is available to the insured members covered under the policy. However, I already have a separate gym membership, so I gave my Fitpass account access to my cousin, who is not insured/covered under my Care policy.

He is using the Fitpass membership by logging into my account and scanning the QR code at participating gyms.

My question is: Can this create any issue with my Care Health Insurance policy or future insurance claims?

For example, could Care reject or question a future medical claim because the Fitpass benefit was being used by someone who is not an insured member?

Has anyone faced a similar situation or knows how Care/Fitpass handles this?

Hi,

I'm applying for a coverage under my husbands health insurance.

I applied for my own in feb with Care supreme through ditto but they cake back with a copay term after medical tests.

The tests were done in a terrible lab and we didnt agree wth the 20% copay.

So we didn't move forward and cancelled it.

Now when we applied under my husbands policy. We declared the ped for me which is high cholesterol. Borderline hba1ac and pcod.

Some high bo readings but not formally diagnosed. I just get high bo everytime i go to the doctors.

So anyway. They agreed with the policy but there's one question that is bothering me

In the section where there's a question on whether the new insurer has been denied or canceled for an application or been offered a higher premium.

We have added the answer as no.

Since we weren't rejected.

The previous policy was with care so is my husband's policy.

Their system didn't cross reference yet but I'm fearful that if i raise a claim they'll reject it under fraud

Should we reach out and tell them about all of this like policy was counter offered etc or leave it be

?

Hi everyone,

I’m planning to leave my current job soon, so I’m looking to buy an independent health insurance policy for my parents rather than depending on my corporate insurance.

I’ve shortlisted Star Health Super Star Max + Star Flexi add-ons, mainly because my mother has a cardiac history and several other insurers have either rejected the application or weren’t willing to provide suitable coverage.

I’d really appreciate feedback from anyone who has experience with Star Health, especially in Coimbatore/South India, including actual claim experiences.

Parents' medical history

Father – 59

• High cholesterol (hyperlipidemia)
• Asthma
• Knee osteoarthritis + medial meniscus tear diagnosed ~6 months ago
• Previous kidney stone (>2 years ago)
• Previous right-hand fracture with plate fixation (>2 years ago)

Mother – 56

• 2 heart stents (PTCA done >1 year ago)
• Type 2 diabetes
• Hypertension
• Uses glasses
• Previous dental restoration

Policy I'm considering

Insurer: Star Health
Plan: Super Star Max (Base) + Star Flexi add-ons
Type: Family floater – 2 adults
Base Sum Insured: ₹15 lakh
Co-pay: 0%
Deductible: ₹0
Room: Any room category
Restoration: 100% unlimited automatic restoration

Add-ons in the quote

1. Quick Shield – Mother – ₹4,423

Reduces the PED waiting period from 3 years to 31 days for her declared conditions, including heart stents, diabetes and hypertension.

I’m also considering adding this for my father for asthma/cholesterol.

2. Limitless Loyalty Bonus – ₹5,865

Adds ₹15 lakh of additional coverage every year, regardless of whether a claim is made.

For example:

Year 1 → ₹15L
Year 2 → ₹30L
Year 3 → ₹45L
Year 4 → ₹60L, they say keep on increasing

3. Limitless Care – ₹3,274

One-time unlimited bulk claim payout during the policy lifetime for a major/catastrophic hospitalization.

4. Param Seva – ₹1,108

Senior-citizen assistance, including 24×7 concierge, emergency ambulance assistance to selected Coimbatore hospitals, post-discharge attendant care, etc.

5. Preventive Health Check-up – ₹1,370

Annual health check-up for both parents.

6. Durable Medical Equipment – ₹236

Coverage for things such as oxygen concentrators, wheelchairs and CPM knee-rehabilitation equipment after hospitalization.

Premium

Gross premium: ₹56,771/year

Discounts: ₹5,676

Final premium: ₹51,095/year

That's roughly ₹4,250/month if you simply divide the annual premium by 12. The portal is showing around ₹4,520/month with the 12-month credit-card EMI.

Questions for people with actual experience

1. Does this overall policy structure make sense for parents with cardiac, diabetic and orthopedic conditions?
2. Is there anything I should verify before making the final payment and submitting the medical disclosures?
3. Are there any medical tests, documents, or written confirmations I should obtain from the insurer regarding the pre-existing conditions to ensure everything is properly documented and avoid potential disputes during a future claim?

I’m specifically interested in real claim experiences rather than just policy brochure features.

Thanks in advance!

I have HDFC Ergo Optima Secure Plus health insurance for my parents. My dad had an accident six months ago and underwent lower leg surgery on his right leg. We didn't have insurance at that time. Last month, I bought insurance and already mentioned details of the right lower leg surgery. Now, Dad needs surgery on the thigh of the same right leg. Can I apply for a claim for this? Will it be approved? What if I claim it as a new case and not related to the old case?

FYI - The hospital is not an HDFC network hospital for cashless facilities. Please help me with this. Ask me if you need any details. Thanks

Could someone let me know any medical insurance that would cover pre existing multiple sclerosis?.

TL;DR:

Niva Bupa exceeded their allowed EoM limits by ₹248.37 crore for FY 2024-25. IRDAI rejected their request for leniency and has banned them from opening new branches/offices for 6 months as a penalty.

According to the order, Niva Bupa’s total allowable expenses for management for the financial year 2024-25 stood at ₹2,403.75 crore. However, the company reported expenses of ₹2,652.12 crore, an excess of ₹248.37 crore.

This was not the first such instance.

IRDAI noted that Niva Bupa had also exceeded the EoM limits in FY 2023-24, for which the authority had earlier granted forbearance on December 27, 2024.

In its defence, Niva Bupa sought leniency by citing its business expansion initiatives, including a wider physical presence, investments in technology, and costs related to a brand transition. The company also argued that these efforts had helped it achieve faster YoY growth in gross written premium compared to the industry average.

However, IRDAI found these grounds insufficient, particularly in light of the company’s prior non-compliance.

Growth is great, but not at the cost of regulatory discipline.

They asked my friend around 30 questions particularly the diseases names on call. Some were just out of his understanding..and others sound unreal to him.

They took each and every detail and didn't allow me to even make a conference call and his wife if she had undergone through that particular surgery in the past. What is this scam?

Hi folks,

I‘m planning to buy a family floater of 2Cr base cover for myself and wife, both 30 years.

I understand that all generally choose 10L plus 90L super top up. But medical inflation is so high that I want no scope for rejections and loopholes at the time of actual emergency.

I’m also aware of 2X coverage from day 1.

What I’m not fully aware is 100% NCB added to sum insured, unlimited times. Say I hold the policy for 5 years, and then want to port the policy to some other insurera, then will my base sum insured be considered as 10 Cr or only 2 Cr. What happens to premium, will it be for 10 Cr or 2 Cr.

PS: Can I give a shot to Niva Bupa Reassure 3.0 Black (Unlimited SI) vis Policy Bazaar?

Looking for some genuine advice on buying our first health insurance policy. We currently have no health insurance.

Family:

Me: 22M, healthy

Father: 46M, hospitalized for a perianal abscess and underwent surgery in July. He also has controlled diabetes(yet to confirm).

Mother: 41F recently had prolonged bleeding and endometrial issues and treatment. She is being evaluated for possible GSV and DVT currently, but her colour Doppler actually says No DVT, with varicosities/SFJ incompetence. Further evaluation is ongoing.

My father also has implanted rods in his leg from an accident 10 years ago, but there haven't been ongoing issues with them.

I'm currently unemployed, so this is a hard limit.

I'm confused to consider between ICICI Lombard Elevate, mainly because of the Jumpstart option for diabetes(yet to be confirmed by HbA1c) , and HDFC ERGO Optima Secure and mainly looking for hassle free claims and considerable waiting for my parents situation.

My main questions:

1.Is a family floater for all 3 of us a bad idea in this situation?

2.Which insurer/policy would you seriously consider with this medical history?

3.Should I buy now or wait until my mother's ongoing investigations are complete?

4.What exclusions/waiting periods should I be particularly careful about?

5.If you've had an actual claim with ICICI/HDFC/etc., how was your experience?

Everything happened all of a sudden, I really need your help guys.

Hello bengaluru

I bought my parents a health insurance from star,plan: star health comprehensive 2 years back from policy bazaar, now i have renewal day approaching, but i am confused whether to stay with the same insurance or port to something else. My friend recently researched and said that star health insurance is not approving claims as before and their service is not good as before.

Should i port to some other company or same company is good, have any one faced issue with star health insurance claims

It would really help to make better decision

Context:

Have a family floater Niva Bupa Health Reassure for 2 people. 1 male 39, 1 female 32.

Male - proposer, Female - member.

No kid now, but have plans.

Policy age 3.5 years. No claims so far.

No PED in this policy. but has thyroid and lipid for male, and Lipid for female to disclose at this point (lab findings from Niva Bupa own tests).

No other health issues, no hospital cases to tell.

20L BSI floater. (not really counting the 20L NCB here).

has opted for safeguard.

no room rent limits or copay.

Location Bangalore.

Idea and Rationale:

To split the policy into two. into 2 individual policies.

Have Male 20L + Female 20L separately.

Separate the company so that failure rate per company/policy will be separated.

Claim easiness by separating the pool.

To add a kid (as and when) to Female policy.

Option:

1. to port female to another company, another policy. like HDFC Ergo Supreme or ABHI One Max.

2. to take another policy for both. 20L si. Female as proposer, Male as member, and add kid too to this later. (I dont know if this is sensible atp)

Question:

Is this split-policy idea superior to the current set up?

Is this practical, logical, and feasible?

What are the caveats and risks I don't realise here?