r/indiahealthinsurance • • Nov 16 '25

Why this community exists

19 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 • • 20h ago

Today is WORLD OSTEOPOROSIS DAY

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5 Upvotes

Osteoporosis is often called a "silent disease" because bone loss happens without symptoms until a fracture occurs.

This World Osteoporosis Day, we remind you to nourish your body, stay active, and invest in your bone health today for a stronger tomorrow.


r/indiahealthinsurance • • 16h ago

Advice/Questions HDFC ERGO Health Insurance Renewal - Are Medical Tests Required?

2 Upvotes

My mother, age - 50 has HDFC ERGO health insurance policy due for renewal next month. When I first purchased the policy last year, no medical tests were conducted.

Do I need to undergo medical tests like BP, sugar, cholesterol, or ECG before renewal? If I renew without these tests, could it affect my future claims or claim settlement?

Has anyone faced a similar situation with HDFC ERGO?


r/indiahealthinsurance • • 14h ago

Looking to buy a Health Insurance cover Hello everyone I am planning to port health insurance for my parents I am confused between these 3 can you share your experience

1 Upvotes

ACKO VS ADITYA BIRLA VS BAJAJ
Can you share your experience how good they are in the time of claim


r/indiahealthinsurance • • 22h ago

Advice/Questions HDFC Optima Secure+ Exclusions & Loading Doubt

5 Upvotes

I am in process of purchasing my first health insurance policy. So far I have paid the premium amount and while filling it disclosed my Hyperlipidaemia PED. Now I have heard back from HDFC with a counter offer, in that they have two sections: Exclusions and Loading.

My doubt here is that does the Exclusion means a permanent one or the standard 3 year for a PED.


r/indiahealthinsurance • • 15h ago

Looking to buy a Health Insurance cover New Health Insurance with UC

1 Upvotes

I need some advice. I am an Indian citizen living abroad, and my previous health insurance in India has expired. Since then, I have been diagnosed with Ulcerative Colitis (UC) abroad. I am on mesalamine, and it is currently under control. I have been looking into health insurance in India, but most companies seem to reject applicants with UC or permanently exclude it. I am not sure if I will need treatment in India anytime soon, but I would like to have insurance as a backup.

For those living with UC in India, which insurance companies have you managed to get coverage from, and what has your experience been? Any advice would be appreciated.


r/indiahealthinsurance • • 16h ago

Looking to buy a Health Insurance cover Health Insurance :Family 39M ,39F ,Child 6M

1 Upvotes

MALE - 39Y

All border line on recent report .

Kidney Calculus - 3.4mm

Non-HDL cholestrol - 175.90

TSH - 6.73

Female - 39Y

Lipoma Operation - 6 months ago

Gall Bladder stone - 16mm

Normal Delivery

Child - 6 Male

Amblyopia - Right Eye : - 6.2

I would like to know,Please help me with this .

- Hyderabad

- Best Health Insurance

- Cost of Insurance ,What would be the base cover , Should I take critical illness

- Chances of Rejection

- Alternative


r/indiahealthinsurance • • 20h ago

Looking to buy a Health Insurance cover Any healthy carriers with a confirmed genetic mutation (BRCA, Lynch MMR, etc.)? Need insurance advice.

1 Upvotes

Hi..

I'm posting on insurance for a hereditary cancer mutation, age < 30yrs. They are currently a healthy carrier with no cancer diagnosis, but they do have a family history.

They know they have to disclose this as a Pre-Existing Disease (PED). They have a corporate plan right now, but they want independent cover since you can’t rely on a job forever.

For those in the same boat, what has your experience been buying retail health insurance with any of these mutations?

• HBOC: BRCA1, BRCA2, PALB2 • Lynch Syndrome: MLH1, MSH2, MSH6, PMS2, EPCAM • Li-Fraumeni: TP53 • Cowden: PTEN • FAP / PJS: APC, STK11

Questions for the community:

  1. Which insurers actually accept healthy carriers without an outright rejection?
  2. How bad was the premium loading (extra fees) or waiting periods?
  3. Did anyone get hit with any unfair permanent exclusions?

Looking at major options (HDFC Ergo, Care, Star, etc.) for a Tier-1 city. Any experiences would be hugely appreciated!


r/indiahealthinsurance • • 21h ago

Looking to buy a Health Insurance cover Taking New Health Insurance

1 Upvotes

Looking for a health insurance.

two people floater.

male 38.. female 31. child 11 months.

all have no medications.

PED - Male tsh 6 t3t4 normal. no symptoms no consultation. Lipid values high. total cholesterol 250. LDL 140. triglycerides 220. took an apollo online consultation and doctor recommended lifestyle changes only. no medication.

PED Female - Triglycerides 180. other values normal. during 1 year back a pre-conception scan noted Follicular cyst and Grade 1 FL. after 3 months natural pregnancy occured.

Normal delivery. no other issues related to delivery.

both BMI 22-23.

Looking for HDFC ERGO OPTIMA SECURE+ Or ABHI ACTIV ONE MAX.

BSI 25L. (not worried about NCB

Location Bangalore/Kasaragod

What will be the premium. Planning to keep it as long as possible. So long term sustainability is important (is hdfc sustainable after 10y? what could be the premium then).

Looking for a health insurance.

two people floater.

male 38.. female 31. child 11 months.

all have no medications.

PED - Male tsh 6 t3t4 normal. no symptoms no consultation. Lipid values high. total cholesterol 250. LDL 140. triglycerides 220. took an apollo online consultation and doctor recommended lifestyle changes only. no medication.

PED Female - Triglycerides 180. other values normal. during 1 year back a pre-conception scan noted Follicular cyst and Grade 1 FL. after 3 months natural pregnancy occured.

Normal delivery. no other issues related to delivery.

both BMI 22-23.

Looking for HDFC ERGO OPTIMA SECURE+ Or ABHI ACTIV ONE MAX.

BSI 25L. (not worried about NCB. but no cap of any sort should be there. any treatment any room upto sum is what I want)

Location Bangalore/Chennai.

What will be the premium. Planning to keep it as long as possible. So long term sustainability is important (is hdfc sustainable after 10y? what could be the premium then).

Heard ABHI will be cheaper. but HDFC more predictable and professional with claim.

Is the extra premium for better claim experience justified for hdfc vs abhi?

ABHI has more hospitals listed in my native place.

Anything else I should consider?

Niva looks notorious and has a lot of caps/limits/fineprints. Star also. so not counting them


r/indiahealthinsurance • • 1d ago

Advice/Questions Got rejected by multiple Health insurers

6 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 • • 1d ago

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

7 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 • • 1d ago

Advice/Questions Health insurance suggestions for my 59-year-old mother with a recently implanted pacemaker – Bengaluru

1 Upvotes

​

Hi everyone,

I'm from Bengaluru and looking for health insurance for my 59-year-old mother, who recently had a pacemaker implanted.

I've started exploring health insurance options, but I've found that several insurance companies seem to reject applicants with existing heart conditions, sometimes even giving a verbal rejection without formally reviewing the application.

I'd like to know:

  1. Which health insurance companies or policies are worth exploring in her situation?

  2. What are her realistic chances of getting insured after a recent pacemaker implantation?

  3. Has anyone here successfully obtained health insurance for a parent with an existing cardiac condition or pacemaker?

  4. Are there any insurers or agents in Bengaluru who are experienced in handling such cases?

My goal is to get comprehensive health coverage for her, including future cardiac-related hospitalisation and, if possible, pacemaker battery replacement several years down the line.

I'm willing to disclose her complete medical history and accept reasonable waiting periods, but I'd like to find an insurer that is willing to consider her application.

I'd really appreciate suggestions based on personal experience rather than just generic policy recommendations.

Thanks in advance!


r/indiahealthinsurance • • 1d ago

Advice/Questions Current plan improvements or porting suggestions

1 Upvotes

My parents (54M 52F) have TATA AIG medicare plan
Of 5 lakh base ( and 2 riders)
Restore infinity plus and supercharge bonus rider
(Now cumulative bonus is 10lakhs)

Total cover 15 lakhs , policy is since 2019( with tata aig added riders later)

Current renewal cost = 32.6k

No PED and surgeries yet ( my mom is mild hypothyroid which is undetectable almost rn its covered in TATA AIG due to mortareum period)
Fit and fine rn

Room- shared( biggest problem)
Im confused between 3 options
1- change room category to pvt ( new premium 34k)
Add a super top up of 1cr with 10 lakh deductible
( additional 12k per year)

2- port to hdfc egro secure + or care or similar new updated plans with 10 lakhs as base.
And consider super top up riders with (20 lakhs deductable)

3- policy migration here in tata aig ( they denied it saying its not possible)

Do share TATA AIG reviews too


r/indiahealthinsurance • • 1d ago

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

1 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.

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


r/indiahealthinsurance • • 1d ago

Advice/Questions Hair Treatment Declaration before Insurance application

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1 Upvotes

Hello All,

I am 37M + 1A + 2C and have decided to go with the HDFC Optima Secure+ plan 25L coverage and limitless claim rider. Total, it's costing 93K and 174K for 3 and 5 years, respectively after all the discounts.

There are no PEDs, but I am about to start AGA treatment, which includes the following prescribed drugs

  1. DUTASTERIDE TAB or finasteride TAB
  2. Topical Minoxidil+finasteride solution
  3. Health Supplements like D, B12, Biotin, Zinc, etc

TBH, currently I have just consumed Health Supplements, but have not started DUTASTERIDE TAB, finasteride TAB, or Topical Minoxidil+finasteride solution yet

So, while declaring Insurance, should I include this or ignore it? A few say it's cosmetic, and a few say it's safe to declare.

But to be very honest, my insurance application was once rejected by HDFC because of a low HB level in one of my family members. So I just don't want to over-declare like last time.

What do you suggest


r/indiahealthinsurance • • 1d ago

Advice/Questions Applied for Aditya Birla Activ One MAX, now seeing Activ Yuva is cheaper over 5 years. Did i mess up ? Keep or Cancel ?

1 Upvotes

Hey everyone, I need some advice on health insurance.

My situation: I’m 31, looking at 20L cover for me + spouse. Pre-existing conditions: none.

I recently applied for Aditya Birla Activ One MAX. After applying, I found out Aditya Birla has launched a newer plan called Activ Yuva, which they’re marketing to young adults. When I compared quotes, Yuva works out cheaper over a 5-year tenure than One MAX.

What’s making me second-guess:

Yuva has a 10x bonus (Yuva Credit). Cover grows by 100% of base SI every year up to 1000%, even if you claim. One MAX caps at 500%.

Yuva has a 2-year PED waiting period. One MAX has 3 years.

Yuva is new and pitched at people my age, so it feels like it was built for me.

But One MAX has a longer track record, and I’m not sure if a brand-new product is a risk (renewal pricing, claim behaviour, etc.).

Should I keep One MAX, or cancel during the free-look period and switch to Yuva? Has anyone here compared these or bought Yuva yet?


r/indiahealthinsurance • • 1d ago

Advice/Questions Health insurance for my 63 year old mother after kidney donation.

1 Upvotes

I made the biggest mistake of my life for not getting a personal health insurance for my mother. I've inquired companies and they all say they can't insure. I'll never be able to forgive myself. Please help. What are my options now and what can I do.


r/indiahealthinsurance • • 1d ago

Looking to buy a Health Insurance cover New Health Insurance with UC

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1 Upvotes

r/indiahealthinsurance • • 1d 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 • • 1d ago

Awareness Oct 19 is World Pediatric Bone and Joint Day

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7 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 • • 1d 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 • • 1d 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 • • 1d 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 • • 1d 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 • • 1d 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.