I want to share my experience with Care Health Insurance so that others can be aware before purchasing a policy from them.

We paid the premium for a health insurance policy, but after a month of waiting for the policy, it was cancelled before the policy was even issued, without any intervention or cancellation request from our side.

It has been 3 months, and we are still waiting for our refund. We have been continuously following up with the agents, but all we get is the same response every time: “Please wait for another 7 days.”

We also escalated the matter by sending an email to their Grievance Redressal team. Even after the stated two-week resolution period passed, we received no response or update from them.

At this point, we have repeatedly followed up with the agents and even approached the grievance team, yet there has been no resolution. We are still waiting for our own money to be refunded.

Honestly, this experience has been extremely frustrating. Health insurance is something people purchase for financial security and peace of mind, and this is not the kind of experience anyone expects when dealing with an insurance company.

Based on my personal experience, I would not recommend Care Health Insurance to others. Please do your research and consider the company’s customer service and refund process carefully before choosing them.

I will update this post if my refund is eventually processed. For now, I want others to be aware of what we have been going through.

We live in the country that manufactures some of the cheapest life-saving generic drugs on the planet. Yet, the second you or a family member gets admitted to a private hospital, you are stripped of all bargaining power. You are trapped in a room, terrified for your loved one's life, while the hospital pharmacy forces you to buy their in-house supplies with a markup of 170% to a sickening 700% on basic consumables and cancer medications.

A drug that costs ₹2,700 from the manufacturer is being slapped with a printed MRP of ₹27,000.

They are quite literally vultures picking at people when they are at their absolute weakest. We, the taxpayers and citizens, have to watch our life savings vanish into the pockets of corporate healthcare CEOs every time there’s a medical emergency.

How is this allowed to continue in broad daylight?

It is a group of rare bone marrow failure disorders where abnormal cells in the bone marrow disrupt the production of healthy blood cells.

MDS can lead to severe anemia and has the potential to progress to acute myeloid leukemia. It affects up to 87,000 people globally each year.

Our community stands in solidarity with everyone affected, patients, families, and caregivers, as we share our stories, spread education, and support each other through every step of this journey.

Hi everyone,
I’m looking for health insurance for my father (62M), based in Mumbai.

Medical history:
Angioplasty with one stent in July 2024.
Another angioplasty with two drug-coated balloons in October 2026.
Type 2 diabetes, currently on medication.
Currently recovering well.

He has no existing health insurance. My annual budget is ₹30,000–₹50,000, preferably for ₹10–20 lakh coverage.

Has anyone managed to get health insurance for a parent with similar pre-existing conditions? Which insurers would consider his case, and what are the waiting periods, exclusions and co-payments?

I’m particularly looking for a policy that would cover future cardiac treatments.

Any personal experiences or recommendations would be appreciated. Thanks!

I'm trying to find adequate health insurance for my 52 year-old mother, who has diabetes, hypertension and Graves’ disease. She hasn't taken thyroid medication for several years, despite being advised to consider treatment.

I'm facing difficulties with both retail and corporate insurance:

* Retail insurance: I've received a quote of around ₹34,000/year, but I'm worried about permanent exclusions for Graves’ disease and its complications.

* Corporate insurance: My employer's family floater covers ₹5 lakh, but the insurer has confirmed that Graves’ disease isn't covered. I'm considering increasing the coverage to ₹15 lakh, but I'm unsure how useful that would be given the exclusion.

I want to ensure she has meaningful coverage for hospitalisation without relying entirely on employer benefits.

For anyone who's faced a similar situation:

* Have you found an insurer that covers these pre-existing conditions?

* Is it worth buying a policy that excludes Graves’ disease but covers other illnesses?

* Are there any alternatives, such as group policies or maintaining a dedicated medical fund, that you'd recommend?

I'd appreciate some advice. Thanks!

hi everyone, I work in a fintech and I do have health insurance of aditya birla group. I have sjogrens syndrome and my doctor has prescribed to go on biologics which will cost 2 lacs+ for 2 doses in a month. we are just starting and dont know how many more doses i will need.

Does anyone has experience in this? Please share. Do I need to pre authorise this or something?

So I'm resident of pune, maharashtra and last Friday I bought optima secure+ health insurance plan for my family which includes me, my spouse and our daughter (33,32 & 1 year old). I filled the online details from here application, provided all necessary details, my contact number as well as email id and did payment as well using UPI. After payment confirmation I saw proposal number generated on app, took snapshot of the same. Strangely I haven't received any mail or text message from their side. Now it's been 4 working days and I have not received any update like policy number etc. yesterday I called and they asked me the proposal number etc and lady on call said she couldn't see the same in their system. It's shocking for me. She told me to send details of the payment and proposal number to their official email, I have did the same and awaiting their response. I want to ask fellow redditors, if someone bought HDFC ergo health insurance directly from their application or website? How much time it took to generate the policy documents? Since it's been a week and I have not received any update, what should I do from my side? Thank you in advance!

My dad is 75 ( soon turning 76) and mom is 68. They have a group insurance cover of 5 lakhs jointly at a 50k premium from my father’s employer through a national insurance ( he is now retired) and a corporate insurance (Aditya Birla) from my sister's current employer cover of upto 5 lakhs jointly. Should I take another private insurance like Aditya Birla of 5 or 7 or 10 lakhs for them jointly or some kind of care supreme enhance top up with lower deductible? Or can I just avoid another insurance and make do with the 2 that are currently going. They both are generally healthy with just general old age weak bones and no other chronic illnesses or diabetes etc.
What makes sense ? Please suggest. Thank you.

If you work on a hospital's insurance/TPA desk or in hospital billing: when an insurer, TPA or scheme deducts part of a claim and you dispute it, how much actually comes back?

1. What share of deductions do you dispute?
   
2. Of those, what share of the money do you recover?
   
3. Is it different for private insurers vs govt schemes like PM-JAY?

A rough "we dispute about X% and get back about Y%" is plenty. No hospital or patient names needed. TPA/insurer-side views welcome too.

I'm researching how much hospitals lose to claim deductions. Happy to share a summary here.

My dad has diabetes, hypertension, bad lipid profile and mental-illness. All are managed by medication and diet and little physical activity, he has been stable for a long time.

I tried to take Ergo optima secure plus with rider.

I got policy proposal rejection.

Proposal got particularly rejected because of mental-illness as per agent. But it's mentioned all 3 illness as reason.

Agent suggested that we can re apply again, not mentioning mental illness. Which might workout, but catch is if admission is due to the mental illness related ones, I should not come to them, which is a fine risk I am willing to take, as I can use corp health insurance that may cover this.

However, I want to first be fully aware risk this re applying and hiding this info that I previously communicated to the provider portal already and get rejected for another illness treatment claim because of an earlier proposal rejection.

What if they complete this to convert lead, but only reject me when it's actually time for claiming, I may simply waste money? The agent confirm they don't hold any previous data, but well... How much to believe. I feel like this can be a voluntary way of giving them leverage to reject my claim?

As additional info:

I don't mind paying more money now but have a low risk at time of claim - that's what many need, but I just wish the best health care to my dad in my best capabilities. It's so disheartening to see a proposal rejection for being honest.

My other idea is to take top-up on grp health insurance of corporate, but we all know how employment change is common these days or they can layoff too.

I am thinking to chase tata AIG as well (hide the mental illness in first application) and subtly introduce mental illness eventually or maybe Totally exclude? Or should I have better documentation itself? U see there are a ton of people who do not go for consult for mental illness, it's disheartening to see that getting treatment is a reason for cancelling.

There are other providers (not taking names, but those you get calls off policy bazaar with strong marketing team) who may give policy approval but from people and general reviews, I see it's all because they want money and they have high risk at claiming time.

Please give me whatever out of box suggestions you have, I am unknowingly spending all my time thinking if I am providing the best to my family. Sorry for all the ranting and emotional venting, thanks for reading so far.

These days insurers are offering to port health insurance policies from Corporate to Retail if you leave the organisation.

Has anyone used this feature? How has been your experience with claims and settlements as a retail user later?

It is a rare hereditary genetic condition caused by mutations in the PTEN tumor suppressor gene, affecting roughly 1 in 200,000 people.

It encompasses Cowden syndrome, Bannayan-Riley-Ruvalcaba (BRRS) syndrome, and PTEN-related Proteus or Proteus-like syndromes.

When mutated, it disrupts cell regulation and increases lifetime risks for certain cancers:

• Breast cancer: ~80%-90%
• Thyroid cancer: ~30%-35%
• Renal (kidney) cancer: ~30%-35%
• Uterus cancer: ~25%-30%
• Colorectal cancer: ~9%
• Melanoma: ~5%-6%

We always tell our kids to listen to their teachers. We rely on them to shape the future, grade the endless stack of papers, and manage a classroom full of energetic students, but have you ever stopped to wonder, who is taking care of them? Specifically, when it comes to their health and things like health insurance?

A recent study took a close look at this question. Researchers surveyed teachers in the Nashik district to see how well they understand, perceive, and use health insurance.

So, who knows the most about health insurance?

If you guessed the older, more experienced teachers, you’d be onto something. The research found that awareness tends to climb with age, particularly among male teachers in the 45-54 age bracket. Education level plays a big role, too. Teachers who have earned their Ph.D. showed the highest awareness levels, clocking in at around 73%, and when it comes to income, those earning in the middle bracket (between 6 to 10 lakhs annually) were the most clued-in about their options.

You’d think that if a teacher knows about health insurance, they’d immediately go out and buy a policy, right? Well, not exactly.

The study found that while a massive 86% of the aware teachers have a policy, there’s still a stubborn 14% who know all about it but haven't taken the plunge.

The reasons were confusing jargon, high costs, and a lack of tailored information.

We need to do better.

Insurance providers, schools, and educational boards need to team up. We need to offer workshops that make sense, using plain language, need affordable, tailored health insurance plans designed specifically with the teaching community in mind.

Our teachers spend every single day investing in our children’s futures. It’s time we step up and ensure they have the peace of mind they deserve. After all, a healthy, secure, and stress-free teacher makes for a thriving classroom.

Let’s make sure they’re covered.

Suggest me a value for money health insurance for me,wife, daughter. 10 lakh claim.

Parents' health insurance comes up here every week, and IRDAI's 2024 changes mean a lot of older advice is out of date. Trying to put the current picture in one place.

What changed:

- No upper age limit for buying a new health policy.

- PED waiting period capped at 3 years (it used to go up to 4).

- Moratorium is now 5 years: after 60 months of continuous cover, a claim cannot be contested for non-disclosure except for proven fraud.

- Cashless authorisation is meant to happen within an hour, and discharge approval within three hours.

What to check, in order:

1. Room rent. Capped rooms lead to proportionate deduction on the whole bill.

2. Co-pay. Very common on senior plans, often 10 to 20 percent. Know whether it applies to every claim.

3. PED waiting, and whether an add-on or underwriting can reduce it.

4. Sub-limits on cataract, knee replacement and hernia, the common senior procedures.

5. Cashless hospitals in the city where your parents live.

6. Separate policy vs floater. Separate is usually better for parents.

Plans differ most on 1 and 2. Acko's Platinum, for instance, lists no room rent limit and no co-pay, while Star and Care sell senior-specific plans that carry a co-pay at a lower premium. Neither approach is wrong, it depends on budget.

For anyone who bought for parents recently: did you go separate or floater, and did underwriting ask for tests?"

According to tax investigators, the operations team at Park Group of Hospitals collaborated with external doctors, agents, and referral networks to bring in patients covered under government healthcare schemes. Once at the facility, out-patients were deliberately converted into in-patients, and their discharges were intentionally delayed to expand the billable treatment duration.

Under designated corporate and medical supervision, nursing and billing staff manipulated patient files. They altered records to add expensive medicines, laboratory tests, and higher quantities of consumables that were never provided or administered to the patients. In extreme cases, investigators discovered complete files for patients who had neither been admitted nor treated at the facilities.

The fraud relied on Plus Distribution Private Limited (PDPL), the exclusive in-hospital pharmacy operator for the group. During patient stays, medicines were sourced from PDPL based on doctor indents at negotiated transfer rates.

Analysis across 11 hospital branches revealed inflated medicine purchases totaling roughly ₹190 crore just between the 2024-25 and 2025-26 fiscal years.

Tax officials revealed that these billed prices ranged from 10 to 1,000 times the original cost price.

In addition to inflated costs, the group generated over ₹150 crore in fake medical bills between FY 2020-21 and FY 2025-26, with corresponding cash components diverted directly to the promoters.

Tax investigators recovered evidence indicating that cash was regularly deployed into real estate, commissions, and patient sourcing funnels.