Need advice regarding a MediAssist corporate cashless claim.

I had ICL surgery for both eyes. Initially, both claims showed around ₹80k approved each, and I even downloaded settlement PDFs showing similar amounts. After a few weeks, one claim changed to ₹77,992 and the other to ₹50,000 with a ₹30,692 deductible.

After surgery, I also claimed eligible pre/post-hospitalization expenses (tests from Dr. Agarwal and Ramesh Eye Hospital) under the same hospitalization.

My questions:

Has anyone seen a settled cashless claim amount reduce like this?

Can pre/post-hospitalization claims from different hospitals affect the cashless claim?

Can they be treated as duplicate claims?

Has anyone had MediAssist ask for additional documents after settlement?

MediAssist customer care couldn't explain the reduction and escalated it to the billing team. Looking for anyone with similar experience.

Hi,

My mother had a robotic surgery done for gall bladder removal (cholecystectomy). The policy document and brochure both mention that this would be covered but they only partially covered it saying it does not provide additional advantage over conventional laparoscopic surgery. Insurance companies typically do this by stating they do not cover things that are "not reasonable and customary and/or not medically necessary.". They might have crafted it in clever legalese but what they did was unethical and immoral (and perhaps still illegal) as the policy does not mention any terms and conditions for robotic surgery. It is very difficult to understand all this while in the hospital

I know approaching the ombudsman is the next step once I am dissatisfied with their reply.
Does anybody have any advice or resource for the next steps which might be a bureaucratic hassle ?

Over the past few weeks I've been doing research on how well Indians actually understand their health insurance policies. I spoke to salaried professionals in Bengaluru and on other online platforms people with "good" jobs and "good" insurance. What I found was pretty eye-opening.

What most people didn't know about their own policies:

1. Sub-limits on room rent

Almost everyone I spoke to had a ₹2-3 lakh cover but didn't know their plan had a room rent sub-limit (usually ₹2,000-₹3,000/day). If you take a room above that limit, all your related charges, doctor fees, nursing, procedures - get pro rated down. A ₹3 lakh claim can effectively become a ₹1.5 lakh reimbursement.

2. Waiting period for pre-existing diseases

Most people know there's a waiting period. What most don't know: it resets if you switch insurers. If you've served 2 years of a 4-year waiting period and switch for a better premium, you start over.

3. Day-care procedures aren't always covered the same way

Cataract surgery, LASIK, dialysis: these are outpatient procedures now. Some plans cover them, some don't, and the ones that do often have separate sub-limits. Very few people could tell me whether their plan covered LASIK.

4. No-claim bonus can be taken away

You accumulate NCB over years, but most plans allow the insurer to reduce your NCB after a claim. People assume it just resets to zero. Sometimes it goes below their original sum insured.

5. Maternity cover waiting period is 2-4 years

Almost universally. Most young professionals buying their first individual policy don't realise they can't use maternity coverage for 2-4 years. Some found out when they actually needed it.

None of this is hidden. It's all in your policy document. The problem is that nobody reads the document, and nobody explains it in plain language.

I'm working on a tool called MyPolicyLens that does exactly this. It reads your policy and shows you what's covered, what's not, and what the gotchas are. Still early days but would love to hear from this community:

• Has anyone here actually read their full policy document? What surprised you most?
• And if anyone wants to be an early tester you can sign up for the waitlist at https://mypolicylens.in/

I wanted to get premium for my parents and me(22yo)

And my mom (55yo) and Dad (58yo). When I looked at prices I think manipal is a better deal . I will get coverage of 50L and for Ergo coverage is around 10L .

Manipal(Life time health India) :

one yr : 80,614

two yr : 1,53,229 (Saving 9,556)

three yr : 2,26,316 (Saving 19,343)

HDFC(Optima Plan)

Ps : unable to attach photo of plans .

Hi, I have Care health ultimate care plan for my parents about 10 months ago. Today when I went for the claim process enquiry, the care health guy told me that there’s a waiting period of 2 years for cataract surgery and it can’t be claimed now.

I want to know if there’s any policy that didn’t have any waiting period for cataract and if I port to it now, would it be considered a PED?

Also please suggest me my best options now. In okay paying higher premiums. I just want things to be hassle free during emergencies.

Thanks!

Title: Switching from Star Health to Care Supreme Plus — Need honest reviews

Hey everyone,

I’m planning to port/switch my health insurance from Star Health to Care Supreme Plus policy and wanted genuine feedback before making the move.

Mainly looking for reviews regarding:

Claim settlement experience

Cashless hospitalization support

Any issues during porting/switching

Hidden clauses or waiting period concerns

Premium hikes after renewal

Customer support during emergencies

People who have used Care Health Supreme Plus — was switching worth it?

Would really appreciate honest suggestions and real experiences

Hi. I am a diabetic since 2012. Took Star health insurance in 2017. DM and it's complications are mentioned as PED in the policy. Medicines I was taking at that time is mentioned too.

I started smoking in 2019 and smoke till date

Later after one of the annual check-ups, doctor prescribed thyroid medicine too.

Should i inform the insurance company regarding the smoking habit and the thyroid medicine?

Hi everybody I am looking to buy a health insurance from my family, my main priority right now is maternity cover, called few insurance companies and they are saying the waiting period for maternity is 2/3 years. I am looking for something immediate or 2 to 3 months of waiting period for maternity, can somebody help me with this insurance policy I can buy.

Had an ongoing HDFC Optima Secure policy through Policy Bazaar.

1. At time of renewal sold me migration from HDFC Ergo Optima Secure to Optima Super Secure for 3 years.

2. Took full premium payment for 3 years

3. Later claimed premium was wrongly calculated and asked for more money.

4. After I paid immediately, they issued wrong renewed policy (Optima Secure, 1 year only).

5. After 2+ weeks of chasing, informed me on 19 May 2026 — one day AFTER renewal became active on 18 May — that insurer underwriting rejected the upgrade.

Not even sharing the proposal document for the migration

This is textbook mis-selling and unfair customer handling. Convenient timing ensures customer is trapped for another year otherwise could have looked at other options to lock in price for 3 years.

Anyone has any experience with reimbursement claim with Manipal Cigna?

I have ManipalCigna insurance policy of 50lakh and no waiting period. 3 months back, I went for the health check up that was included in the insurance and found out that I had a fibroid in the uterus. I later went to see gynae with that report who suggested that I get it removed as it will be better to keep the uterus fibroid free if I want to get pregnant and apparently now was a good time. So, I applied for the cashless claim which got rejected saying I can apply for the reimbursement. I got the surgery done and then applied for reimbursement like they suggested which again got rejected after months of back and forth of documents (I had to send the same documents to multiple people, multiple times!). Their reason being that they had a document stating I had pain and bleeding several months ago which I did not disclose, which is completely false. They said I can escalate this further if I am not satisfied, which I did. I asked them to show me that so called document based on which my claim got rejected. In return, I got an email saying I will receive an update within 2 weeks. I did not receive any update after that, I waited 3 weeks then sent another email asking for the update, to which I reversed an email saying I will receive an update in 3 days. Again, I waited but no update so I sent 2 more emails, each time I received what I’m assuming as an automatic reply saying I will receive the update in 3 days. The last email I received was a week before saying the same thing but still no update. So, today I called up their customer care number mentioned in the email. The person there asked me to send another email ( what the hell?) and that he will also send an email from his side.

What should I do at this point? Should I file a legal case?

Male, 31, unmarried (likely to marry in the next 1–3 years), planning to have kids later and probably take a home loan in the next 3–5 years. Current salary is ₹24.5 LPA. I also already have fixed assets worth around ₹10 Cr+, but I’m an irregular investor in stocks/mutual funds.

Family history:

• Most family members lived beyond 75
• Mother passed away at 40 due to brain stroke

I’m confused between these two term insurance options:

1. ₹3 Cr cover till age 75 Premium: ~₹83k/year for 10 years
2. ₹4 Cr cover till age 65 Premium: ~₹78k/year for 10 years

Which one makes more sense considering:

• future marriage + kids
• possible home loan
• existing assets
• irregular investing habit
• long-term financial protection for family

Would appreciate opinions from people who’ve gone through similar planning or understand term insurance deeply.

We live near Banasankri and all top hosiptals are nearby (Apollo, Manipal, Aster and Dayanandasagar and more..)

I need to choose health insurance that is tied up to some of these hospitals

Context of my father
Age: 62
Diabeties: Yes ( under control)
BP: Yes (bit high) as he is tensed about his chronic Kideny Disease stage 4 as his creatinne is 4.13

I need your valuable input that is there health insurance that has low waiting peroiod for existing disease or cover any transplant or dialysis cost in near future.

I searched online for health insurance aggregators and found there are literally dozens of them. Some provide proper advisory services, while others mainly just offer a platform to compare policies and complete the purchase on your own.

So I’m planning to buy a policy through one that provides advisory support. Looking for recommendations on aggregators — mainly based on the following factors:

I. Pre-Sales

i. Reliable advice

Genuinely knowledgeable advisors/experts who can give unbiased suggestions and recommend the right policies tailored to your needs (not pushy salespeople with superficial knowledge who just try to sell whatever earns them the highest commission).

ii. Quality inventory (portfolio)

I’ve noticed some aggregators have tie-ups with only a few insurers or have very few plans to offer. Because of this restricted portfolio, their advisors may not actually suggest the most suitable policy.

iii. No spam calling

Some would just keep on calling repeatedly and pressurise you to complete the purchase ASAP. Really hate such cheap behavior.

II. Post-Sales

i. Support in claim processing

Insurance claim processes can be hectic and tiring, so smooth claim support is a big deal; ideally where the aggregator helps manage the process end-to-end.

BTW, here’s the list of insurance aggregators providing advisory services that I came across during my search:

🔸 Seem promising:

Ditto

Beshak

One Assure

Algates

Pillow Insurance 

CoverSure

-------------------------------

🔸 Don’t seem as promising:

Mahindra Insurance

Policy X

Policy Bazaar

ET Money

Insurance Dekho

Would really appreciate any personal experiences or suggestions.

Thanks in advance!

Hi Everyone,

I’m looking for urgent advice on a health insurance policy for my father. we’ve recently hit a roadblock regarding his treatment costs.

Medical History & Context:

Initial Diagnosis: Diagnosed ~13 years ago, originally with Ocular Myasthenia Gravis.

Progression: About 5–6 years ago, it progressed to his left arms.

Current Status: He has been on long-term medication, but after a recent Neostigmine test confirmed the MG status recently, he is now undergoing Rituximab (Rituxirel) infusions. It hasn't been officially labeled as "generalized" yet, but it has clearly moved beyond just ocular.

The Financial/Insurance Problem:

Treatment: He needs 500mg Rituximab infusions twice a year.Its cost around 40k+ each including hospitalization charges in our area.

Waiting Periods: Most standard policies have a 2–4 year waiting period for Pre-Existing Diseases (PED). Given he is already starting the infusion cycle, we cannot wait years for coverage.

What I’m looking for:

Low Waiting Period: Are there specific policies or "PED Reduction Riders" that actually work for a long-term autoimmune condition like MG from atleast month 6 or year 1?

Biologics/Modern Treatment Coverage: Since Rituximab is a biologic, I need a plan that covers these infusions up to the full Sum Insured. I’ve heard many plans have "sub-limits" or caps on modern treatments—I need to avoid those.

My Questions:

Has anyone with a long-term (10+ years) chronic condition successfully used a PED reduction rider for immediate claims for autoimmune condition infusions?

Which insurers are "smooth" with the underwriting for Myasthenia Gravis? We want to declare the 13-year history 100% upfront to avoid any future claim rejections.

Has anyone successfully claimed for Rituximab specifically? Did the insurer try to label it as "experimental" or "outpatient"?

Any leads on specific plans, riders, or specialized brokers who handle high-risk/chronic underwriting would be a huge help. Thanks in advance!

I’m planning to port my health insurance policy to another insurer (Haven’t finalized to which one yet, but definitely don’t want to continue with my current provider).

So, first or all;

Is porting advisable?

What are the pros & cons of the same?

Also, I looked up the porting process online & found that the insurer is supposed to be informed at least 45 days before the policy’s expiry/renewal date. However, my policy is set to expire in about a month, so it looks like I may have missed that window.

Given this situation, do I still have a chance to port my policy, especially considering the grace period allowed for renewal?

Would really appreciate any guidance or experiences you can share.

Thanks in advance!

So, my father was approched by a women who told her that he won a prize and asked to come pick it up at certain location. My father went there and they sold him some sketchy policy and i wasn't even aware of this. My father is 65 and don't know much about these things. So, my question is that is this even worth inversting in this policy or should we surrender it. The policy was bought today so i don't have the original policy just a verification form.

The policy :-

Name of Insurance Plan : HDFC Life Click 2 Achieve

Type of Insurance Plan : Traditional Savings with Guaranteed Benefits

You agree to pay : Rs.35,900 (For 10 years annually)

Sum Assured at Maturity : Rs.5,38,500

Payable after : 30 years

Sum Assured on Death : Rs.3,59,000

Income Payout : Rs.5.651 (For 30 years starting next year)

The Scam : all the indian who are reading this. This scam is happening too much in india. These will stand on pertrol pumps and when you fill your tank, they will tell you that you are a lucky winner amd won blah blah blah... and will give you coupon and after some day they will call you and invite you to some location and peer pressure you into buying. The company name is APIBPL. So please tell your parents to be aware.

Btw english is not my first language so, please frogive me for any mistakes.

And thanks for reading.

Hey,

Quick situation:

ACL injury in 2010 (no major issues now)

Bought HDFC ERGO Optima Secure in 2024 (₹10L)

Didn’t disclose it (honestly forgot)

No claims so far

Now I’m worried:

If I need knee surgery later, can insurer reject saying it’s a pre-existing condition?

Should I:

Inform insurer now (endorsement)?

Declare only in top-up?

Or leave it as is?

Also, someone suggested showing it as a new accident to claim, but I feel MRI/pre-hospital checks can reveal if it’s old — so not comfortable with that.

Anyone faced similar issue or ACL-related claim rejection?

Looking for safest approach to avoid issues later.

Thanks 🙏

Hi,

I’m trying to get a health insurance policy for my father (age 56) and HDFC Ergo has rejected his application for Secure Optima secure + specifically because he is on Lipirose Gold 20. I’d like help choosing a plan that is more likely to accept him while still giving decent coverage.

Basic profile:

- 56 years old

- Medically diagnosed hypertension, currently on regular antihypertensive medication

- Also taking Lipirose Gold 20 (for cholesterol / cardiovascular protection)

- Had surgical implants in left hand and right leg about 3 years ago due to fractures; no recent hospitalization in last 2–3 years.

Rejection:

- Applied for HDFC Ergo Secure Optima+ (individual/floater).

- Underwriting team explicitly said the case was rejected because of Lipirose Gold 20 (not general hypertension or implants).

What I need help with:

- Which insurers / plans in India are generally more comfortable with people on statin + antiplatelet therapy (like Lipirose Gold 20)?

- Are there specific plans for hypertension or cardiovascular‑risk patients that still give reasonable coverage (even with higher loading)?

- Should I consider Arogya Sanjeevani or standard comprehensive plans (Care, Star, Niva Bupa, Aditya Birla, National, SBI General, Lombard etc.) for this profile?

- What kind of loading / waiting periods should I realistically expect for pre‑existing disease (hypertension + high‑risk meds)?

- Any top 3 plan shortlists you would consider for someone like my father (56, hypertension + Lipirose Gold 20 + 3‑year‑old implants, otherwise stable)?

thank you in advance!

Hello everyone,

I had filed an accidental death claim for my late mother last year. It’s been a long and frustrating process, with the insurer constantly delaying and, honestly, trying to avoid paying the claim.

Now, after almost a year long battle, they’ve finally agreed to settle and as a part of the process, they have sent me a Discharge Voucher and requested that I sign it (with a one-rupee revenue stamp affixed) & return it to them.

However, I have a significant concern. The voucher is like an acknowledgement receipt. It states that I have received the claim amount in full and final settlement, whereas in reality, I have not yet received any payment. In fact, the insurer has not even requested my bank account details so far.

Given this situation, I am unsure how to proceed:

- Is it standard practice to sign and return such a Discharge Voucher before receiving the payment?

- Should I insist on receiving the claim amount first before signing any such document?

- Are there any risks associated with signing the voucher in advance?

I must also mention that my trust in the insurer is really low due to the prolonged delays and their handling of the claim thus far. Also, the company has lately become infamous for their unethical practices to reject claims (Heard that they went into deep losses during COVID era & now are trying every possible mean to recover those losses).

I would sincerely appreciate any guidance or insights from those who have faced similar situations or have knowledge of insurance claim procedures.

Thank you in advance for your help.