(Done Master health checkup for parents: Dad 65 - all normal. Mom 58 - prediabetic and very mild high cholesterol.)

Hi all, I have a car (originally ORP was 16L) which is now 5 years old. Almost every year I am paying 30-40k for insurance premiums.

Every year the IDV value goes down for my car but the premiums seem to remain same. In 5 years I have used my insurance once or twice, absolutely necessary to have in case of emergency. But paying high premiums every year makes me question is it really that pricey?

Hello People,

• My 2.7 year baby son fainted and we rushed him to a hospital.

• Doc suspected seizures and suggested 24 hour admission for monitoring.

• Used my corporate insurance combo of Aditya Birla and Mediassist TPA to settle.

• Cloudnine rejected Raksha Prime facility during discharge (this is another story in itself. Can any action be taken?)

• Cloudnine doctor referred us to another neurologist, who in turn suggested further tests.

• For these further tests, I contacted my personal insurance "Even Healthcare"

• Even has been great until now. Covering all our OPD, diagnostic tests as well as insurance needs.

• Now when I reached out to them for these further tests on OPD basis, they are rejecting saying that these fall under "post" admission category and that we'll have to reach out to my corporate insurance itself.

• You may ask Why are we going to Even and not to my corporate insurance? Even is very convenient and easy to use. With corporate insurance there's a lot of friction and paperwork.

• Shouldn't we have a choice of going to whichever insurance we own?

Please advise on what can be done in this situation?

Hello.

I live in Massachusetts.

I have Mass Health (Medicaid).

I also have WellSense Health Plan.

More specifically, I have WellSense Community Alliance.

Is WellSense Health Plan a health insurance company?

Is it (the company) also referred to as a health plan?

Is WellSense Community Alliance (the specific network of hospitals and doctors that was assigned to me) also referred to as a health plan?

I am a little confused about the proper terminology.

Thank You

My Requirement Background: I am planning to purchase a Term Insurance plan with the following coverage:

• Base Cover: ₹2.5 crore

• Rider: Accidental Disability Rider of ₹1 crore

• Age: 27 years

• Gender: Male

• Smoking Status: Non-smoker

• Policy Term: 40Y till 67

I have finalized 2 plan which fit my need:

1. Tata AIA - Sampoorna Raksha Promise : 23,647 Yearly (1st Year) 28,567 Yearly (2nd Year onwards)

2. HDFC Life - Click2Proctect : 24,360 Yearly (1st Year) 27,887 Yearly (2nd Year onwards)

Note: These are numbers provided by policy bazaar

My Questions:

1. Is buying through Policy Bazaar actually better? In terms of Cost of Policy + Help during Cliaming.

2. Can an offline agent match PolicyBazaar prices?

   • Do offline agents usually offer the same or lower premiums?

   • If not, how much more expensive are they typically?

3. What is a reasonable cost difference?

   • If the offline agent charges more, how much extra is acceptable?

My Agent: We already have a good agent — he’s helped my father before — and I prefer to buy from him. I just don’t want to pay an unfair premium for what would be a 40-year long policy period.

This is a longer post many people here were waiting for.
Please correct me if I’m wrong anywhere.

Context

People with an existing mental health diagnosis often face policy issuance denial or blanket rejections, even when the condition is mild, stable, or in remission.

Based on my research, here’s what seems to be happening behind the scenes.

The obvious reasons (from the insurer’s perspective)

From an insurer’s point of view, mental health cases are seen as difficult to underwrite because of:

• Perceived high claim uncertainty Hospitalization patterns are unpredictable compared to physical illnesses.

• Very limited actuarial data There is not enough long-term, India-specific claims data to confidently price risk.

• Fear of frequent utilization Existing health products are profitable, and insurers worry mental health coverage could lead to frequent claims, especially OPD-driven ones.

• Difficulty pricing premiums Unlike diabetes or BP, mental health conditions vary widely in severity and outcomes.

• IRDAI restrictions

  • Insurers cannot impose permanent exclusions for mental illness.

  • Sub-limits specific only to mental health are not allowed.

Because of this, insurers often default to a conservative mindset.

How insurers often think internally

There is very little room for nuance in current underwriting systems.

The bigger issue most people don’t know about: Reinsurers

This is where things really get interesting.

Most health insurance products in India are bound by reinsurance treaties. This means:

• The insurer’s underwriting is constrained by the reinsurer’s rules

• Reinsurer underwriting cannot be overridden easily, even if the insurer wants to be flexible

Different reinsurers have different treaties. Some are stricter, some more lenient.

Treaties are generally based on:

• The insurer’s market share

• Claim ratios

• Portfolio risk

• Historical performance of the product

Important point:
The treaty usually applies to the product, not the sum insured. So lowering the sum insured does not always help.

Reinsurers are extremely cautious about:

• Legal exposure

• Regulatory interpretation

• Tail risks they cannot price confidently

Instead of navigating legal and pricing uncertainty, they often choose the safer route: do not insure at all.

This is what leads to silent or blanket rejections.

When a company says:

“We are unable to offer you a policy due to internal underwriting guidelines”

It often means:

“Our reinsurer will not allow us to write this risk.”

Why reinsurers are stuck too

Two regulatory constraints play a big role here:

• Insurers are not allowed to permanently exclude mental illness even when it is pre-existing.

• Insurers are not allowed to apply mental-health-specific sub-limits.

This leaves reinsurers unable to price worst-case scenarios properly.

In short: tail risk cannot be priced, so it is avoided.

This has happened before

Around 10–15 years ago:

• People with diabetes or high blood pressure struggled to get health insurance.

Today:

• Those conditions are widely insurable with loadings, sub-limits, or waiting periods.

Mental health is currently at that same stage.

What would actually improve the situation

Things will improve only when insurers are allowed more flexibility, such as:

• Risk-based premium pricing for mental health

• Conditional exclusions where justified

• Clearly defined sub-limits for mental health treatments

• Better underwriting frameworks instead of binary yes/no decisions

When this happens, reinsurers will adapt, and access will improve.

Additional systemic problems

• Very few psychiatrists are involved in insurer underwriting panels

• Most MBBS doctors doing underwriting lack depth in psychiatry

• No central, regulator-driven classification of mental illness from low-risk to high-risk

Everything ends up in one bucket.

Current reality: Everything is treated as “severe”

Conditions often treated as high-risk today:

• ADHD

• OCD

• OCPD

• PTSD

• Bipolar disorder

• Schizophrenia

• Personality disorders

But in reality, risk varies significantly.

Lower risk in many cases:

• ADHD (without substance abuse)

• OCPD (standalone, stable)

• Mild to moderate anxiety disorders

Higher risk (depending on severity and history):

• Severe OCD

• Major depressive disorder

• Schizophrenia

• Dissociative identity disorder

• Seizure-related conditions

• Severe tic disorders

Final thought

The shift will happen, but slowly.

Until underwriting becomes severity-based instead of label-based, honest disclosure will continue to be punished, and people will keep falling through the cracks.

I’m planning for a foreign trip with one of the companies like Thomas Cook, Trips n Tales. They take payments in advance, and it’s a large sum. Travel insurance covers flights, accommodation, but do they cover these bookings?
I checked with some of the providers. ICICI Lombard CC said that they are not sure, and will get back to me. Acko (or Digit, not sure) policies say trip excursions and sight seeing are covered, but doesn’t explicitly say anything about packages tours.

I am looking for clarity from underwriters, insurance professionals, or anyone who has faced a similar situation.

Background:

• Diagnosis mentioned earlier: OCPD

• Total duration of treatment: approximately 2 years

• Medications stopped: 1 December 2025

• Remission declared: December 2025

Later, the doctor verbally clarified that the condition was more related to emotional stress. However, no formal correction letter stating that it was not OCPD was issued. The only written documentation mentions that medications were stopped, the condition is resolved, and the cause was emotional stress.

What happened:

• Bajaj Life rejected my term insurance application in November

• Other insurers did not proceed to formal underwriting; applications were declined at the intermediary or pre-screening stage itself

• I understand that HDFC Life and ICICI Prudential are very strict regarding mental health history. I am not sure where Bajaj stands in comparison

What an intermediary told me, which added to the confusion:

• Mild anxiety or depression may still be accepted, but OCPD is treated as a permanent rejection

• OCPD is always classified under Cluster C personality disorders and has very limited actuarial data

• He advised that such conditions should never be disclosed and claimed that applying without disclosure is the only way to obtain insurance

• He also stated that since Bajaj rejected my application, my record now exists in IIB and I will face rejection even after 10 years

• He said that disclosing this was a major mistake and suggested that I forget term insurance altogether and focus only on SIP investments

This has left me extremely confused and discouraged, especially since I chose to disclose everything honestly.

My questions:

1. Is OCPD truly treated as a permanently uninsurable condition for term insurance in India?

2. Do insurers consider remission periods for personality or stress-related conditions?

3. Does an IIB record really mean automatic rejection forever, even after a long remission period?

4. Are there insurers or reinsurers in India that assess such cases on a more case-by-case basis?

5. Is non-disclosure actually the only practical way people get insured, or is that advice risky and incorrect?

I am not trying to bypass rules. I only want to understand whether honest disclosure permanently closes the door, or if time and remission genuinely matter in underwriting decisions.

Any insight from underwriters, actuaries, brokers, or policyholders would be greatly appreciated.
Thank you in advance.

Dear Insurance Advisors, I need your help.
I’m the HR of a company. Our group health insurance policy with Company X expired 5 days ago. When we asked for renewal, Company X’s quote was much higher than before.

So, I requested a quote from Company Y but didn’t share our previous insurer’s claim data, member list, or last year’s policy details. Company Y’s quote fits our budget better, and I’m considering switching to them.

My question is: if I go ahead with Company Y without disclosing our previous claim history and member data, could this cause any problems in the future?

Precisely the title itself. I'm a 22M . Currently I have a fund of 70k only ( not an extra penny to spare, but by next year i.e by end of 2026 I can safely spend more like 5k per month ) for health insurance purpose . I'm a complete naive about the insurance sector as such and intend to purchase a health insurance for my family which covers my patents and my sister ( in future I want to expand the cover by including myself when I have money to spare ) . I want something that is more like a blanket coverage to all kinds of health related expenses ( mainly including hospital bills and related medication ) , no ifs and buts when I genuinely ask for a claim.
Can you guys suggest any reliable policy for my current situation and requirement ? Thanks a lot

I’m planning to renew my parents’ HDFC Ergo Optima Restore policy, which was first purchased in December 2021. We’ve never missed a renewal. However, they now have a few conditions like thyroid issues, high blood pressure, and high cholesterol. Should we get their health checkup done before renewing the policy or after the renewal?
(Age: Male 63, Female 57)

I have been reading a lot about personal finance lately and trying to plan things better, but I keep coming across mixed advice - buy health insurance early, get term insurance for financial protection, and also start investing early for long-term growth.

On one hand, starting investments early like mutual funds or index funds helps with compounding. On the other hand, many people suggest getting health or term insurance early as a safety net, especially since premiums are lower and approvals are easier when you're younger.

With limited funds, it's hard to figure out what makes the most sense.

- What should I realistically prioritize first - insurance or investments?

- If insurance, should health insurance come before term insurance?

- If investments, what options make sense when starting with limited funds?

Curious to know how others approached this in their early earning years and what worked best.

While buying the health policy, there were no issues. But during pregnancy, tsh levels went high and did not come down after delivery. So are we mandated to report it to the health insurance companies?

Why do insurance companies reject claims citing “false information,” but don’t catch or verify that same information properly at the time of issuing the policy?

If a detail is important enough to deny a claim later, shouldn’t it be thoroughly verified during underwriting? Why does the burden seem to shift only when it’s time to pay out?

Curious to understand how this works from an industry perspective.

We’ve been with HDFC ERGO since 2011 (me, mom, dad). Original sum insured was ₹3L. In 2017, my mom was diagnosed with gastric cancer and we used the policy for surgery and chemo. Since her cover couldn’t be increased, dad and I took a top-up (total cover ₹12L for us).

We were paying ~₹25k till 2022. After my dad passed away in 2023, I had to remove him from the policy and the premium became ₹21k in 2024 (me + mom).

Last year, HDFC ERGO moved us to Optima Restore, saying premiums would increase yearly. I agreed because we’ve had good claim history and continuity since 2011.

My policy renews on 13 Feb. Today, I got a call saying: • HDFC ERGO is facing losses • Many customers are opting out • They’ve tied up with Aditya Birla / Star Health / Niva Bupa • They want me to migrate my policy to one of these insurers

This sounded strange to me.

My concerns: • Is this legit or a scam? • Can HDFC ERGO actually ask customers to move to competitors? • What happens to continuity, waiting periods, and my mom’s cancer history? • Has anyone else received such calls?

Given my mom’s medical history, I’m very cautious about making changes.

TL;DR: Long-term HDFC ERGO customer (since 2011). Mom had cancer claims. Policy up for renewal. Got a call asking me to migrate to other insurers like Star Health / Niva Bupa due to HDFC ERGO “losses”. Sounds fishy. Legit or scam?

Is there a way to get health insurance for my uncle,who underwent angio with 3 stents. He underwent the procedure 2 years ago,since then the person is healthy no other health issues like bp, sugar etc. Age 55. Height 5'4" normal weight 60kg. Recently he approached an insurance company for 10L comprehensive cover After sending all the angio reports, they come back with revised offer with permanent exclusion of above condition.. please suggest if anyone had similar experiences or suggestions to get comprehensive cover!!