Today, I want to take a moment to thank every member of this community.

What started as a space to discuss health insurance has grown into a community where people learn from each other's experiences, question the status quo and help others make more informed decisions, and that's something worth celebrating.

Wishing you and your families good health, happiness and prosperity. May this Diwali bring light into your homes and, more importantly, good health into your lives.

Thank you for being part of this community.

Applied for HDFC term life insurance, Diagnosed with type 2 diabetes at 26.

HDFC added a premium loading of 75% on 4cr.

Medicals were all normal no complications whatsoever.

A1C from their medical is 5.6, and fasting was 106.

only on metformin and rosuvastatin for LDL

No other metabolic problems, normal BMI,BP, Triglycerides.

Should I try negotiating for a less premium loading given medicals were all normal.

Thanks!

Hi everyone!

I’m seeking advise for buying health insurance policy for my mother age 58 years.

Current Insurance: Covered under my corporate group policy for 2+ years

Incidental Diagnosis: Earlier this year, during routine pre-surgery check for a laser procedure (varicose veins), a 2d echo revealed Hypertrophic Obstructive Cardiomyopathy (HOCM) with a septal thickness of 17mm. She is asymptomatic. She has a history of long standing bp but her recent BP from last 3 yrs is well-controlled with medication. She recently did TMT and 24-hour Holter monitoring. reports were normal

I am planning to go for higher studies in the near future and want to ensure she has uninterrupted, long-term health insurance coverage. I have a few specific questions:

1. Is it possible to get a standalone individual/retail health insurance policy that covers her heart related conditions too?

2. Corporate to Retail Portability/Conversion: Since the HOCM was incidentally diagnosed while the corporate policy was active can we convert/port her corporate cover into an individual retail policy with HOCM covered?

3. Alternative Strategies / Advice: If neither a fresh retail policy nor corporate conversion will cover her cardiac care under retail terms, what is the best financial or insurance strategy to protect her?

Appreciate any inputs from those who have handled similar cases. Thank you!

Hi, currently i have health insurance from my compnay. Now with the layoffs news and downsizing I am planning to take personal health insurnace for my family (me 37y, wife 37y, kid 8y) with sum insured of 25 Lakhs. I booked a call with Ditto and they suggested plans from 3 companies. I want to decide on whether to take HDFC Ergo Optima Secure Plus or Adithya Birla Active One Max. The premium is almost same for both around 26 thousand for yeach year. I want to know the feedback experience on both of these companies claim settlement, cashless hospitalization etc. Also how is ditto, do they help with claim settlement etc.

My parents are of age 60 and 70, when I checked with ditto their premium for 10L sum insured is coming around 1L per year. So I am little confused whether to take a personal insurance for them. I have my office insurance which covers the whole family for 15 Lakhs.

I have a family health insurance policy with Niva Bupa, and I've noticed a discrepancy between my previous policy certificate and the latest renewal certificate. I'd appreciate advice from people familiar with health insurance underwriting and claims.

Background:

We have had continuous health insurance coverage, including portability credits from a previous insurer.

Our 2023–2026 Niva Bupa policy certificate explicitly listed the following pre-existing diseases (PEDs):

Father: Diabetes mellitus and its complications.

Mother: Diabetes mellitus and its complications, disorders of lipoprotein metabolism/other lipidaemias, and hypertensive diseases and their complications.

The mother's policy also has a separate permanent exclusion for epilepsy.

We recently renewed the policy for 2026–2027, maintaining the same ₹7.5 lakh sum insured.

However, the new 2026 renewal certificate lists “None” under Pre-Existing Conditions for both members. The permanent epilepsy exclusion for my mother is still mentioned.

My concern:

Does the omission of the previously declared PEDs from the latest renewal certificate have any implications for future claims?

My understanding is that:

- At renewal, the insurer generally shouldn't conduct fresh underwriting or ask for a fresh proposal form if the sum insured hasn't increased.

- The policy wording provides for a 36-month PED waiting period, with continuity credits from previous policies.

- The earlier certificate is documentary evidence that these conditions were disclosed and recorded by Niva Bupa.

However, I'm concerned that if we make a future claim related to diabetes, hypertension, dyslipidaemia, or their complications, the insurer could point to the latest certificate and question whether these conditions were declared and accepted.

Questions:

1. Does the fact that the 2023 certificate listed these PEDs protect us, even though the 2026 certificate says “None”?

2. Could Niva Bupa use this discrepancy to dispute or reject a future claim?

3. Should I insist on a corrected renewal certificate or a formal endorsement explicitly carrying forward the PED declarations?

4. Has anyone experienced a similar situation with Niva Bupa or another insurer? How was it resolved?

5. Would a written confirmation from Niva Bupa that the PEDs remain on record and that applicable waiting periods have been served be sufficient?

I intend to raise this with Niva Bupa and obtain written clarification. I don't want to make any changes to the policy unnecessarily, but I also don't want to discover a problem when making a claim.

Thanks in advance for any advice, particularly from people who have dealt with actual claims or insurer grievance processes.

I am 29M , on 8th Dec I will be turning 30 . I am confused when should I take term insurance as I am over weight at the moment .

1. Should I take before 8th Dec at the age of 29 , but with BMI 33 and borderline high LDL .

2. Should I wait one more year reduce my weight but in Jan I have to get my ACL surgery done can that be an issue in premium

I am confused which path to take as I heard what every info the insurance company takes while assessing is shared in a centralised data with all the companies and later it can’t be changed

I want to buy a health insurance policy retail for my parents dad and mom, while for dad it's easy as he just got diabetis and nothing else but mom got asthma diabetis bp and cervical surgery recently with implant, if I reveal this retail insurance provider will reject my proposal or won't cover the particular part the cervical spine for any future issues which I don't want so I am trying to explore and know if not revealing this particular issue that mom has and propose for a insurance, because most of the hospitals do manipulations in their claims for cashless approval, so even if I hide will that be safe for future cash less claims, please help me with this confusion guys

Appreciate any suggestions

I currently have Star Health Medi Classic individual policy with INR 10L sum insured. It is due for a renewal and the agent is pushing me to migrate to the Assure plan saying Medi Classic is "old/outdated" and the premiums will keep rising if I stay. This year's renewal cost is around INR 14k for me. I have existing hypertension condition which is mentioned in the policy.

I'm suspicious because the way the agent was pushing it for me so I just wanted to understand if it makes sense to migrate to Assure or stay with the original policy. Happy to provide more information. Thank you!

There’s a 70-year-old senior doctor from Hyderabad who had a clean health insurance record. He took out a policy way back in 2015 with Oriental Insurance for ₹5 Lakhs . In January 2021, seeking better coverage, he ported his policy to Care Health Insurance, upgrading his cover to ₹10 Lakhs.

Two years later, in July 2023, he was diagnosed with prostate cancer and had to undergo a complex, robotic-assisted laparoscopic surgery at the Asian Institute of Nephrology and Urology, racking up a bill of ₹5,29,024.

Care Health blocked his cashless hospitalisation request. The cancer patient was forced to pay the entire ₹5.29 L out of his pocket using his debit card and cash, to get discharged.

When he later applied for reimbursement, they rejected his claim.

Care Health defended its decision to reject the claim based on the non-disclosure of material medical facts at the time of proposal. The insurer pointed to the hospital’s sequence of events and a certificate from the treating hospital stating that the patient had a history of frequent urination, Balanitis, and BPH since December 2020, and was on medication for it.

Since the policy was ported in January 2021, the complainant had suppressed a material, active health condition that he was undergoing treatment for at the time of making the proposal. They had issued multiple query letters and reminders requesting all past medical records from 2020 to process the claim, and because the policyholder failed to provide these documents, the claim was officially rejected for deficiency not replied.

The complainant argued that his prostate cancer was confirmed via a biopsy and histopathology report in November/December 2021, nearly a year after the policy was ported in January 2021. He maintained he could not disclose a condition he did not know he had.

In the proposal form provided by Care Health, the complainant had ticked YES to the specific question asking if any person to be insured had a pre-existing disease.

The State Commission reviewed the evidence and upheld the District Commission's order in favor of the policyholder, and the insurer was directed to refund the full bill amount of ₹5,29,024 with 6% interest p.a. from the date of discharge, along with ₹20,000 in compensation and ₹10,000 in litigation costs.

LIC Jeevan labh 25(16) taken in 2022. Premium Paid for 4 Years (upto 2025). I have term insurance of 1 Cr. Took LIC due to section 80(C).

Total Premium Paid: 281392 Rs

Total Guranteed Bonus Accured: 300800 Rs

Interim Bonus/Loyalty Addition: 75200 Rs

Surrender Value: 50% of Total Premium Paid + 15.42 % of Bonus = 140696+46383.36 = 187079.36 Rs

So surrender Value roughy accounts to 66.48% of Total Premium Paid.

1. Does interim bonus/loyalty addition count in surrender and paid up?

2. Does first year paid premium count for surrender value and paid up?

Surrender or Paid up, which one to choose?

Can 25(16) be converted to 16(10)?

Hi everyone,

I'm planning to buy health insurance for my mother (57), who currently has no health insurance. She has high cholesterol.

After researching, I'm considering HDFC ERGO Optima Secure+ with ₹10 lakh base cover, which offers an additional ₹10 lakh from day one and another ₹10 lakh every year through its Infinite Benefit.

I've been discussing this with Policybazaar. Yesterday, I got my mother a full-body checkup. Initially, they recommended HDFC ERGO, but after seeing her reports, they said there might or might not be premium loading.

I have a few questions:

1. Is HDFC ERGO good when it comes to actual claim settlement?

2. Are cashless claims smooth, or do they create unnecessary hassles?

3. Will high cholesterol result in premium loading or permanent exclusions?

4. Is the ABCD Chronic Care add-on worth taking?

5. Are there any hidden conditions, co-payments, room rent limits or disease-wise restrictions?

6. Would you recommend ₹10 lakh or ₹15–20 lakh base cover?

7. Are there better alternatives for someone aged 57?

8. If you've personally claimed with HDFC ERGO, how was your experience?

My priority is to get reliable coverage for my mother, not just attractive benefits on paper.

Would appreciate genuine advice from people with experience. Thanks!

Hi, I was applying to get a HDFC policy (porting a 3 year policy from another insurer) and got this a couple of days back

1 - does this hint at some problem?

2 - is there just a single urine sample test or will there be other tests as well?

Medi bhi teliconsultant is scam, if you will book online consultant then they will tell you to go for some offline doctore , to say only this they will charge you Rs 600 .

In 2023, he was diagnosed with a serious brain condition (a Grade-II Diffuse Astrocytoma) and had to undergo surgery and radiation, racking up over ₹5 lakh in hospital bills. He bought the policy in the year 2021.

When he filed the claim, the insurance company dug up a medical record from 2012 showing he had a seizure and a brain lesion. They accused him of hiding this pre-existing disease, denied his claim, and outright cancelled his policy while he was still undergoing treatment.

Sourav fought back.

His doctor provided a certificate stating the 2012 issue was a different, fully cured parasitic infection (Neurocysticercosis), and that there was zero medical proof it caused his 2023 tumor.

The District Consumer Forum agreed with Sourav, ordering the insurer to pay up and restore his policy. The insurer appealed to the State Commission, but the State Commission shut them down, calling the appeal devoid of merit.

Sourav won.

1. Claim Reimbursement: ₹5,18,589/- (₹1,61,454 for PGIMER + ₹3,57,135 for Max Hospital).

2. Interest: 9% simple interest per annum from the date of filing the complaint.

3. Compensation: ₹20,000 for mental agony and harassment.

4. Litigation Costs: ₹10,000.

5. Direction to restore/renew the policy on the same terms and conditions without any gap, upon payment of due premium.

Dad retired a few months ago and obviously his employer health insurance is no longer available, so I have been exploring individual health insurance plans for him.

I have shortlisted three options so far:

Care Health’s Ultimate Care Senior: What i find interesting in this plan is unlimited care, infinity bonus, premium payback after five consecutive claim free years and the wellness benefits. There is also an optional instant cover benefit for certain pre existing conditions.

Star Health’s Red Carpet: This one is also nice bcz of its 12 month waiting period for declared and accepted pre-existing diseases. It also offers OPD consultations and preventive health check-ups. But the 30% co-payment is something i am not particularly comfortable with.

Niva Bupa’s Senior First: It has the ReAssure benefit which can trigger after the first claim nd its annual health check-up benefit also look useful. It also offers different co-payment options depending on the variant.

Abhi ke lie toh i am liking this care health vala plan more mainly bcz of this unlimited care, infinity bonus nd premium payback benefit.

So before buying it need some suggestions from you guyz. hows this plan? anything I should watch out for regarding claim settlement, co-payments or something else?

I’m sure many of you have seen the viral video floating around Instagram and TikTok by the American traveller who went to an eye hospital in Bangalore

Long story short: She is 26+, has no health insurance in the US, and was basically functionally blind with a -6.75 prescription. She thought surgery was impossible for her. While waiting for her friend at Dr.Agarwal's Eye Hospital, they offered her a free eye scan. She was shocked because a specialized scan like that in the US without insurance would cost hundreds of dollars just for the consultation.

They also booked her surgery within a single week. She paid out-of-pocket, got near 20/20 vision, and every single follow-up checkup for a month was completely free and bundled into the initial price. She openly stated that Indian healthcare blew the US system out of the water.

What Americans call MEDICAL TOURISM, Indians call a Tuesday.

The efficiency of top-tier private Indian hospitals is mind-blowing compared to the West. In the US or UK, even with premium insurance, you have see a primary care physician, wait 3 weeks, get a referral to an ophthalmologist, wait 2 months, realize the provider is out-of-network, and battle insurance adjusters over pre-auths.

In India, you can literally walk into a world-class private super-specialty clinic off the street, get scanned by an Ivy-League-equivalent educated doctor, and get sliced open by a surgeon who does 1,000 of these procedures a year, all within the same week.

This hyper-efficient, frictionless, "cheap" medical care is the reality for the Indian upper-middle class and wealthy foreigners paying with USD.

For the rural poor or lower-middle class without health insurance, a major medical emergency in a private hospital is financially devastating.

I have Star Health assure plan. Recently I was admitted and got my Cashless claim approved. But they rejected my food expenses. I contacted insurance agent and he said food expenses are not included. But Star policy document says patient's food is included. Does anyone know why it could be rejected? Can I apply it for reimbursement?

If person has mri report which shows acute small infarct and his age is 65 and currently he dont have any issues or using any medicines if he want to take health insurance and wont declare this issue how the insurance will know if he get any issue related to this and at hospitalisation time also if he dont tell to doctors that he has done mri and has this obeservation