u/Sandehi

Trying to understand this part of a claim.

Relevant for general public as well.

The First clConsultation Paper is a mandatory document in claim. In most cases the insurer delays decision because this is not available or not in the proper format etc.

But in India medication screening and timely medical consultation are not yet so common, especially in non-urban areas.

People often realize they have diabetic when their legs swell or they fall often or they have severe numbness. (I know these examples - 1. a lady in her 50s consults a doctor when she falls frequently without proper reason. she actually went because of pain after a fall. and she was diagnosed with extremely high diabetes, and nerve damage starting. 2. a man in his very early 60s goes for a kidney stone issue and realizes that he has high diabetic. 3. a man in his 60s had been feeling chest pain and dizziness etc. he said it's gas. and then once he fell down. and he had heart issue and he got a pacemaker now! in all these ppl were basically not very medically aware or they hadn't looked at their life from a medicalized perspective).

What happens in such cases where a health issue is in advanced stage but there's no consultation prior?

Companies usually dont accept the advanced treatment hospital admission papers for first consultation paper.

(in the above case for ex. the doctor himself was not ready to believe that the lady had never had an FBS test!)

So how is this situation handled?

Context:

Have a family floater Niva Bupa Health Reassure for 2 people. 1 male 39, 1 female 32.

Male - proposer, Female - member.

No kid now, but have plans.

Policy age 3.5 years. No claims so far.

No PED in this policy. but has thyroid and lipid for male, and Lipid for female to disclose at this point (lab findings from Niva Bupa own tests).

No other health issues, no hospital cases to tell.

20L BSI floater. (not really counting the 20L NCB here).

has opted for safeguard.

no room rent limits or copay.

Location Bangalore.

Idea and Rationale:

To split the policy into two. into 2 individual policies.

Have Male 20L + Female 20L separately.

Separate the company so that failure rate per company/policy will be separated.

Claim easiness by separating the pool.

To add a kid (as and when) to Female policy.

Option:

1. to port female to another company, another policy. like HDFC Ergo Supreme or ABHI One Max.

2. to take another policy for both. 20L si. Female as proposer, Male as member, and add kid too to this later. (I dont know if this is sensible atp)

Question:

Is this split-policy idea superior to the current set up?

Is this practical, logical, and feasible?

What are the caveats and risks I don't realise here?

Mirae Asset Small cap 250 momentum quality 100 etf.

can some expert check the holding basket and share what you think.

I have been tracking some stocks and I have the issue of panic selling in direct stock. I feel good about the top holdings in this. considering to add money. around 60k.

Himadri speciality, LT foods etc i had but panic sold at 1% profit.

I see such stocks here in their holding.

now thinking about adding to focused etf or concentrated funds where i feel a basket level conviction

Risk appetite - Higher Moderate

I am considering this fund for a minor investment. (start with 1% of my total and increase to 5% in some 4-5 months).

Already I have a diversified mf portfolio with Flexi cap, Mid cap and Small cal fund.

Thinking about adding this active momentum fund.

reasons:

1. Market seems bullish in the coming months. earnings are good as per q1. geopolitical tensions are settling. stocks are showing good momentum after the long stagnation and consolidation across. foreign markets start losing gas. overall i feel a good time to capture momentum.

2. kotak selection criteria look good- momentum+ earning improvement

3. i have been tracking many stocks and i find entry difficult and seeing big loss difficult. so better outsource that to a fund. and kotak 's stock basket aligns with my conviction watchlist!! that how I ended up here.

4. I want less number of stocks and high active churn. Kotak'a churn % is 180+. 40 stocks. (I wanted 30 or below like MO momentum fund, but i couldn't get convinced of their stock basket. but 40 is not too bad)

5. goal is to add extra alpha possibly. capture the momentum in a bull phase. (i believe market will make ups in 2026 -27).

6. Primary function in my portfolio: replacing a personal stock basket, for higher alpha.

So whats your thought?

anyone holding this fund?

does this sound good and reasonable?

risk tolerance - above average in the context of fund. but direct stock panics me. i have more trust on fund manager than on myself

holding period - primarily for wealth creation. as long as momentum theme is intact. I will consider exiting on sight of 🐻

my currency INR

I am considering this fund for a minor investment. (start with 1% of my total and increase to 5% in some 4-5 months).

Already I have a diversified mf portfolio with Flexi cap, Mid cap and Small cal fund.

Thinking about adding this active momentum fund.

reasons:

1. Market seems bullish in the coming months. earnings are good as per q1. geopolitical tensions are settling. stocks are showing good momentum after the long stagnation and consolidation across. foreign markets start losing gas. overall i feel a good time to capture momentum.

2. kotak selection criteria look good- momentum+ earning improvement

3. i have been tracking many stocks and i find entry difficult and seeing big loss difficult. so better outsource that to a fund. and kotak 's stock basket aligns with my conviction watchlist!! that how I ended up here.

4. I want less number of stocks and high active churn. Kotak'a churn % is 180+. 40 stocks. (I wanted 30 or below like MO momentum fund, but i couldn't get convinced of their stock basket. but 40 is not too bad)

5. goal is to add extra alpha possibly. capture the momentum in a bull phase. (i believe market will make ups in 2026 -27).

6. Primary function in my portfolio: replacing a personal stock basket, for higher alpha.

So whats your thought?

anyone holding this fund?

does this sound good and reasonable?

risk tolerance - above average in the context of fund. but direct stock panics me. i have more trust on fund manager than on myself holding period - primarily for wealth creation. as long as momentum theme is intact. I will consider exiting on sight of 🐻

my currency INR

A Niva Bupa Reassure 1 since 2023 Feb. No claims so far. 25L BSI. No PED then.

in Annual Health checkup ups later on I found my lipid profile a bit elevated. and TSH a little elevated but T3, T4 normal. no medications no symptoms.

I continued to renew till now. next renewal 2027 Feb.

in 2025 I took a Niva Bupa Super Top-up.

because I had lipid and TSH in their own screening system I disclosed it likewise.

A medical person called me and asked fhe same question as in the proposal form and I disclosed these elevated values.

the she sent a medical transcript for my approval and it showed only thyroid being noted. for cholesterol question it marked my answer as no. and before i decide it auto approved.

then i sent an email to niva bupa clarifying the situation (out of my ocd level good will). I said i disclosed 2 and transcript had only 1, i just want to convey this and bring to your attention.

they then said "noted" and issued the top-up with 2 PED mentioned: thyroid abnormalities, lipid abnormalities.

I thought I did a great job and being so transparent in disclosure and slept well till now.

now from my colleague I came to know about a similar case where he disclosed his high cholesterol as PED (without any medication consultation etc), and when he made a claim for a heart-related/high-bp related issue, Niva Bupa asked for first consultation report from the doctor. He has no such doctor or document. but they are insisting on that document and froze his claim till then.

He is struggling now with a ~2L claim.

Now I am worried about my policy!!

Am I in trouble?

what should I do now? can I do something at all? what about cancelling my top-up? my main policy is still clean without PED?

What's the seriousness of my stupidity?

I have those emails i sent them. will that help?

I'm in academic job. 37M. Assistant Professor designation. in private university.

(all reference: India, INR).

qualification : PG, NET, PhD.

worked as guest teacher for 1.5y.

then joined regular post. Now completed 5.5 y.

salary is 13.3L CTC now after this June increment.

When I see across jobs like IT and such, salary is going above the roof like 1.5L, 2L and 2.5L I am feeling down about my financial. Academic job is actually very stressful with a lot of deadlines, and no separation between work-hour and non-work-hour.

at night also i will be working on curriculum design, evaluation, instruction design, event planning, outreach attempts and networking, project and research, student guidance related works, student career and internship related works and discussion etc.

edit due to confusing wording: on record work hours - 42h per week. off record I work almost 25 h, making my total work hours 65h per week on average (I have work diary to track that). there's performance appraisals and scores etc. its hectic.

the 9 to 5 is just on record for private universities and off record is not counted anywhere. and the service tag basically justifies free labour.

(I like academic job so that part is fine).

My main worry is that "Will I be pushed to the lower class in future" with this low and slow-growing salary.. Now a middle class.

I am saving around 30k per month in MF.

Total 16L MF now at age 37. 1.5L emergency fund in FD.

I see young 25y people showing their 20L 30L portfolio and 1.5L pm salary, and I get panic!!!

I have an intense FOMO I think.

I don't want to retire early etc. but want to retire well enough. MF goal - 1 cr by 47 age, and 4cr by retirement.

wife has a car from in-laws. now its our family car. i have own ancestral home though now living on rent, for work.

parents in ancestral home.

I have a 25L health insurance now. planning to take a 1 cr term also. married, no kid yet.

I don't even know what to ask now, like, Im empty in mind.

with this post I'm looking for anything that comes to your mind. as advice. I want some interaction on this!

am I overthinking? or should I try to optimise my life to catch up or at least stay afloat for a reasonably good future?

What's your thought on life levels!? what would be a healthy financial fact sheet for me at 37 age?