r/HealthInsuranceIndia

Hi everyone,

I am looking for urgent advice on a health insurance policy for my sister. She is 25 years old.We have recently majored in a roadblock regarding her treatment cost.

Medical history and context :

Initial diagnosis: in 2021 mctd with sle.

Progression: in june 2026 she has major critical condition pulmonary arterial hypertension, ild, lupus nephritis, hyperbilirubanic anemia.

Current diagnosis: she is in long term medication and long period of hospitalization.

Financial problem/ insurance problem:

Insurance problem:Every insurance has a waiting period for ped.

Treatment: she needs to cover medicine and hospitalization charges.

What I am looking for:

Low waiting period: are there any specific policies which have a low waiting period? May be 30 days or immediately?

My questions:

How can I proceed with this kind of condition?

I never had any kind of insurance in my family.

What should I specifically look for in insurance?

Should I take critical care insurance?

Which company provides the best insurance in india?

Has anyone with long term condition like this successfully used ped reduction for immediate claim for auto immune disease?

Any leads on specific plans, who handle this kind of condition that would be huge help. Thank you in advance.

Hi everyone,

I’m looking for some genuine advice on health insurance for my parents. I’m trying to make a long-term decision now rather than waiting until they are older or develop more health issues.

**Parents**
Dad: **54 years old**
Mom: **49 years old**

**Current health**
**Mom:** Some leg pain and dental issues, but no other major health problems.
**Dad:** Cholesterol levels fluctuate / has cholesterol issues, but otherwise no major health problems.
No major surgeries or hospitalisations that I’m aware of.

**Current insurance**
We currently have an **Oriental Insurance** health policy.
From the policy document I have:
Dad: **₹5 lakh sum insured + ₹2.1 lakh cumulative bonus**
Mom: **₹2.5 lakh sum insured + ₹87,500 cumulative bonus**
Premium: around **₹26,000/year**
The policy is already active and has some continuity/accumulated bonus.
My main concern is that the coverage may not be sufficient as they get older.

**What I’m confused about**
Should I:
**A)** Continue the existing Oriental policy and add a **super top-up**?

**B)** Continue Oriental but try to increase the existing coverage?

**C)** Keep Oriental for now and buy separate individual policies from another insurer such as **HDFC ERGO** or another reputed insurer?

**D)** Cancel/switch from Oriental completely and move to HDFC ERGO or another insurer?

I’m particularly interested in understanding **whether cancelling an existing policy with accumulated continuity/bonus is a bad idea**, especially when the parents already have some existing health conditions.
**How should I actually compare policies?**

Apart from premium and sum insured, what should I look at?
For example:
Room rent limits
ICU limits
Co-pay
Disease-specific sub-limits
PED waiting period
Claim settlement experience
Cashless hospital network
Restoration/recharge benefits
No-claim/cumulative bonus
Lifetime renewability
Any hidden exclusions
Whether a super top-up makes sense

**Ditto vs local insurance agent**
I’m also confused about where to purchase it.
Is **Ditto** a good option for researching/buying health insurance? Is their advice genuinely useful, or is it better to speak to a good **local insurance agent/broker** who can help during claims?

For parents’ health insurance, does the intermediary actually make a meaningful difference during a claim, or is it mostly about choosing the right policy directly from the insurer?

I’m not looking for the cheapest policy. I want something that will be **reliable for the next 15–20 years**, especially when my parents are older and more likely to need it.
If you have actually bought health insurance for your parents or have gone through a claim, I’d really appreciate your experience.

**Would you personally continue the Oriental policy in this situation, add a super top-up, or switch to HDFC ERGO/another insurer? And how would you make that decision?**

Used AI for better writing !

Hi i am renewing my policy with Aditya Birla 2 questions I have regards to porting and PED.

Porting: my agent told me as I have undergone a surgery on my left knee if I port they will be a permanent exclusion on my left knee as insurer expects some problem or surgery on that knee.

Renewal: my agent saying that you can renew with Aditya Birla is the best option and no need to disclose PED surgery as it took place after policy inception but I want to be cautious as many claims are being rejected nowadays saying non disclosure of PED.

Heyy! I need some suggestions for health insurance for both me and my husband. We’re both 30 years old.
Our main criteria are:
No room-rent cap
Maternity coverage, if possible
NICU and newborn care coverage
Cashless facility is a must

Also, would you recommend buying the policy directly through the insurance company’s website, through Policybazaar, or through Ditto?

Hi all

A few days ago I was contacted by an insurer with a good premium, good plan. After reading the documents I felt this is good so I went ahead. I disclosed my PEDs - Asthma from my teenage days (never needed hospitalization, nowadays not an issue at all compared to 15 years ago) and a road accident a decade ago which led to stitches and scars but no major complications since. I had paid for a PED wait time reduction rider that included Asthma.

The insurer agreed to issue a policy but put PED waiting periods of 36 months for "respiratory illnesses" and "injuries related to body parts where surgery/dressing has occurred previously". Since I have no lasting complications from my old injury this seemed fine, but the funny part is that the insurer declined the PED wait time reduction rider in my policy and issued a refund of extra amount paid (as premium reduces without the rider)

Now my questions are:

1. "Respiratory illness" is a very broad term, is the insurer correct to issue the caveat?
2. Why did the insurer's underwriter not want to approve the PED waiting time reduction rider?
3. If I wait out the 36 months (written in my policy) will I face no further claims related issues afterwards?

I am still within my free look period, so I am seeking your advice.

Hi guys,

I’ve had Care Supreme for the past 3 years No PED, 31 years, an individual policy purchased through IndusInd Bank. I’m considering porting to HDFC ERGO mainly because my experience with the intermediary during my father’s claim last year was not good.

My renewal is on 1st September, so I’m running out of time.

The porting experience has been horrible so far, especially with Ditto. Their advisor seemed quite inexperienced, and I received conflicting information from them.

Initially, Ditto told me that no deductible would apply for my pincode if the sum insured was ₹10 lakh+, and they even confirmed this over email. They processed my application, but due to a technical issue it wasn't completed.

Now they’re saying there is a new update and that because I’m porting from Care, a ₹25,000 deductible is mandatory.

I also spoke directly with HDFC ERGO, and they said the deductible is compulsory for porting to Optima Secure Plus.

Policybazaar told me that HDFC ERGO does not accept porting if the existing policy was purchased through a bank, even though mine is an individual policy.

I don’t want a policy with a deductible, so I’m confused about what to do.

Would you recommend:

Continuing with Care Supreme, or

Porting to HDFC ERGO Optima Secure Plus with the ₹25k deductible?

Has anyone here successfully ported from Care to HDFC ERGO without a deductible?

Would really appreciate genuine experiences, especially from people who have actually gone through this porting process. Thanks.

Hi,

I am planning to take a health insurance for my family(self+wife+1 kid) and would like to have suggestions regarding which to choose. I already have a health insurance from my workplace for 3 Lakhs and the new one will be a additional. Suggest some good insurance providers.

Hi all, looking for advice on a health insurance issue.

My father has a group health policy (Group Care 360°, Care Health Insurance) through Union Bank of India, continuously renewed since 2018 with some claims during 2020-2023.

On this year's renewal (Jul-2026 to Jul-2027), I noticed a new clause added to my Certificate of Insurance: "20% co-payment will be applicable in all claims." This clause did not exist in any previous year's policy document.

I wasn't informed of this change before renewal. When I raised it with the insurer, they said they'd sent an email about it in May, but I never received any such email. No renewal notice, no notification of changed terms, nothing.

I've asked them to remove the co-pay and issue a corrected certificate, but so far I've only gotten a response pointing to this alleged May email.

Questions:

Has anyone successfully gotten a co-pay clause removed/reverted after it was silently added at group policy renewal?

Is there a way to demand proof of delivery (not just "we sent it") for that email?

Since this is a group policy (bank is the Master Policyholder, not me individually) — is IRDAI Ombudsman even the right escalation path, or should pressure go through the bank first?

Any experience with Bima Bharosa (IRDAI grievance portal) for something like this?

Any pointers on process or precedent would help. Thanks in advance.

Was looking for a policy that would cover the following things:

1. Room rent eligibility - At least single private AC room or any room Policy
2. Waiting period in the policy - No hospitalisation for first 30 days, accidental emergencies should be covered, slow growing diseases since 2 years are not covered, pre-existing conditions since 3 years are not covered
3. Covering all major hospital in Cashless hospital list and preferrably an all India coverage
4. Prefer in house settlements rather than TPA
5. It should cover day care treatments & Ayush plan (24 hour hospitalisation not required)
6. Refill benefit in policy for same & different illness both when cover is exhausted, minimal waiting period beteen restore
7. Would be great if consumables can be covered in the policy if not some add on in which it can be covered would be fine
8. The best CSR & ICR

After doing my research, and considering my requirement Reliance General Health Insurance is what I am inclined towards, please suggest and guide me in the right direction as I am a first time health insurance buyer!

Looking for a cover of 10-20L preferrably. Thanks in advance!