r/indiahealthinsurance

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▲ 10 r/indiahealthinsurance+1 crossposts

My father had a fall on 23-02-2026, he suffered fracture and was operated.

They rejected the claim saying patient had pre existing decease which was not disclosed at the time of policy issue which is completely false.

My father was diagnosed with hypertension after policy issue for which we also provided the original prescription letter from doctor.

Secondly they said that patient had pain and swelling in right groin and was unable to walk from 23-02-2024, which is very funny because he had that after the fall on the same day 23-02-2026. I don't know how they can read from doctors progress report 26 as 24?

We raised this issue as well provided the letter from.treating doctor itself.even after providing all this info they rejected my claim.

Funnily enough they read the date themselves wrong and rejected and rejection because of BP which is nowhere related to the fall.

What should be done in this case?

u/Disastrous-Fan231 — 10 hours ago

Early in my career and looking to buy health insurance. Is Arogya Sanjeevani a good choice?

Hi everyone,

I'm in my early 20s and have recently started my career. I want to buy my own health insurance instead of relying only on my employer's corporate policy.

While researching, I came across the Arogya Sanjeevani Policy. From what I understand, it's a standardized policy offered by all insurers, but I'm not sure if it's a good long-term choice or if I should spend a little more on a comprehensive plan. �

NITI AAYOG +1

Has anyone here actually used an Arogya Sanjeevani policy or made a claim under it?

I'd appreciate any insights on:

How has your claim experience been?

Any drawbacks you discovered after buying it?

Would you recommend it for someone just starting their career, or should I look at other comprehensive health insurance plans instead?

For context:

Age: 24

No major health issues

Looking for an individual policy primarily for financial protection against hospitalization.

Used ai for polished version

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u/law_da_lahsun — 8 hours ago

Help me decide health insurancer

We are 7member in the family. Me, wife, our 2 kids, my sibling and parents. I have covered my family and parents from corporate insurance. But that doesn’t seem like enough. I am looking to cover my sister as well. Should i buy from outside? How should i design it? Should i design in one policy or different policies? I am also looking for the amount including with insurer and policy. One of my kid has CHD. So he went through open heart surgery if their any policy which can cover him as well.

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u/Dev-Tech-2513 — 14 hours ago

Does buying insurance via Amazon vs agent make a difference?

I have shortlisted the HDFC Ergo Optima Secure Policy. Amazon is offering a pretty competitive price compare to going via an agent from Beshak. From what I know the commission is 5%, but the difference is more than that.

My only question is - does it make any difference during times of claim?

25M, No preexisting disease, getting my first HI, have corporate cover already.

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u/why_notme007 — 23 hours ago

Looking for a good health insurance for 20 year old.

Hello, I am 20F. My family does not have health insurance currently. I want to buy a good health insurance for myself. Can you all suggest something? I do not have any diseases. I want to find one with an affordable premium. Thank you

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u/Mindless-Woke925 — 1 day ago

Optima secure plus

I wanted to port from my existing star health policy (10 years) SI 10L.

The hdfc advisor conveyed me that for porting-

  1. I need to increase SI to atleast 15L or above

  2. Need to opt for aggregate deductible of Rs 25,000 per year. There is no complete cashless policy.

Can anyone who has ported confirm if above 2 conditions are true?

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u/silly_lilly12 — 1 day ago

What’s the biggest mistake people make while buying health insurance? And how is Care Supreme?

Bhai I always thought ki mujhe insurance ki kya hi zaroorat hai abhi se but recently I heard that some of my friends had to be admitted to hospitals due to issues like diabetes and BP.

So now I’ve started thinking ki ab mujhe bhi le hi lena chahiye but ab yeh confusion ho rahi hai ki kya kya check karu lene se pehle.

At first I thought it’s just about picking a decent cover amount and that’s it but the more I read, the more I realised how many things people usually ignore like waiting periods for pre-existing diseases, room rent limits, sub-limits on treatments, and even the hospital network.

Before this I would have probably just gone for the cheapest premium without understanding all this. Right now I am thinking about the care supreme plan from care health because it doesn’t have room rent limits and ek optional add-on bhi aata hai jo PED waiting period kaafi reduce kar deta hai.

Now I am wondering what are some mistakes people usually make while buying health insurance that they regret later? Ignoring PED waiting period? Not checking exclusions properly?

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Health insurance for self plus parents ; Should I get one plan or seperate ?

I want to get health insurance with my parents who are 60

Should i get family one or separate since I will get married too

Acko is offering me their platinum plan for 50k in offer

Kindly shed some light

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u/nik_awesome — 1 day ago

Aditya Birla insurance job

Hey so basically I gave an interview, they said I need to give IC38 exam then I'll have a training period of 3 months after that I'll be promoted to Agency partner. Can someone shed light on it if it's a scam?

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u/Seraphim_talks — 2 days ago

I'm layed off. Office offers me to port the health insurance without waiting period. It's New India Assurance policy. Is it worth?

  1. Is new india Assurance policy worth? They are asking a premium of 15k for 10Lakh and 18k for 15Lakh cover.

  2. Policy has capping of treatment limit for certain diseases. Can overcome it by having a top up/ super top up insurance policy. If the main policy doesn't cover, will the supertop cover it?

u/New_Hat_1482 — 3 days ago

Looking for the best health insurance for my parents (57 & 47) – Need suggestions

​

Hi everyone,

I'm planning to buy a health insurance policy for my parents and would really appreciate some advice from people who have gone through this.

My father is 57 and my mother is 47. Neither of them has had any surgeries or major hospitalizations so far. However, both of them have diabetes, which is well under control, and my mother also has thyroid, which is also under control with medication.

I'm looking for a ₹15 lakh family floater (combined) if that's the right choice, but I'm also open to separate policies if they're better for this situation.

So far, I've checked Star Health and Care Health, but I'm still not fully convinced after reading different reviews.

My questions are:

- Which insurer would you recommend for parents with pre-existing diabetes?

- Is a family floater a good idea, or should I buy separate policies?

- Are there any insurers known for a smooth claim settlement experience?

- Any policies or insurers I should avoid?

I'd really appreciate recommendations based on actual claim experiences rather than just brochures. Thanks in advance!

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u/Life_Competition_99 — 2 days ago

Need opinions before buying HDFC ERGO Optima Secure+

I'm in my early 20s, healthy, with no PEDs, and looking for a health insurance policy that I'll keep for the long term.

After comparing several plans, I'm leaning towards HDFC ERGO Optima Secure+. Claim settlement experience and policy quality are my top priorities, so I'm okay paying a slightly higher premium if it's genuinely worth it.

The main feature that attracted me is the Infinite Benefit (100% base SI added every renewal regardless of claims, with no maximum limit). I went through the policy wording and couldn't find any obvious hidden conditions.

Is Optima Secure+ currently the best overall plan, or are there better alternatives? Also, are there any catches with the Infinite Benefit that I may have missed?

Thanks!

u/Fun-Staff-5513 — 4 days ago

Health Insurance for parents

I am seeking to procure health insurance for my parents, aged 45 and 49. I have narrowed my options to HDFC Optima Secure+ and ICICI Elevate. However, during a consultation with Ditto, they advised against ICICI due to its reportedly low Claim Settlement Ratio (CSR), suggesting Care Supreme instead.

Are there any other suitable plans available for my specific requirements at this time?

Is ICICI Elevate a good choice?

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u/Difficult-Cattle-362 — 3 days ago

Please Suggest a good health insurance for parents (senior citizen)

Currently my parents are 67, 64 currently. They've no major surgery or health issues as of now. Is it a good idea to take health insurance now?? Any good health insurance which would be good??

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u/Particular_Permit369 — 3 days ago

How much time for HDFC ergo health insurance acceptance?

Hi
I applied for a family floater me, wife kids with some PEDs,
1.how much time does it take for accept/rejected notification?
2. I have written mostly the doctors exact diagnosis while filling and attached reports if any, does ergo call back for more information?
3. Does hdfc ergo go through every parameter of blood report if attached, doctor hasn’t mentioned anything about those parameters though.

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u/Ok-Philosopher-1236 — 3 days ago

Need Health Insurance Advice for My Brother's Complex Medical History (India)

Hi everyone,

I'm helping my brother purchase his first comprehensive health insurance policy and would really appreciate suggestions from people who have experience with underwriting, pre-existing diseases (PEDs), or similar situations.

My Brother's Profile

- 28-year-old male

- Unmarried (buying an individual policy for now)

- Plans to convert it into a family floater after marriage, so we're looking for an insurer that allows this without losing continuity benefits.

What We're Looking For

- ₹10 lakh sum insured

- No room rent limit (any room category)

- Restoration benefit (preferably unlimited, or at least 100% restoration) that works for both the same and different illnesses after partial or full exhaustion of the sum insured

- Consumables cover (either inbuilt or available as an add-on)

- No co-pay or arbitrary claim deductions

Medical History (will be fully disclosed)

  1. Eye Condition

- Certified Low Vision (60% disability)

- High myopia (-6.5 left eye, -6 right eye)

- Cataract surgeries in 2001 (3 surgeries across both eyes; the first two attempts failed)

- Glaucoma surgery in the right eye in 2016

- Currently using prescribed Misopt eye drops daily

  1. Blood Condition

- Diagnosed with a condition causing persistently high hemoglobin (polycythemia)

- Managed through therapeutic phlebotomy every 6-8 months

- No major complications otherwise.

My Questions

  1. Which insurers are most likely to issue a policy without permanently excluding his eye condition or blood disorder?

  2. If exclusions aren't avoided, which insurers are generally more reasonable with waiting periods or premium loading for cases like his?

  3. Which companies have the easiest process for converting an individual policy into a family floater later while retaining continuity benefits?

  4. Has anyone with a similar medical history successfully obtained comprehensive coverage? If yes, which insurer and what were the underwriting terms?

I'm looking for genuine experiences from policyholders, insurance advisors, or anyone who has gone through medical underwriting with similar conditions.

Thanks in advance for any advice!

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u/Knight_Fury96 — 3 days ago

Star Health rejected my enhancement request

Star Health support informed me today that my policy enhancement request has been rejected. We've been with them for 15 years.

My parents claimed in the current policy that's going to expire in 30 days. My mother went through a heart stent and balloon angioplasty in the current policy that's expiring.

After learning that we can raise enhancement requests during renewal, I submitted a request to upgrade the policy SI from 4L to 10L. This is because the current level isn't suitable for the current health market.

What do I do now?

More details of my insurance on this post: Insurance details.

u/eddigudda — 4 days ago

Need genuine advice

I am in dire need of genuine advice basis your experience with these health insurance

I’m 27 Male looking to get a health insurance for myself. I have locked in a 15lac Base SI but confused between these two companies
Premium charges:
Hdfc - 10,643
Care Supreme - 10,006(added add-ons to be at equal par with HDFC benefits)

I have an inclination towards HDFC for now and can easily go with HDFC at present with my current finances.
But what concerning me is the premium when I touch 60years basis below(Hdfc increases premium by 3-4% annually vs Care does it every 5years by 15-20%) :

HDFC premium for a 60year right now is 48,200
Adding a 10% increase gets me to 53,020(61year) and adding 10% every year touches the premium to
85,389(66years)

On other hand for Care Supreme(exact same benefits) (post 60years of age is a steep jump and then on every 5years a 30% increase)
61year premium right now is 40,944, adding 30% to it comes 53,330 for 66years of age

No it comes to ₹85,389 for 66years in HDFC vs 53,330 for 66years in Care

Concerning part is would I be in a financial condition of bearing a whooping 85k at a age of 66years(probably no corporate job by then)
Or I should go with Care since 53k is way less

Confused between the reliability and strong claim processing among the two Health Companies.
Pls chime in with you reviews

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u/Few_Entrepreneur_895 — 4 days ago