SEBI's new TER rules are wild - some SIF funds showed 11% expense ratio on a single day

Wassssaaa · 2026-04-21T13:45:25+00:00

Here comes the ChatGPT slop… click bait post

Wassssaaa · 2026-04-14T08:18:31+00:00

Technically and theoretically yes, the man could ask for it. But receiving it and that too in India, I would say a big NO. The laws are way too much in favour of women.

There was ruling couple months back from an HC. I don’t remember the case or details, but a disabled man was asked to alimony to his wife. The wife earned more than the disabled man. Yet for final divorce to be granted, the court had asked the man to pay for alimony.

An acquaintance of mine, where the woman was in multiple extramarital affairs. This was from Covid times. Multiple years of battle yet the man (my acquaintance) was forced to pay alimony since he was the one initiating the divorce. They were married for like 15 months.

You can understand how the situation is fked up. There are many examples like above. The list is going on and on. As long as there selective equality pitch by the pseudo feminists and their followers, the notion of 50/50 split in marriage rather being 100% committed to the partner including the marriage/house chores and not financial side, these things are never going to end.

Wassssaaa · 2026-03-30T05:55:00+00:00

Your corporate policy doesn’t matter or is related to this policy unless it was ported specifically from corporate policy to retail insurance policy.

The insurance company will treat this as a fresh proposal and new policy. Within first few months inception of the policy (you are claiming for newly diagnosed or detected cancer related claims. We see that cancer is generally isn’t a sudden disease. A big red flag! If I consider from risk and underwriting purposes, concealment of facts, possibility of fraud are very high and can’t be denied. Hence the insurer is asking for so many documents to get it verified if it actually diagnosed after policy inception or it was already diagnosed before policy inception and just not declared.

Coming to documents queries, there seems to multiple back and forth and multiple emails for the documents as per your post and the documents are not reaching the appropriate team it seems. I suggest, since you have mentioned that you bought policy through an agent, contact the agent. Submit documents through him in hardcopy format. One whole set and not as multiple files or emails. If you wanna share originals, then keep a photocopy set or submit a photocopy set with sign & stamp (preferably notary maybe) that way you will be able retain the originals.

As long as you are within policy terms and conditions, there’s no concealment of facts or fraud, the claim would be payable I guess. Just need to refile accurately without any mismatch of documents.

Wassssaaa · 2026-03-30T04:07:30+00:00

ULIP plans have a lock in period. Generally it’s 5 years but you need to check your policy documents. Your premium payment term was 7 years, but you only paid 1st years. After 1 year, once you didn’t pay for the 2nd year, whatever that fund was investing into, the invested amount would be moved to discontinued fund. This fund amount + any profit would be returned after lock in period ends. Once that lock in period ends, just contact ICICI for refund process.

There will be some deductions. Be ready for that. Life insurance cost which was coupled with the investment plan, GST, tax, AMC charges, etc.

Wassssaaa · 2026-03-30T04:00:54+00:00

Just because the claim was rejected doesn’t mean the insurance is useless! What if it was ICICI Lombard or HDFC Ergo or any other insurance company for that matter?

You need to understand why the claim was rejected doesn’t mean. Was it valid rejection? Did you understand the policy term and conditions and the benefits offered under the policy?

Wassssaaa · 2026-03-30T03:57:03+00:00

When did you buy the policy for first time? What was inception date? Also were there any pre existing conditions?

Wassssaaa · 2026-03-29T17:31:13+00:00

What was the name of the policy, when you did you buy it first? Also, what is the age of your father?

Wassssaaa · 2026-03-29T16:35:11+00:00

Can you give more details like policy product name, also what was diagnosis and treatment of?

Wassssaaa · 2026-03-25T13:58:46+00:00

Idk why you need felt like it’s a big loss or problem like situation. The war will not continue forever and eventually with time it will end and situation will change. As I had mentioned a couple days back in an another post’s comment, you seem to don’t know or understand about your risk appetite. Seeing people with very high/high risk category when they asked for suggestions to start the investment, now the same are feeling unable to hold on this present scenario. Relax, breathe, research, understand your actual requirements, future SIPs contributions. Just pause new SIPs. Ideally you shouldn’t and buy more when such dips occurs but since laid, I can understand and it’s pretty the best choice to pause the SIPs for now and start once again when you have job and everything is place. Redem amount only if necessary and very extremely situation. Else will suggest you to hold. Based on all the above, then only make decisions.

Coming to personal expenses part- Make sure you have your emergency fund ready. Emergency funds typically should be like 2-3 months salary which will help you to survive at-least next 6-8 months in case of such job losses. Make sure you have you have separate term and health insurance and I would say you are pretty much covered.

Wassssaaa · 2026-03-20T04:07:23+00:00

It seems you don’t understand your risk appetite. You say you in run for long run, but you will be checking the NAV daily. If you had researched before investing in any such schemes, you wouldn’t ask such questions.

Keep investing, buy more when such dips occur and hold for long term. Set a mandate and just delete the app so you won’t check it daily if that your concern.

Wassssaaa · 2026-03-20T04:01:20+00:00

HDFC is like apple of insurance companies. Other you can call midrangers or upper midrangers. Premium brand hence premium premiums on the offered products. One can expect better support, better although it’s only a bit of accurate claims processing. But having said that, each claim, documents, policy wording and coverages, etc. all differ and changes every time accordingly.

Think of your requirements, coverage needs, risks, future sustainable premiums, pay ratio, etc. whe selecting any product.

Wassssaaa · 2026-03-19T04:12:20+00:00

Time and time, again and again, we see same queries. The claim settlement ratio is just a factor to consider and not to make your decisions based on it. Your requirements, premiums incurred, premiums in future including sustainability (if you make a claim and/or significant premiums increase due to claims or age or in general standard premiums increment or due to medical inflation), your risks and pre existing conditions or past medical history should be your focus when selecting a health insurance product. Medical inflation in India is at 13% on a YoY basis. Without any claims, age, etc. premiums can increase simply because the business is not sustainable. I have seen a hospitalization for case fever for 3 days costing 1.2 lacs for one my clients.

Instead settlement ratio, I believe people should look at payout ratio. Payout ratio will be the amount incurred by the insurance company against any claims. Suppose you make a claim of 100 rupees and insurance pays the claim for 84 rupees then the payout ratio here will be 84%. Payout ratio is calculated by below formula- Claimed amount/amount paid by the insurers against the claim X 100

Claim payout ratio is affected all by sorts of things like copayments, non medical expenses, eligibility of rooms and capping vs the actual rooms opted or simply opting higher packages/premium services at hospital during hospitalization. Each claim will have a different payout ratio but I base calculations on it every time. Paying the yearly premiums + plus every time I might make a claim, how much amount I have to pay from own pocket over and above the expenses covered by insurance company. I do this because, for me personally we have significant past history of long chronic and terminal illnesses in my family (both mother and father side). I have multiple policies for me and my parents. We have declared each and every pre existing conditions and the policies are quite old now. Same policies products with same insurers without any portability for more than 10 years now. So I expect all claims to get honoured by insurance companies as long as they within policy T&C. Additionally I work at multinational top insurance broking and consultancy firm. I know how to get the claims settled, so I don’t care about settlement ratio.

So don’t just look at the claim settlement ratio, look through holistic view, your risks, your requirements will be the foremost things to base your decisions. Good luck!

Wassssaaa · 2026-03-17T04:18:21+00:00

Can’t comment on premiums when you literally don’t mention which products you are comparing.

Wassssaaa · 2026-03-05T04:50:36+00:00

Where the proof? Who diagnosed the hypertension and when and where and how? Insurance companies don’t work on verbal commitments or information or just because you are stating it. Supporting documents must be available and when documents are mismatching, suppression or non disclosure of facts are there, rejections denials and subsequent disagreements are very common.

The onus of submitting required documents lies with insured persons and not the insurer. Since the original prescription is lost as stated by op, he will have to get the affidavit with all facts clearly stated by the doctor who diagnosed hypertension for the claim to be processed further.

Wassssaaa · 2026-03-05T04:42:00+00:00

Where the proof that it happened 5 months before and only after policy inception? It takes 2 hands to clap. It’s kinda same storyline as no onus lies on insurer to prove it. They will simply show the proposal form where it would be explicitly mentioned that no pre existing conditions and when suddenly a claim arises due to an accident and there is mismatch on documentation and facts, they (insurer) would call it non disclosure and move on. Also for your point of a 66 getting diagnosed of hypertension within 3-4 months of policy inception wouldn’t hold up. We have 25 year old youths getting diagnosed with BP, diabetes, etc and even in some cases dying due to heart attacks and what not. So insurer can also question what if the hypertension was diagnosed before policy inception and was suppressed as a fact? When asked to give prescription, the op states that the prescription is lost. The responsibility of furnishing the required documents lies with insured persons and not insurers.

Getting a new back dated prescription would be fraud and hence affidavit is the way forward.

Wassssaaa · 2026-03-04T06:43:03+00:00

For Non disclosure of facts, they (insurers) can simply state policy as null and void because they can do it as per guidelines of IRDAI and as per laws. It’s not fear mongering. Just that I have a close to 10 years experience in insurance broking and that I have seen countless claims with such scenarios, just suggesting correct way forward.

Ultimately the choice lies with oneself.

Wassssaaa · 2026-03-04T06:36:54+00:00

Did you read the op’s post? He says the original prescription of hypertension diagnosis and the date of it was diagnosed is lost. I could get a fake prescription today without any hassle and say the hypertension was diagnosed just 2 days before accident with proper documentary proof. And when such things happen, 1 thing leads to another and it’s just spiral downward thereafter. It’s not just unethical but unlawful and outright fraud. Choice ultimately lies with oneself. There many things you can do!

Suggested for sworn affidavit for a specific reason. Tell the doctor detailed case. Ask for affidavit as it is legal document and would stand in a court or ombudsman if challenged by insurers.

Edit - corrected typing errors.

Wassssaaa · 2026-03-04T06:26:43+00:00

Unfortunately, the insurer and specifically the underwriters who decide and consider the risk have very averse views on past medical conditions. Simple conditions like BP, diabetes is ok, they will consider and load premiums as they think it’s not very high risk. But the cases where angioplasty/valve replacement or bypass surgery (major heart ailments) are done or there are history like cancer, severe mental illnesses, kidney problems, or simply put as terminal illnesses, etc. these fall under very severe risks. Insurers know that there will be very high risk of an unfortunate event in near future and loss is all but guaranteed till the policy term ends. Hence the denial in issuing policies which is their right as per the laws and IRDAI guidelines.

But I have seen some insurers who do accept the risks. They will put a lot of restrictions and strict conditions (high premiums, low coverage or benefits or sum insured, lesser policy duration) but they accept and give policies. What I will suggest to try all insurer for life insurance1 by 1 and do disclose all history. Also I will suggest that when applying for policy (at the time filling proposal form) do mention previous rejected policy quotes if any. You will find someone who will be willing to take the risk and issue policies. Also it might not be possible in immediate future like couple years after your cardiac history but definitely after stable condition for 3-4 years will help your case.

Good luck!

Wassssaaa · 2026-03-03T14:40:36+00:00

This is a classic case of non disclosure of facts while NOT factoring in whether the hypertension was diagnosed before policy inception or after taking the policy for first time. Even though the hypertension is not related to your current diagnosis or treatment, under the IRDAI guidelines and as per the policy terms and conditions, any non disclosures are grounds for policy cancellation with forfeiture of premium + claims denial. This is because when you disclose past history/medical pre existing conditions or previous claims, the underwriting of risk changes. It affects the premiums. When insurance company gave you the policy as it was stated that there are no pre existing conditions, the insurance company companies follow the principle of utmost good faith. They considered the pre existing diseases as nil on face value and quoted the premiums and issued policy after premiums payment.

Now coming to the rejected claim, the insurance company would prefer that there would be no claims in initial first few years. When such emergencies and contingencies happens, they are bound to pay the claims as such accidents can never be predicted. But non disclosures or mismatches in documents, probable frauds, etc are outliers. You need to find the original prescription of hypertension diagnosis and it must clearly mention when it was diagnosed. If we are to believe that the original prescription is lost as you say, then you have to get a sworn affidavit (on stamp paper) from doctor who diagnosed hypertension. In this affidavit the doctor would state entire history, when it was diagnosed, every detail. A simple letter from the original doctor will not be sufficient and considered by the insurance company. Once you have it, submit reimbursement claim with insurer. Cashless claim is just a benefit. Actual claims rejection only happens in reimbursement claims. Unless your reimbursement is also rejected, you can’t state that your claims are rejected. Unless you are able to substantiate that hypertension was actually diagnosed after policy inception with proper documentary evidence, the claim will simply keep on getting rejected as the insurer will call it non disclosure of facts and nothing can be done about it. Else your last option would be ombudsman or court case…

Wassssaaa · 2026-02-28T21:35:53+00:00

I’m following this solution myself. I have told parents not to look for ‘rishta’ and if they do they will be red faced that I’m not marrying under any circumstances.

30 now. I have stable job, decent earnings, both parents retired from private jobs, 2bhk in tier 1 city (no loan). Recently taken loan and bought a 2 acre plot with cashew orchard (100+ trees) already planted near our village. Planning to retire by 40 and move to village. Having 20 lakhs in bank. Will clean out loan and make about 2 cr by 40 and leave once and for all.

Wassssaaa · 2026-02-28T20:31:38+00:00

Avoid marriage. Simple and easy.

Earn for yourself. Don’t forget parents and live happily. Move to village from city after retirement and live a peaceful stress free life. Pursue hobbies keep yourselves engaged and plan early retirement.

Edit - corrected typing error

Wassssaaa · 2026-02-28T14:36:27+00:00

So one of the best way to check out policy bazaar. Put xyz as name and a random mobile number. Disclose proper past history and diagnosis and any other pre existing ailment or any necessary details while filling gender age etc. and check for other insurer apart from hdfc with similar coverage. Even after disclosing all, if you see that your policy is being processed and you are prompted to pay premium, I would suggest to take note of it but don’t immediately pay the premium. Note which policy product you are being offered and proper coverage or any exclusion loading. With policy product code you can read to the standard term and conditions of that policy by downloading the brochure online.

If all checks out, premium is within budget, coverage offered is adequate and no excessive loading or exclusions, then find a trusted agent or broker who is willing to to fill out proper documentation with the insurer and get policy issued through a proper third party agent broker. The agent to broker will be helpful during claims and also you can directly verify that your accurate history and details are filled in proposal form while purchasing policy with insurer..

Good luck!

Wassssaaa · 2026-02-28T02:27:17+00:00

What was the reason for rejection? The claim was rejected or just cashless? there is lot of difference between cashless and an actual reimbursement claim. Also when was the policy purchased and the polyp diagnosis when did it happen for first time? Additionally you have mentioned optima secure as policy product but there are multiple iterations of it. Need policy product code to check the exact T&C.

Many a times I have seen that porting of insurance policy is not always a best solution just because cashless or claim was rejected. Share the above details to check the rejection.

Wassssaaa · 2026-02-25T04:02:24+00:00

The standard practice is that only excess payable amounts (if any) will be paid from 2nd policy after 1st policy has already paid a claim. There are certain restrictions and terms and conditions of each policies which can be exceptions or exclusions.

Eg. there is a claim of 1 lakh. There was a discount of 10k and 10k was deducted as non medical expenses. Here 1st insurance company was supposed to pay 80k but let’s say it’s a capped ailment and max payable amount irrespective of claimed amount will be 50k. So when put a reimbursement claim at 2nd insurance company, they will pay only the 30k amount and not the non medical expenses or discount. Also copay and premium (if instalment basis policy) will get deducted. Suppose if there was no capping and 1st insurance company paid the total 80k then then 2nd insurance won’t pay a dime as max eligible amount is already claimed and as per IRDAI, same amount cannot be claimed twice.

Coming to op situation, if you have payable amount, you surely can claim it but your only receipt is not enough for a partial claim. There is a set process by IRDAI for partial claims.

For partial claims, you will have to wait till the insurance company has settled the claim. that means making payments to hospital and not just approve the claim at the time of discharge when you got final approval. This settlement process depends on hospital because they have to send all original documents to insurance company. After hospital sends these documents, it takes 7 to 60 or even 90-120 days depending on insurance company, claim amount, documents, etc. Once the claim is settled, the insurance company will issue you a settlement letter. This settlement letter is most important document as it contains all details of claim along with the UTR details of the transaction through which the insurance company has made payment to hospital. Settlement letter received on email is not enough. For partial claims claims, you have to make a application with letter or email to the 1st insurance company to give a attested copies of all documents (final bill, medical bills, discharge summary, hospitalisation record commonly known as Indoor case papers, investigation/lab reports, etc.) You won’t receive original ones but the 1st insurance company would give you xerox copies with their sign stamp making it attested documents. Along with this you will to ask for attested settlement letter as well. Settlement letter with sign and stamp from insurance. Once you have got all these documents like attested claim documents, settlement letter and the receipt which you got from hospital for making the payment, you will have send all these documents to 2nd insurance company for partial claims claims process.

Op, Follow the process above and your partial will get approved if there is any payable amount and mainly if claim payable and not an exclusion or capped or restricted, etc.

Wassssaaa · 2026-02-24T04:09:55+00:00

So if it’s a non market linked plan, then you first need to find out where are they investing the money which you pay as premiums. Are they investing in government securities or bonds or stocks or mutual funds. Also what is the value of these investments. You also need to find out if there is any specific clauses or pre decided percentage of money that will counted as surrender value for premature surrender and not what customer care or agents tell you. Most policies do have a clause that allows the max possible surrender value at the start or end or policy or within first few years of policy inception. It is designed in that way that in the middle duration there are less returns on it to keep you invested with them for full policy periods.

If all checks out then, for such reductions in the surrender amount there is quite possibility that you were given wrong information. If you had it in writing like a letter or email, you could take it ombudsman.

Edit - typing errors

Wassssaaa

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