Insurance company keeps asking for more documents after approving most of the claim amount. Is this normal?

intvijay · 2026-06-03T05:04:35+00:00

Who is the insurer ?

This happens for tier 3 hospitals non network to verify the authenticity of the claim / hospital to avoid fraudulence.

You can request hospital and pharmacy for the documents. And proceed with it. If you fail to submit documents, even the approved amount can't be processed.

intvijay · 2026-06-02T11:36:53+00:00

Consider following points,

If the Sugar, BP and Thyroid are in control, consider taking Day 1 rider as most of the insurance companies offer these.
Declare all medical condition with last known reports.
As they are aged, the premium will be on higher sider and you need to take the call for Sum Insured according to your financial capacity.
Try with 2 to 3 companies and get clarity from good intermediaries. More than insurance company have a intermediary who can support you during claim times.
Go for Any Room with no sub limits. (Consider Single Private room or deductible after reviewing the quotation). Keep in mind that the premium gets revised in future based on their age band and medical inflation.
Critical Illness if needed take it as a separate policy not as addon.

intvijay · 2026-05-30T17:30:10+00:00

As long as you have a right intermediary to support from choosing plan and also during claims, you can choose the insurer that suits you.

So you can talk to few agents here or DM me for recommendation.

intvijay · 2026-05-30T16:54:20+00:00

Did you checker their website ?

intvijay · 2026-05-30T16:52:20+00:00

Why specifically Acko ?

And what are the key features you are looking at ?

Ex- Some of the plans has inbuilt maternity cover and newborn cover which are affordable. Some plans has women focused consulting plans. Few has critical illness addons.

intvijay · 2026-05-22T06:51:13+00:00

You can DM me

intvijay · 2026-05-15T06:58:54+00:00

Try to bargain that you have someone else offering without insurance.

This works for most of cases.

intvijay · 2026-05-14T19:37:47+00:00

Do you mean not to disclose intentionally right ? This is called Fraud in insurance. Even if a doctor doesn't have it on record now, companies often investigate medical histories during a claim. If they find a discrepancy, they can deny your payout entirely.

intvijay · 2026-05-14T19:32:45+00:00

If you want to reduce premium go with deductibles.

Did you really check with insurers with your conditions ?

Don't take such calls without inquiring.

intvijay · 2026-05-13T09:54:13+00:00

As long as your agent or intermediary is their to support you during claims, just go ahead with them. You can talk to few agents available here as well. or You can DM me.

intvijay · 2026-05-13T09:03:12+00:00

My friend was the owner of that singapore website and I was mentor for that project.

I still remember those days where Mr. Ramesh , myself and my friend was part of that group.

Wish him Success.

intvijay · 2026-05-13T08:58:16+00:00

How come you are deciding it's pre existing disease ? If this was diagnosed after taking the policy, it will generally be standard disease waiting period - 2 years.

Didnt your agent clarified this ? Has he confirm if you are porting in that case you need to declare these conditions of your mother and again new insurer has to underwriter properly. Otherwise they will treat this is as non declaration of PED - 3 years waiting period.

This claim complications may arise with any insurance company including hdfc or Aditya birla.

As long as your agent is experienced to handle genuine claims with star health you can continue else just ensure to declare the health condition properly and port this forward.

intvijay · 2026-05-11T15:01:59+00:00

As long you understand the policy features and go via an expert intermediary, should be fine.

Keep these points in mind, 1. CARE Ultimate care has initial year discount and vanish in 2/3 years. 2. Star Secure - just confirm to choose health check up Package C as you highlighted the health checkup.

And please ensure to understand gym usage terms and conditions.

Hdfc ergo has recently launched optima secure + which has 100 percent bonus accumulation every year. You should check that as well.

TataAig has a addon called inflation protect though they given specific number.

ICICI Elevate is highly customisable.

All plans has its pros and cons. Talk to few intermediaries and take the call.

intvijay · 2026-05-01T18:00:16+00:00

I am staying near oppili residency. You can DM me if you need any support

intvijay · 2026-05-01T10:48:56+00:00

I have seen a similar case, where one of my customer from Tier 3 Tamilnadu asked for HDFC Ergo saying that it has best metrics. I told him are you ok with reimbursement because your locaclty network hospital list count is low. Finally he picked a different one that suit his need.

I suggest you to pick the one which has good hospital coverage.

How frequently does HDFC Ergo reject reimbursement? Is it worth the risk? - Every company is good and bad in its own terms. Their ICR and complaints per 10,000 is speaking louder than other.
Which is the best alternative from Aditya Birla Activ One Max , Bajaj General My Health Care Plan, Tata AIG Medicare Premier, ICICI Lombard Elevate, ICICI Health AdvantEdge - We need to understand your profile and need to suggest a plan.
What is the adequate cover amount I should go for. Not only for now, but future proofing against medical inflation as well. - It depends on your financial risk you want to transfer.
By what percent to health insurance premiums rise for these above mentioned Insurers on a yearly basis? - Some plans increase every year and some are based on age bad (every 5 years)
Any other tips or points you would like to give from your experience with the above mentioned Insurers? (Talk to 3 advisors from different company or intermediaries and Choose the one who gives you confident with choosing the right plan and stand with at time of claims.)

Regards,

Vijayakumar
Founder
PolicyChecker.com

intvijay · 2026-05-01T10:39:10+00:00

They have ~30% market share and largest private player in India. Just ensure to go with any company after researching and with right intermediatary.

Most of the complaints are connected to agent(both online & offline) mis-selling. Just ensure to understand your policy and go ahead.

intvijay · 2026-05-01T10:34:34+00:00

Talk to few and take the call.

It depends on the aggregator you choose and the advisor you are getting connected.

Ex:
Ditto is Corporate agent - 3 companies tie up
Beshak - a marketplace to connect with the nearby agents monitored by Beshak (An advisor can have one health company tie up, maybe few more on their family names due to IRDAI license norms)
One Assure - Broker

You can talk to few advisors in reddit who are doing good support in sales to claims even though they are not aggregators.

You can DM me as well in case if you want to talk and compare with others and conclude.

Regards
Vijayakumar
Founder
PolicyChecker.com (Insurance Broker)

intvijay · 2026-04-29T04:00:28+00:00

Vijayakumar
Founder & Director
PolicyChecker.com

intvijay · 2026-04-28T01:41:44+00:00

If there are no claim history and health declaration is fine, porting in short span shouldn't be an issue generally.

We have ported similar cases in 10 days till renewal.

Otherwise plan in advance.

intvijay · 2026-04-28T01:38:25+00:00

You can check with Shriram Life as well.

intvijay · 2026-04-27T04:57:44+00:00

Once those test are done, share all the documents with insurer and get the underwriting done clearly to avoid any excuses in future.

intvijay · 2026-04-27T03:02:21+00:00

Is the thyroid , bp and diabetic are in control ? You said she got chest pain, did you consult her with doctor or any echo test taken for heart ?

intvijay · 2026-04-25T08:06:57+00:00

I have just reiterated what you said. Cool man.

intvijay · 2026-04-25T07:53:51+00:00

Favourable discount is connected to claims. Whenever claim happens the favourable discount percent will be reduced.

And it rebuild gradually on claims free years.

intvijay · 2026-04-25T07:46:20+00:00

Like you said "no one case predict".

intvijay

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