🚨 Insurer rejected a 9-year-old girl’s health insurance claim.
Saying, she had a pre-existing condition.

And her own mother herself confessed to it!

Still, Ombudsman asked the insurer to pay the claim.
Whaaat-whyy?! 😳

Let’s break down the story in S01E75 of #ClaimStories 👇 Seeing your child in the emergency room is one of the most stressful situations a parent can go through. 💔

But it's even more heartbreaking when the one support system you rely on - your health insurer - turns its back on you.

This is the story of Abha Shah, a mother who faced just that.

🚨 ~70% of health insurance customers are unaware of their rights.

Don’t be one of them. ❌

Here are 10 essential rights EVERY health insurance consumer must know. 👇

#healthinsurance #insurance #rights 1️⃣ Right to lifelong renewability

Your insurer cannot deny policy renewal due to age or past claims.

They can deny renewal only if:
• You committed fraud or misrepresented fact
• You bought the policy with the intention to make a false claim

A man bought two life insurance policies for his brother’ 💰💔

But when tragedy struck, the insurer said - brother cannot claim the money! 😨

Why? Because of ONE MISSING SIGNATURE.

What happened next?

Find out in S01E71 of #ClaimStories  👇 Everyone who buys life insurance has their own unique cause behind it.

Some get it to secure their family's future, others, to protect their families against financial burdens like debts.

But what if this security is taken away just because of one missing signature?  😦

That’s what happened in today’s story…

A single mistake by the hospital turned into a claim rejection. 🚨

The hospital called it an error.
The insurer called it fr@ud!
The patient’s wife called it unfair.

Only the Ombudsman could settle the dispute.

What was the verdict?
Find out in S01E70 of #ClaimStories 👇 We buy health insurance so that in the harsh times when we or our family need care and healing, we don’t have to worry about finances.

But sometimes, even a small confusion can turn this assurance into another battle.

Something similar happened with Sheila Devi…

🚨~ ₹1.05 Lakh claim rejected 🚨

"You hid your illness," said the insurer.
“Hid? How? I didn’t even know about the illness”, said the customer.

Neither did he know how to fight back.

Luckily someone knew.
Another story of how #ExpertsFightClaims 👇

#insurance #healthinsurance #claims #awareness Praveen Kumar never saw this coming.

For years, his life revolved around his kirana shop in Haryana. He opened before sunrise, closed after sundown, and made sure every home in his neighborhood had their daily essentials.

But life doesn’t ask before it changes…

Customer files a life insurance claim of ₹30,00,000.
But insurer says the POLICY WAS NEVER ISSUED! 😨

They said the customer never shared the mandatory medical test report.

But the customer says the insurer never asked for it! 😳

Where did this dispute end?
Find out in S01E69 of #ClaimStories !  👇 Everyone has that ONE source of assurance that they trust for worst-case scenarios.

For many, it's divine energy.
For some, it's an insurance policy.

D. Srinivas and his family were the second kind of people.

Accident at 2:15 PM. Policy issued at 3:54 PM.
~₹76,00,000 insurance claim at stake! 😱

Insurer denies it, calling it "fraud".

But was that really true?
Supreme Court had the final say.

Find that out in S01E67 of #ClaimStories 👇 Getting motor insurance seems simple enough - get a quote, submit a proposal form, pay the premium, and voila! Policy issued, right?

But what happens between premium payment and policy issuance? 🤔

More importantly… does coverage apply during this period?!

A woman passed away, leaving behind a Rs 4,33,495 hospital bill.💔

Insurer rejected the claim, citing a pre-existing condition that had ALREADY been declared!

Is that even legal?
Find out in #ClaimStories S01E65 !  👇 Remember how we always tell you - Share all your medical conditions, lifestyle details, etc. when filling out your health insurance proposal form?

This ensures that the insurer is aware of your condition, and provides coverage accordingly.

But what if, even after making honest declarations, your claim is rejected on the grounds of “non-disclosure”?! 😨

₹25 Lakhs approved in 4 Hours? 😲

Saif Ali Khan’s cashless claim of ₹25L was approved in just 4 hours. 🚨

AMC has written to IRDAI, questioning why celebrities get such swift approvals, while ordinary citizens face delays & lower limits. 🧵👇 According to AMC, this case highlights how celebrities and corporate policyholders enjoy favorable terms and faster approvals.

Meanwhile, regular policyholders face slow processes and lower initial sanction limits. 😓

A man lost his life in a tragic accident 💔

Insurer denied wife’s claim, saying term insurance premium wasn’t paid 😳

But the Ombudsman STILL asked the insurer to pay the claim! 🧐

How's that even possible?
Find out in S01E62 of #ClaimStories 👇 We know insurance is a contract - you pay the insurer premiums and they take care of your and your loved ones’ financial future during tough times.

But what happens if premiums aren’t paid? Can it ever be negotiated? 🤔

A cancer patient filed a health insurance claim for chemotherapy twice 🎗️

Totaling Rs 1,94,661.

Insurer approved it the first time.
But denied it the next! 😱

What went wrong the second time?

Find out in S01E60 of #ClaimStories 👇 Is your partner aware of all the insights of your health insurance?

Haan haan, even if it’s your personal health insurance.

Why should THEY be aware of it?

Let Poonam Lalwani’s story tell you…

Insurer denied son’s death claim of ₹14.45 lakhs😰 Why?

The “type” of disease he lost life to wasn’t covered! 😕

Mother fought the case in 3 courts.
Finally, judge highlighted a MAJOR concern in the policy wording!

What was the final verdict?

Find out in S01E58 of #ClaimStories 👇 Ever thought, when your insurance policy says it will cover a disease, say, a “lung infection”, what kind of lung infection is it talking about?

What happens if your claim is denied because the “type of infection” YOU had isn’t covered?

₹5L claim declined - due to hospital’s typo error! 😳

Customer gets hospital to clarify. 🏥
Insurer disagrees. 🙅‍♂️

Customer’s insurance advisor gets into action. 💪

Another story of how the right expert can help. 👇

#ExpertsFightClaims It all began when the customer was admitted to the hospital with mild chest pain, thinking it was just a minor issue. 🛌

However, after careful observation, the doctor recommended a Coronary Artery Bypass Graft (CABG) surgery - a procedure to prevent any major heart risks.

Insurer rejected death claim of son, worth Rs 21.75 lakhs! 😰

Father fought through 3 courts for 20+ years.
And the verdict is recently out.

Did he win after two decades of a relentless fight?

Find out in S01E57 #ClaimStories 👇 Your insurance proposal is accepted.
You pay the premium, receive the payment receipt.
The insurance coverage begins.

But you haven't received the policy papers yet.
Is that something you must be concerned about?

Dr Tyagi’s story has your answer…

Husband buys life insurance, passes away just 5 months later 💔

Insurer rejects wife’s claim!

Wife fights back... but the truth she uncovers changes everything 😱

What shocking twist turned the case?
Find out in S01E56 #ClaimStories 👇 You must have heard about girl-talk!

Our moms and maasis are typical examples of how women share everything with each other.

But have you ever heard about insurer-talk? 🧐

🕵️‍♂️ We went undercover, testing Tata AIA Life

From policy purchase to cancellation, we reviewed every step of the process.

What started as a simple purchase turned into a series of unexpected hurdles.

Read the full review 👇 Pre-Purchase Experience -⭐⭐⭐ (3/5)

👉Initial Contact: We connected with an agent quickly after calling their toll-free number.

👉Quality of Advice: At first, the agent couldn't answer our questions properly and said they’d call back. On the second call, however, they gave a detailed explanation and clarified everything.

Insurer denied ₹2.5 lakh claim

Reason? "Hospitalization not necessary"

Customer went to Ombudsman, argued doctor advised it. Still, no payout.

This has become very common.

Let's understand:
👉Why this happens?
👉How can insurers dispute doctor's advice?
👉What can you do? First, why does this happen?

To make sense of this, let's understand the different incentives at play for both doctors and insurers.

A policy with “special support to senior citizens”
Denies an elderly’s claim of Rs 3.2 lakhs! 🥺

Case was dragged through 2 courts.
Elderly fought for 8 years. ⚖️

Finally, the verdict is out!
Did his struggle pay off?

Find out in S01E48 of #ClaimStories 👇 Health insurance is meant to be our safety net, ensuring that when we are no longer able to take care of ourselves, it will take care of our health needs.

But for one man, this security quickly turned into a battlefield - just when he needed it the most! 😔

🕵️‍♂️Beshak Test Drive Report Card: ICICI PruLife Insurance

We went undercover to test ICICI PruLife’s insurance process, from purchase to refund.

The result? Some things worked well, others not so much.

Here's our honest review of their performance.👇 Pre-Purchase Experience -⭐⭐⭐ (3/5)

👉 Initial Contact: Our journey began with a call to ICICI PruLife’s toll-free number, where we were connected to a customer service representative.

Health insurance claim of ₹4,42,811 settled for just ₹97,662 😲

Reason: "Proportionate Deductions"

What does this mean? And most importantly, how to avoid it?

Let’s find out! 🧵👇 When you buy a health insurance plan, you expect your medical bills to be fully covered.

But hidden within the fine print are terms that could drastically reduce your claim. One of the most common is 'proportionate deductions' linked to the 'room rent limit'.

🚨Breaking a signal may cost more than just a challan.

It may hike your insurance premium too.

Here’s what Delhi’s Lt. Governor has proposed to Nirmala Sitharaman

A thread 🧵👇

According to Lt. Governor VK Saxena, linking insurance premiums to challans could incentivize safer driving and promote responsible behaviour on India’s roads.

A financial penalty could make drivers think twice before breaking traffic rules.