Personal Experience – Warning About Star Health Insurance

[HumorSimpson]

These are the things I know but the things can be known better when someone claims (ground reality).
But from my understanding, never choose coinsurance, room caps & Ambulance limitations. In addition, if taking policy in groups or for elders then restoration should be there.

Whats a restoration and coinsurance ?

 

[OptiCard]

Whats a restoration and coinsurance ?

Restoration means -->
Let say the coverage is 10L --> if someone admits and took 8L claim then in next admit again the coverage amount will be 10L (not 10L - 8L = 2L). Unlimited restoration --> Consider this as most important factor when the parents are in senior citizen band.

Coinsurance means --> a part of bill amount that everytime you need to pay.
Let say the bill is of 5L and the coinsurance is of 20% --> then need to pay 1L from the pocket and remaining will be on insurance company

Never choose deductible & coinsurance. Even deductible is somehow better but I strongly oppose both.

 

[sunit123]

Could you please tell the procedure to complaint to IRDAI ?

on following portal

https://bimabharosa.irdai.gov.in/

 

[Mekala ManojKumar]

Thanks again for all your responses. I want to understand stand the ground reality of other insurances as well. No bother about the premium but I want to be safe when it comes to claim. And want to know the port procedure as well.Thanks advance

 

[Zacobite]

Thanks again for all your responses. I want to understand stand the ground reality of other insurances as well. No bother about the premium but I want to be safe when it comes to claim. And want to know the port procedure as well.Thanks advance

Ergo / icici / tata / birla/ care are better in that order

 

[sunit123]

Thanks again for all your responses. I want to understand stand the ground reality of other insurances as well. No bother about the premium but I want to be safe when it comes to claim. And want to know the port procedure as well.Thanks advance

check claim settlement ratio through following link....Among old and established companies, HDFC and Reliance General insurance has 99%+ claim settlement ratio...Personally i have reliance as its premium is very less compared to others and has best features..Reliance health is different company and its claim settlement is low....I have health insurance from reliance general

Avoid birla/care/niva bupa/tata etc

Latest claim settlement ratio of health and general insurance companies released by IRDA in 2025, Navi, Acko take lead, Star Health, Zuno fall below 90% - The Economic Times

As per IRDAI, Acko General Insurance leads amongst all general and health insurers with a 99.91% claim settlement ratio within 3 months. Among public sector insurers, United India Insurance stood at 96.33% and overall, general insurers settled 81.13% of all their insurance claims received within...

economictimes.indiatimes.com

 

[SnowLucifer]

Same happened with me. My fathers claim for a heart stain got rejected because he is taking some neurological medicine ( neuro problems started after we took the policy). Kuch relation nhi bas unko reject karne ka bahana chaiye. Prior to that we got 60k cashless approval for eco and epf study. But when the claim for stain got rejected they denied the previous approved amount too. Thankfully we had sastasaathi ( west bengal health insurance scheme for everyone) so we got the satin covered. But for eco and epf study we paid 70k. The agent told the amount will be reimbursed in our account by filling some documents no update yet. But one thing for sure health insurance of some type is must. If we had to pay for the stain the amount would have been 3 lakhs hospital told. But we got message that 56k cashless has been allotted in sastasathi ( west bengal health scheme). So you can imagine how much hospitals loot from patient without insurance .

 

[sunit123]

Bad news for those having Care and Bajaj

No cashless treatment for Bajaj Allianz starting next month, CARE Insurance also issued notice, says AHPI - The Economic Times

Big hospitals in North India, such as Fortis and Max, may stop cashless service for Bajaj Allianz from September 1, 2025. CARE Health might face the same issues if the problems persist till August 31, 2025. The hospital group, AHPI, cites rising costs and slow claim settlements. This could mean...

economictimes.indiatimes.com

 

[OptiCard]

Bad news for those having Care and Bajaj

No cashless treatment for Bajaj Allianz starting next month, CARE Insurance also issued notice, says AHPI - The Economic Times

Big hospitals in North India, such as Fortis and Max, may stop cashless service for Bajaj Allianz from September 1, 2025. CARE Health might face the same issues if the problems persist till August 31, 2025. The hospital group, AHPI, cites rising costs and slow claim settlements. This could mean...

economictimes.indiatimes.com

I don't know why but Tata Neu folks stressed a lot on care plans when I was porting my parents Star Health insurance.
PolicyBazaar stressed on NivaBupa.

Might be having good commission.

 

[DS_CoolGuy]

Entire insurance industry is running by agents. When I was planning to port out, I reached out to Ditto. They suggested me Care and HDFC Ergo. Later, I came to know that they suggest only these two company’s policies to everyone.

 

[sunit123]

Entire insurance industry is running by agents. When I was planning to port out, I reached out to Ditto. They suggested me Care and HDFC Ergo. Later, I came to know that they suggest only these two company’s policies to everyone.

Always do own research and buy directly online. दलालों से सावधान

I bought travel insurance for international travel from reliance general...The quote given by policy bazaar was 9000 Rs and i bought directly a better policy with high coverage @ just Rs 4000.

 

[OptiCard]

Entire insurance industry is running by agents. When I was planning to port out, I reached out to Ditto. They suggested me Care and HDFC Ergo. Later, I came to know that they suggest only these two company’s policies to everyone.

Ya forgot to mention on Ditto.
Ditto too stressed on HDFC Ergo though I said I only want Aditya Birla One Max.

Ditto said, we can't port to Aditya Birla but can issue new policy with them.

 

[iROS]

Everyone has their own horrific experiences with all Health Insurance companies. I feel there is no single answer to our question regarding which is absolute best. I know many people say Ergo/Elevate is best and it might be now but who knows how it will fare in future? Suddenly all over youtube/twitter/reddit & Agents are recommending Ergo/Elevate. Porting isn’t easy & straight forward if you have already claimed in your previous policy. New insurer might not allow you to increase the sum assured in future when you can afford it. People say Care is the worst but my personal experience with my family member was great with it. My experience with Star is mixed. But one thing is for sure that most of insurers will not reject genuine claims like emergency/elective surgeries.

 

[littlefinger]

Star Health is worst health insurance company. Their customer support also feels that they're the boss and always talk on harsh tone.

Recently I went through my parents policy and found:

1. He's paying 45K for just 5L insured amount
2. The NCB used to increase with just 50K every year & if claims then it will be back to 5L
3. Ambulance coverage to 5K
4. Room rent max as Private AC Room
5. No Restoration
6. Worst Part --> 20% coinsurance from the age of 61 years
7. No day care treatment
8. No Hospitalization cover for home
9. Free Health checkup only upto ₹1500 (including all insured)
10. Consumables excluded

I ported to Aditya Birla Active One Max (this month starting only). Why ?

1. Though paying ₹53k but getting 10L coverage
2. The NCB will be increased 100% of the coverage & doesn't matter if claimed or not
   Example:
   Let say the policy insured amount is 10L then next year it will be 20L and then 30L --> irrespective of claims (means no reduction)
3. Unlimited restoration
4. No room cap (can take ultra deluxe, rocket, cloud & bla bla type of room upto insured amount)
5. Day care treatment covered
6. No coinsurance
7. Covers hospitalization at home
8. Consumables included (based on annexure, not everything)
9. Air & Road ambulance covers till insured amount
10. Some discount based on health tracker app --> not sure if it's gimmick or really works (I won't care much)
11. Free health checkup to all member (need to explore still like per member what is the test package. I am expecting better than Star Health which gives only ₹1500 over all the members)

Note:
These are the things I know but the things can be known better when someone claims (ground reality).
But from my understanding, never choose coinsurance, room caps & Ambulance limitations. In addition, if taking policy in groups or for elders then restoration should be there.

How is Aditya Birla One Max experience so far ?

 

[magscas]

Star Health is worst health insurance company. Their customer support also feels that they're the boss and always talk on harsh tone.

Recently I went through my parents policy and found:

1. He's paying 45K for just 5L insured amount
2. The NCB used to increase with just 50K every year & if claims then it will be back to 5L
3. Ambulance coverage to 5K
4. Room rent max as Private AC Room
5. No Restoration
6. Worst Part --> 20% coinsurance from the age of 61 years
7. No day care treatment
8. No Hospitalization cover for home
9. Free Health checkup only upto ₹1500 (including all insured)
10. Consumables excluded

I ported to Aditya Birla Active One Max (this month starting only). Why ?

1. Though paying ₹53k but getting 10L coverage
2. The NCB will be increased 100% of the coverage & doesn't matter if claimed or not
   Example:
   Let say the policy insured amount is 10L then next year it will be 20L and then 30L --> irrespective of claims (means no reduction)
3. Unlimited restoration
4. No room cap (can take ultra deluxe, rocket, cloud & bla bla type of room upto insured amount)
5. Day care treatment covered
6. No coinsurance
7. Covers hospitalization at home
8. Consumables included (based on annexure, not everything)
9. Air & Road ambulance covers till insured amount
10. Some discount based on health tracker app --> not sure if it's gimmick or really works (I won't care much)
11. Free health checkup to all member (need to explore still like per member what is the test package. I am expecting better than Star Health which gives only ₹1500 over all the members)

Note:
These are the things I know but the things can be known better when someone claims (ground reality).
But from my understanding, never choose coinsurance, room caps & Ambulance limitations. In addition, if taking policy in groups or for elders then restoration should be there.

Wow. 53k for 10L coverage seems too much. Even considering age group...

 

[OptiCard]

How is Aditya Birla One Max experience so far ?

Not yet claimed.

Every month I used to get the call for virtual health checks for my father (like diet plan, exercise...).

 

[OptiCard]

Wow. 53k for 10L coverage seems too much. Even considering age group...

Yaaa.
This is what on paper but need to see the ground reality. As per the feedback over multiple forms it's positive only 😊

 

[Dragon_slayer]

Always do own research and buy directly online. दलालों से सावधान

I bought travel insurance for international travel from reliance general...The quote given by policy bazaar was 9000 Rs and i bought directly a better policy with high coverage @ just Rs 4000.

Where did you bought directly from? You mean from relaince's own website?

 

[sunit123]

Where did you bought directly from? You mean from relaince's own website?

Y e s...

 

[Dragon_slayer]

Y e s...

First time hearing such major difference in prices, i buy travel insurance regularly and most of the time prices on policybazzar are similar or lower to direct offering.

In general, aggregators have BAR policy with listed companies, they cannot sell at lower price compared to whats listed on PB website.