Health Insurance for Retinitis Pigmentosa as PED

[bhavyakjain]

Hello

I am looking to get a health insurance for myself. I am 26 (27 next month) years of age..
I was diagnosed with Retinitis Pigmentosa, a genetic eye disorder in 2023. No hospitalization, treatment or medications ongoing. No foreseeable claim requirement for this.

I have shortlisted a couple plans :
1. HDFC ERGO Optima Secure
2. Niva Bupa Aspire Platinum+
3. Aditya Birla Activ One

Can my condition result in rejection of my proposal ?
If approved, What additional exclusions, charges or restrictions I can expect ?
If rejected, what are my alternatives ?

 

[anujdit]

You can go for any insurance company, they will provide you the policy with some waiting period of PED and extra premium if applicable. Check with one company and then try another one.
If you will not disclose the disease, then also you will get policy and after 3 years, no one can reject your claim. However it is not a right way and can lead to rejection chances.

 

[bhavyakjain]

You can go for any insurance company, they will provide you the policy with some waiting period of PED and extra premium if applicable. Check with one company and then try another one.
If you will not disclose the disease, then also you will get policy and after 3 years, no one can reject your claim. However it is not a right way and can lead to rejection chances.

Okay
I will try to apply

I was just talking with Ditto advisor and he scared the **** our if me. He said I wouldn't get this policy. They will reject me outright. And he recommended a very restrictive policy and said there is small chance they will give me even this restrictive one.

 

[V360V360 is verified member.]

You can go for any insurance company, they will provide you the policy with some waiting period of PED and extra premium if applicable. Check with one company and then try another one.
If you will not disclose the disease, then also you will get policy and after 3 years, no one can reject your claim. However it is not a right way and can lead to rejection chances.

Not disclose and you still get the policy - and post 3 years, you can initiate claim and it will get approved?

Never gonna happen Sir

 

[anujdit]

Check my direct message to you for one agent number, who can help you with policy

 

[anujdit]

Not disclose and you still get the policy - and post 3 years, you can initiate claim and it will get approved?

Never gonna happen Sir

Unless no hospitalization taken (they can check history of any claim from any company in last 5 years) and current treating doctor will not mention in claim form the history older than policy (1 or 2 yrs), then claim can be received. How insurance company will know about history?

I have 11 yrs old policy, so don't ask me whether i got such claim or not.

 

[V360V360 is verified member.]

Unless no hospitalization taken (they can check history of any claim from any company in last 5 years) and current treating doctor will not mention in claim form the history older than policy (1 or 2 yrs), then claim can be received. How insurance company will know about history?

I have 11 yrs old policy, so don't ask me whether i got such claim or not.

That's why let's give suggestions if we come across situations in life and have been able to navigate successfully.

 

[sheru]

Hello

I am looking to get a health insurance for myself. I am 26 (27 next month) years of age..
I was diagnosed with Retinitis Pigmentosa, a genetic eye disorder in 2023. No hospitalization, treatment or medications ongoing. No foreseeable claim requirement for this.

I have shortlisted a couple plans :
1. HDFC ERGO Optima Secure
2. Niva Bupa Aspire Platinum+
3. Aditya Birla Activ One

Can my condition result in rejection of my proposal ?
If approved, What additional exclusions, charges or restrictions I can expect ?
If rejected, what are my alternatives ?

If you want, I can take pre approval from underwriting team for your PED, and then on that basis we can proceed.
Let me know if you're interested buying policy via an agent, myself.

 

[sheru]

Unless no hospitalization taken (they can check history of any claim from any company in last 5 years) and current treating doctor will not mention in claim form the history older than policy (1 or 2 yrs), then claim can be received. How insurance company will know about history?

I have 11 yrs old policy, so don't ask me whether i got such claim or not.

Don't try to fool the system. It's there for a reason.

Also there are multiple IFs in your assumption -
1. If company checks history
2. If it does, its for last 5yrs
3. If treating doctor will ask for PED
4. If treating doctor hide or write about PED in case papers
Its better to disclose and be tension free than to hide.

 

[bhavyakjain]

If you want, I can take pre approval from underwriting team for your PED, and then on that basis we can proceed.
Let me know if you're interested buying policy via an agent, myself.

Thanks for your help
To be honest, I am not very comfortable buying from other than offline company agent, for health insurance specifically.
I want to try directly from company agent offline once. If that doesn't work out, will think about alternative route.

If you are willing, I can still use your help in getting a sense of underwriting decision, since you seem to be knowledgeable about that.

 

[Sriim]

Sorry to say that HDFC will most likely reject your application. I had retinal detachment (less serious than RP), but my application was rejected in 2024. I then proceeded with care health insurance.

My suggestion is to proceed with the help of an agent (head a lot of positives about ditto here in TF and elsewhere as well)

In the worst case scenario, the insurer might cover you excluding your PED i.e you'll be covered for any illness expect hospitalisation arising out of RP or complications arising out of it. My father had bypass surgery before 15 years and we got care health insurance in 2022 which covers everything except CAD and it's complications (apparently that will be covered only if policy is purchased within 7 years of bypass surgery)

I wish you well. I'll be utmost happy if some insurer covers you including your RP. Best wishes

 

[Sriim]

If you will not disclose the disease, then also you will get policy and after 3 years, no one can reject your claim. However it is not a right way and can lead to rejection chances.

That's the absolutely worst advice you can give anyone. It might apply for some diseases that can be managed like diabetes/hypertension (still not advisable). But will lead to cancellation of policy in diseases like retinitis pigmentosa

 

[sheru]

Thanks for your help
To be honest, I am not very comfortable buying from other than offline company agent, for health insurance specifically.
I want to try directly from company agent offline once. If that doesn't work out, will think about alternative route.

If you are willing, I can still use your help in getting a sense of underwriting decision, since you seem to be knowledgeable about that.

Will see what I can do.
Allow me a day or two.

 

[bhavyakjain]

Sorry to say that HDFC will most likely reject your application. I had retinal detachment (less serious than RP), but my application was rejected in 2024. I then proceeded with care health insurance.

My suggestion is to proceed with the help of an agent (head a lot of positives about ditto here in TF and elsewhere as well)

In the worst case scenario, the insurer might cover you excluding your PED i.e you'll be covered for any illness expect hospitalisation because of RP or complications arising out of it. My father had bypass surgery before 15 years and we got care health insurance in 2022 which covers everything except CAD and it's complications (apparently that will be covered only if policy is purchased within 7 years of bypass surgery)

I wish you well. I'll be utmost happy if some insurer covers you including your RP. Best wishes

Since RP has no available treatment, anyways I can't claim for it. So it being excluded or not makes no difference at all.
I will try with HDFC once and then Niva or Aditya through offline agent.
If no success, will see.

I heard a lot of negative reviews about Care on YouTube comments and here at TF

Could you pls share which plans you took for both you and your father ?

 

[bhavyakjain]

Will see what I can do.
Allow me a day or two.

Thanks a lot

 

[anujdit]

That's the absolutely worst advice you can give anyone. It might apply for some diseases that can be managed like diabetes/hypertension (still not advisable). But will lead to cancellation of policy in diseases like retinitis pigmentosa

You have not read my first line, where I asked him to pay extra premium to include PED

 

[Sriim]

I was just talking with Ditto advisor and he scared the **** our if me. He said I wouldn't get this policy. They will reject me outright. And he recommended a very restrictive policy and said there is small chance they will give me even this restrictive one.

I'm afraid that's the gist of your situation.

Health insurance before your diagnosis would've been ideal, but we can't change the past.

Take your time, contact all top insurers and choose who gives the best offer to you.

But kindly never ever consider not disclosing this. Even if any agent suggests (they have incentives for achieving certain targets and they might convince you to apply without disclosing so that policy will be approved and they'll get their incentives)

I don't what it's worth, but I wish you get all the help you need.

 

[Sriim]

Since RP has no available treatment, anyways I can't claim for it. So it being excluded or not makes no difference at all.
I will try with HDFC once and then Niva or Aditya through offline agent.
If no success, will see.

I heard a lot of negative reviews about Care on YouTube comments and here at TF

Could you pls share which plans you took for both you and your father ?

I have care supreme. Dad has care heart.

No claims experience so far.

We did need to contact customer care for dad's free health checkup. WhatsApp and call support was pathetic. Twitter and email support was decent.

 

[bhavyakjain]

I'm afraid that's the gist of your situation.

Health insurance before your diagnosis would've been ideal, but we can't change the past.

Take your time, contact all top insurers and choose who gives the best offer to you.

But kindly never ever consider not disclosing this. Even if any agent suggests (they have incentives for achieving certain targets and they might convince you to apply without disclosing so that policy will be approved and they'll get their incentives)

I don't what it's worth, but I wish you get all the help you need.

Thanks

Yes, I will definitely go ahead with full disclosure only.
Don't want to take any chances of claim being rejected at time of need.

 

[Sriim]

You have not read my first line, where I asked him to pay extra premium to include PED

I read it. But please don't even suggest the other option. More chances of negative impact because of it.

No offense intended