Whats a restoration and coinsurance ?
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Personal Experience – Warning About Star Health Insurance
- Thread starter Mekala ManojKumar
- Start date
- Replies 32
- Views 620
OptiCard
TF Ace
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
TF Legend
Mekala ManojKumar
TF Buzz
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
TF Legend
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
In 2025, IRDAI's handbook on Indian insurance statistics highlighted that Acko General Insurance lead amongst all general and health with a 99.91% claim settlement ratio within 3 months. Among public sector insurers, United India Insurance stood at 96.33%. However, at 82.31%, Star Health and...
SnowLucifer
TF Premier
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
TF Legend
Bad news for those having Care and Bajaj
economictimes.indiatimes.com
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...
OptiCard
TF Ace
I don't know why but Tata Neu folks stressed a lot on care plans when I was porting my parents Star Health insurance.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...
PolicyBazaar stressed on NivaBupa.
Might be having good commission.
DS_CoolGuy
TF Buzz
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
TF Legend
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
TF Ace
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.
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.
