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CI want to expose Niva Bupa, an insurance company, and their dubious activities aimed at depriving their customers.
My father ported his 20-year-old Mediclaim policy to Niva Bupa in February 2024 for himself and my mother. In January 2025, my mother was diagnosed with breast cancer and was taken to an oncologist surgeon for treatment. She was advised to undergo eight chemotherapy sessions and a probable surgery thereafter.
We submitted all the original test reports and bills to Niva Bupa as advised by the treating doctor from time to time for reimbursement. Niva Bupa also sent their representative for verification. Subsequently, they requested a certificate from the treating doctor mentioning the duration of the ailment, which was provided to them, even though every required detail was already mentioned in the doctor’s prescriptions. They even asked for a certificate from the treating doctor regarding diabetes and hypertension, as these conditions were mentioned in the nursing home discharge certificate. This was also provided, despite its unlikely direct relevance to the cancer treatment.
Now, after numerous clarifications sought and provided, we have received two contradictory reasons for the cancellation of our claim. Firstly, they cited a ‘fraudulent or falsified statement,’ without providing any specific details. Secondly, they mentioned the non-submission of the treating doctor’s certificate detailing the duration of the ailment, including treatment records and consultation papers, which has already been provided to them. How can there be such conflicting reasons for a single claim?
Despite raising the issue with the Niva Bupa employee who initially approached us for the policy porting, promising various benefits and explicitly stating he would help with any claims whenever required, he has now disclaimed responsibility, stating that their sales team is entirely disconnected from the claim settlement team. Simultaneously, we are unable to directly connect with the claim settlement team to understand the discrepancy and resolve the issue.
One can only imagine the mental agony we are currently experiencing. To compound this, the insurance company’s dicey and questionable actions have further intensified our distress.
This insurance company is more interested to deprive the genuine people by unfair means and add more and more in their kitty.
One needs to be extremely cautious when dealing with such a dubious company! -
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NThis is likely because niva bupa thinks the cancer was pre existing when you ported. They may suspect you were aware of the symptoms. You should be able to prove that you were not aware and no treatment was taken
Also if bp, diabetes was existing during porting and was not declared they may cancel the policy due to misrepresentation.
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PIsn’t it the their job to get the tests done to confirm these things. My friend just got her policy and they did a blood test and an ultrasound. But this was for term insurance but I would expect similar procedures for health insurance.
Also, most health insurance has 1-2 free full body check ups per year which one should get done as they become proof later in cases like these.
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PWhen I was going to buy health insurance for my parents, the agent was pushing Niva Bupa. Read about their claim settlement ratios etc. Was one of the lowest. Went ahead with Hdfc ergo. Have had no qualms with them whatsoever yet. Successfully claimed for one operation inspite of waiting period (for a different body part tho)
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BWhat’s your opinion about Bajaj Allianz?
I couldn’t go with Hdfc ergo since I hold my salary account with the bank. -
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BI can understand your frustration..I have been through this in my life…Nothing is said to you beforehand and during claim all sorts of clauses are thrown at you..Focus on your mother’s health and mental well being….Don’t let her see you getting frustrated… Wishing her and your family all the strength to get through this
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