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HDFC ERGO denied cashless for kidney transplant over alleged undisclosed diabetes and stroke, ₹7.75 lakh at stake

HDFC ERGO General InsurancePC-2026-03476Insurance ClaimsAnonymous ·
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HDFC ERGO General Insurance I have been paying premiums for 3+ years. Now my kidney transplant is on 10th November, and my insurer has refused cashless. My name is Pawan Kumar. I am 49, from a lower-middle-class family in Madhubani, Bihar. I have CKD stage 5 and I am on dialysis. My living-donor kidney transplant is planned at Medanta, Gurugram, with admission on 9th November 2026. I have held HDFC ERGO Optima Secure continuously since 2023. 📄 Policy No: 2856205436998103001 📄 Claim Ref (CCN): RC-HS26-16092653 On 2nd November, HDFC ERGO denied my cashless request. The only reason given is “non-disclosure of diabetes, old CVA 2012.” I have never had diabetes. I have never had a stroke. My nephrologist has certified this in writing. My cardiology, psychiatry and hospital records show the same. And even if it were true, how does it relate to a kidney transplant for kidney failure? IRDAI says a cashless request must be decided within one hour, and that no claim can be repudiated without the Claims Review Committee’s approval. I have sent a detailed written request asking HDFC ERGO to show me the document behind this allegation, and to send their investigator to the hospital if they have doubts. The hospital needs payment before surgery. My family cannot arrange ₹7.75 lakh in a week. Every day of waiting is a day I stay tied to a dialysis machine. I am not asking for charity. I am asking the insurer to honour the policy I paid for. 🙏 HDFC ERGO General Insurance and @IRDAI, please review my case urgently and approve it before 10th November. 🙏 If you know anyone at HDFC ERGO’s grievance or claims team, or have ever faced a similar rejection, please share this or message me. A repost might be what gets this reviewed in time. #HealthInsurance #IRDAI #HDFCERGO #KidneyTransplant #CKD #PolicyholderRights #InsuranceClaim #Medanta

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  1. Case filed

    Filer · 4 Nov 2026, 10:31 am

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