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Niva Bupa health claim dispute via Policybazaar escalated to Insurance Ombudsman without fair resolution

Niva Bupa Health InsurancePC-2026-03189Insurance ClaimsAnonymous ·
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An Unfortunate Experience with Niva Bupa, Policybazaar and the Insurance Ombudsman. I am sharing this experience publicly with the hope that the concerned authorities and organisations will look into the matter and help us get a fair resolution. We purchased a health insurance policy from Niva Bupa through Policybazaar in February 2025, trusting that our family would have financial protection during medical emergencies. Unfortunately, our experience has been extremely disappointing. 1. First Claim – I was hospitalised due to a gastrointestinal problem, and we submitted a claim of approximately ₹4.5 lakhs. We were asked number of tims to submit the same documents again and again even though all required documents were submitted priorly. We had to wait nearly two months for a discussion with the insurance company's doctor and that was arranged only after repeated follow-ups and assistance from a local agent. Frustrated. Even after providing doctors note explaining the medical circumstances and submitting the supporting documents, the claim remained rejected. 2. Policybazaar – Where Was the Support When We Needed It? We purchased the policy through Policybazaar, expecting assistance not just at the time of purchase but also when we needed to make a claim. Surprisingly, when the claim was under process and facing rejection, we did not receive the support we expected. It raises a simple question: Is customer support limited to selling policies and collecting feedback, or does it also include standing by customers during difficult claim situations? 3. Insurance Ombudsman – Still Waiting for Our Complaint to Be Registered With no satisfactory resolution from Niva Bupa, we approached the Insurance Ombudsman on 13 June 2026. We were asked to submit all relevant documents in hard copy for registration of our complaint. We submitted the complete set of documents on 3 August 2026. However, even after several months, our complaint has still not been formally registered, and we are still waiting for the process to move forward. 4. Second Hospitalisation – 3 October 2026 Unfortunately, I was again hospitalised on 3 October 2026 due to viral fever. Once again, Niva Bupa rejected the claim, this time citing Excl02 (Specified Disease/Procedure Waiting Period) under Clause 5.1.2(f). Niva Bupa: Why are genuine hospitalisation claims being rejected, and why are the medical documents and circumstances not being adequately addressed? Insurance Ombudsman: Why is our complaint still awaiting registration despite submitting all the required documents? I sincerely request the senior management of Niva Bupa, Policybazaar and the Insurance Ombudsman to intervene, review the complete matter and provide us with a fair resolution. I hope this post reaches the right people and helps bring accountability to the process. #NivaBupa #PolicyBazaar #HealthInsurance #InsuranceClaims #CustomerExperience #InsuranceOmbudsman #ConsumerRights #HealthInsuranceClaims

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  1. Case filed

    System · 3 Nov 2026, 5:37 am

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