A reality check of health insurance claim: Denial of simple claim sparks huge online debate

We buy health insurance policies to handle emergency health situations. Often, we shell out a hefty premium for the policy hoping we won’t have to cover medical bills ourselves when a medical emergency arises. But if the insurance company denies our claim of a few thousand when we are paying a high premium for it, wouldn’t that make us furious?

This is exactly what happened to a Twitter user named Nitin Shukla. He shared on social media post that Care Health Insurance rejected his claim of Rs 10,000, even though he has been paying an annual premium of Rs 65,000 for that same policy.

In a post on X (formerly Twitter) on September 9, 2025, Shukla wrote that he bought a cover policy with Rs 2 crore coverage from Care Health India through the Policybazaar insurance aggregator. He wrote he is paying Rs 65,000 insurance for the same policy, but his cashless claim of just Rs 10,000 was rejected.


“Anyone takes health insurance for tough times. I too bought one from @policybazaar of @CareHealthIndia — insurance worth ₹2 crore (wb). When a family member fell sick, the doctor advised admission, so we admitted him. We had never thought of using insurance before, always paid from our own pocket for treatment, so we never realised what kind of fraud runs in the name of health insurance."

He added, “We have had health insurance for about 10–15 years, paid premiums and never made a claim. The premium isn’t small either — ₹65,000 per year. For 2 years with Care, I paid about ₹1,30,000 in premiums. And despite that, even a claim of ₹10,000 got rejected.”

Shukla feels that even a Rs 2 crore health cover won’t come handy during a health emergency situation. “Think about it: insurance worth ₹2 crore. I thought if anything ever happened, at least up to ₹2 crore I’d be safe because insurance was there. But today I realised no treatment or claim is ever going to be given.”

Shukla, however, didn’t share the reasons for his claim denial.

A lot of X users, on the other hand, backed the post and vented their anger against insurance companies, sharing similar past experiences. They joined the chorus with Shukla, saying they also have had similar experiences.

A user named Dr. Ramakant Rai echoed Shukla’s views, saying that Care Health India rejected his cashless claim, citing that hospitalisation was not needed in his case.

“My experience with @CareHealthIndia has been exactly the same. They rejected the claim, saying that hospitalisation was not necessary for the treatment. What kind of absurd reasoning is this? But Care Health did this and even gave a separate baseless explanation.”

Another user named Rakesh Arya said that another health insurance company, Niva Bupa, rejected his claim, saying that his cashless claim documents had discrepancies.

“My experience with @Niva_Bupa has been exactly the same. They rejected the claim, citing misrepresentation and discrepancies. What kind of absurd reasoning is this? But @Niva_Bupa did this and even gave some separate baseless explanation.”

Care Health Insurance responded to an ET Wealth query saying that cashless service for the said claim was not registered and the claim is currently under reimbursement processing with the company.

“Unfortunately, the facts of this case have been misrepresented. At no point of time was this claim rejected. Cashless service for the said claim was not registered, and the claim is currently under reimbursement processing with us,” said Manish Dodeja, Chief Operating Officer, Care Health Insurance.

Policybazaar assured him of a quick approval of the claim.

Policybazaar reacted to Shukla’s post on X and assured him of reimbursement within 24 hours.

“Hello Nitin, after the latest update, Kamlesh has spoken with you. We will collect the reimbursement documents from the hospital, and the payment will be approved within 24 hours or by today itself. We will keep you informed about the progress,” Policybazaar wrote on X.

However, there were balancing voices too, where users said that all insurance companies are not alike and one should choose their health insurance policy carefully.

A user named Prashant Kumar writes that one should select a policy with proper understanding and expert advice.

“Not all companies are the same, and not all health insurance policies are the same either. What’s important is that you choose a policy carefully, with proper understanding and expert advice. I have claimed twice for myself and once for my wife so far, and I have received about 95% of the total claim amount.”

A user named Umesh Kumar Vats said he has had four successful claims for his family members’ treatment.

“You should not spread such false propaganda. I have made three claims — once for myself, once for my wife, once for my child, and once for my father. After some minor deductions of a few thousand, all the claims were approved without any problem.”

While the social media outbursts continues, reimbursement claim of Nitin Shukla is under process and hopefully the issue could be resolved by the health insurance provider very soon.