Health insurance · Kandivali East, Mumbai

Health Cover That Pays When It Matters.

We're health insurance agents in Kandivali East, Mumbai. We compare plans from leading insurers for you, your family and your parents, explain the fine print before you buy, and stay with you when you claim.

Plans we arrange

The Right Plan for Every Stage of Life.

Family floaterOne sum insured shared by the whole family. Usually the simplest way to cover a young family.
Individual plansSeparate cover for each person, useful when ages or health needs differ a lot.
Parents over 60Plans for senior citizens, with honest advice on co-pay, waiting periods and how premiums rise with age.
Top-up and super top-upExtra cover above your base or office policy, for far less than a bigger base plan.
Critical illness coverA lump sum if a listed serious illness is diagnosed, paid on top of your hospital cover.
Group mediclaim for companiesCover for your employees and their families, with help adding people during the year.

The fine print

What We Check Before You Pay.

Two plans with the same sum insured can pay very differently. We go through each of these with you, in plain words.

Room-rent limits and co-payA room-rent cap can cut the whole bill, not just the room. Co-pay means you share every claim.
Waiting periodsHow long before pre-existing illnesses and specific treatments are covered.
Sub-limitsCaps on particular treatments or procedures that sit inside the sum insured.
Cashless hospitals near youWhether the hospitals your family would actually use are in the insurer's network.
The insurer's claim recordHow reliably and how quickly the insurer settles claims, not just how cheap the premium is.
Renewal and bonusesWhat happens to your cover and premium at renewal, and what you earn for claim-free years.

At claim time

One Call, and We Take It From There.

01Call us firstBefore a planned admission, or as soon as you can in an emergency. We tell you exactly what the hospital and insurer need.
02We follow it upWith the hospital's insurance desk and the insurer, so cashless approval or your reimbursement doesn't stall.
03If it's cut or refusedWe check it against your policy wording and take it up with the insurer, and then the Insurance Ombudsman if needed.

Questions

Health Insurance, Answered Plainly.

What is the waiting period for pre-existing illnesses?

At most 3 years (36 months) since April 2024, down from 4. Waiting periods for specific illnesses and procedures are also capped at 3 years. Many plans offer shorter ones, or an add-on that reduces them. Declare every condition honestly when you apply.

Can my parents buy health insurance after 60?

Yes. Since April 2024 there's no upper age limit to buy health insurance (it used to be 65), and insurers must offer plans for senior citizens. Expect a medical check, waiting periods and sometimes a co-pay; we compare these across insurers.

What is a family floater?

One health plan with one sum insured shared by the whole family. It usually costs less than separate plans, but a large claim for one person leaves less for everyone else that year, so the sum insured matters. Older parents are often better off on a plan of their own; we compare both.

What are room-rent limits and co-pay?

If your room costs more than your policy allows, many policies cut the related charges in the same proportion, not just the room. Co-pay is the share of each claim you pay yourself. Both vary by plan; we point them out before you buy.

What's the difference between cashless and reimbursement?

Cashless: the insurer settles the hospital bill directly, and you pay only for what the policy doesn't cover. Reimbursement: you pay the hospital, then claim the money back with the bills and reports. We help with both, and make sure eligible costs before and after the hospital stay are claimed too.

How fast must a cashless claim be approved?

Within 1 hour of the hospital's request, and final approval for discharge within 3 hours. If the insurer is late, it bears any extra charges the hospital adds. These IRDAI rules have applied since mid-2024.

Can I get cashless treatment at a hospital outside the network?

Usually, yes, under the "Cashless Everywhere" scheme, if the hospital agrees. Tell the insurer at least 48 hours before a planned admission, and within 48 hours of an emergency one. We'll help you with the request.

Can I switch health insurers without losing benefits?

Yes, at renewal. Apply at least 45 days before your renewal date. Waiting periods you've already served carry over, the new insurer must offer at least your current sum insured, and porting is free. We handle the paperwork.

Can a health claim be rejected for something I didn't declare years ago?

Not after 5 years (60 months) of continuous cover, except for proven fraud or a permanent exclusion in the policy. It used to be 8 years. Years with your previous insurer count if you ported.

Will my parents' premium jump every year?

For policyholders aged 60 and over, insurers can't raise the premium by more than 10% a year without consulting IRDAI (from January 2025). Premiums still differ a lot between plans, which is why comparing at renewal pays.

My claim is delayed or rejected. What can I do?

Tell us what happened, even if you didn't buy the policy through us, and we'll tell you honestly whether it's worth pursuing. The formal route: complain to the insurer's grievance officer, who must resolve it within 14 days. If that fails, go to IRDAI's Bima Bharosa portal or the Insurance Ombudsman, which is free, must be approached within a year and handles claims up to ₹50 lakh. The Ombudsman is open to individuals, sole proprietors and micro enterprises, not to partnerships or companies.

Tell Us About Your Claim

More on claims, tax and other cover: see all our FAQs.

Serving all of Mumbai

Visit Us in Kandivali East, or Do It All by Phone.

Our office is at 102, New BMC Market Building, Akurli Road, Kandivali East, Mumbai 400101, open Monday to Saturday, 10 am to 6 pm. Wherever you live in Mumbai, we can handle your health cover by phone and WhatsApp.

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