I was recently declined health insurance for sum assured above ₹5 lakh after declaring my spine slip disc (L4/L5) and sharing MRI reports from 2022 and 2025. I have not had surgery nor been advised one. I already have a policy of ₹10 lakh. Is it worth exploring further insurance options? I am also considering a critical illness cover—does that make sense?
—Name withheld on request
Health insurance in India comes with a lifelong renewal guarantee. Once a policy is issued, insurers are legally required to renew it—even if your health deteriorates later.
That’s why insurers tend to be cautious at the underwriting stage when they see conditions that could lead to long-term or repeat claims, such as spinal issues. However, underwriting standards vary widely across insurers. A rejection by one company does not mean all insurers will take the same view.
You may still apply to other insurers, some of whom could be open to underwriting your case.
Use a top-up
Given that you already have a ₹10 lakh health insurance policy, a practical option is to buy a top-up health insurance plan.
In a top-up policy, you can choose a deductible of ₹10 lakh, which will be met by your existing policy. Any claim amount beyond that will be paid by the top-up insurer.
Top-up policies are significantly cheaper than standard base policies, and the chances of issuance are much higher, since the insurer’s risk starts only after the deductible threshold is crossed.
Critical illness cover
You’re also right to explore a critical illness insurance policy. This type of cover pays a lump sum upon diagnosis of one of the listed illnesses such as cancer, stroke or heart attack.
If there is a family history of critical illness, this cover becomes especially important. Its primary purpose is to handle out-of-pocket expenses not covered by regular health insurance, as well as to compensate for loss of income during treatment and recovery.
Unlike hospitalisation covers, the payout is not linked to actual medical bills and can be used flexibly.
