Summary of this article
A family in Mumbai has accused Niva Bupa Health Insurance of denying a cashless claim of Rs 61.6 lakh for a bone marrow transplant, despite having a medical cover of over Rs 2.4 crore.
The case has sparked widespread outrage online, with many questioning whether health insurance in India truly provides protection when it matters most.
Health insurance claim rejections take a heavy toll on families, especially if the amount is in lakhs and the policy promised broader coverage. Recently, many health insurers have come under the radar for rejecting claims without due consideration.
In a viral social media post on LinkedIn, Avigyan Mitra, a health insurance and investment advisor, flagged a case where a patient was denied a mediclaim worth Rs 61.6 lakh.
What was the case?
The patient, admitted to Sir HN Reliance Foundation Hospital for treatment of Myeloid Leukaemia, was in urgent need of a bone marrow transplant. According to the Mirta's post on LinkedIn, the insurer had given written confirmation on July 3, approving a package of Rs 25 lakh for the transplant and marking it as “final and inclusive.”
A family in Mumbai battling a medical emergency has accused Niva Bupa Health Insurance of rejecting their cashless claim despite having coverage of over Rs 2.4 crore. The case triggered anger on social media, where many have questioned the purpose of having health insurance with broader coverage if claims are rejected at a time of medical crisis.
But once hospitalisation began the next day, the costs quickly crossed that amount. When the family sought cashless approval for the full bill of Rs 61,63,038, Niva Bupa reportedly turned down the request, stating that “liability cannot be established.”
The post highlighted the contradiction: the same patient, same treatment, same policy, yet a sudden reversal in the insurer’s stance.
Screenshots of the insurer’s earlier approval mail, alongside the rejection letter, were shared widely on social media. Several users who reshared the post said that health insurance was meant to provide security during emergencies, not leave families scrambling for money when it mattered most.
“Health insurance is not just a policy, it’s a commitment of security in moments of vulnerability,” one post read, urging the Insurance Regulatory and Development Authority of India (IRDAI) to step in.
Angel investor Udit Goenka also weighed in, calling insurance “the biggest scam business in India” while sharing the post.
So far, Niva Bupa has not issued any public statement on the case. Meanwhile, the family’s fight is drawing attention to a larger concern, that high premiums and big coverage numbers mean little if insurers can deny claims on technical grounds when lives are at stake.
