[Resolved]  Star Health And Allied Insurance Co Ltd — MEDICLAIM REJECTED

Address: Ahmedabad, Gujarat

I HAVE TAKEN MEDI CLAIM FROM STAR HEALTH AND ALLIED INSURANCE CO LTD.

DUE TO EXTREME ABDOMINAL PAIN AND VOMITING AS PER DOCTOR'S ADVISE I HAVE TO ADMIT MY WIFE MRS. PRITI V. DUBAL IN VEDANT MEDICAL HOSPITAL, GHODASAR, AHMEDABAD ON 6/2/2011 AND DISCHARGED ON 7/2/2011 SHE WAS ADMITTED FOR 24 HRS. IN THE HOSPITAL.

I HAVE SUBMITTED THE CLAIM ALONG WITH ALL BILLS AND PAPER PROVIDED BY DOCTOR FOR TREATMENT ON 04/03/2011 AFTER 18 DAYS ON 22/03/2011 I GO LETTER FROM THEM ASKING FOR IPD PAPERS WHICH I HAVE SUBMITTED TO THEIR AHMEDABAD OFFICE ON 25/03/2011.

TILL 15/04/2011 I HAVE NOT GOT ANY CORRESPONDENCE FROM THEM, SO I HAVE CALLED THEIR CUSTOMER CARE DEPARTMENT AT THAT TIME THEIR EXECUTIVE TOLD ME THAT THE CLAIM IS REJECTED DUE TO 2 RESONS

1) ADMISSION TIME IS LESS THEN 24 HRS WHICH IS TOTAL WRONG BECAUSE DISCHARGE SUMMARY CLEARLY INDICATING THAT PATIENT HAS BEEN ADMITTED FOR 24HRS. IN THE HOSPITAL.

2) FOR THIS CASE PATIENT SHOULD BE TREATED AS OPD PATIENT THE ADMISSION WAS NOT NEEDED. (HOW COULD THEY DECIDE WITHOUT EXAMINING THE PATIENT)

MY CLAIM IS GENUINE. IF MY INTENSE WAS TO DO SOMETHING WRONG I MIGHT TELL DOCTOR TO SHOW ONE OR 2 DAYS MORE IN ADMISSION.

SO, YOU ARE REQUESTED TO HELP ME OUT TO GET MY CLAIM FROM THE STAR HEALTH.