| Address: Chennai, Tamil Nadu |
Ref.: P/191212/01/2013/001882
Claim intimation No.: CLI/2014/191212/0189580
Ref. E-mail Dated 26-Dec-2013 and 28-Dec-2013 to Star Health Grievance department is same as support, what can we expect from Star Health?
from: grievances <[protected]@starhealth.in>
to: Bijaya Kumar Mohanty <[protected]@gmail.com>
cc: info <[protected]@starhealth.in>,
support <[protected]@starhealth.in>,
cuttack <[protected]@starhealth.in>
date: Fri, Jan 3, 2014 at 12:06 PM
subject: REOPEN REQUEST IN CASHLESS CLAIM
Dear Sir/Madam,
We confirm the receipt of your mail.
Please find the Service request number ---SR[protected]----- for your reference
With Regards,
B.BHUVANA
Customer Support
Star health & allied insurance
Dear Sir/Madam,
I have received from Star health denied with reason fax Letter on dtd 28-Dec-2013.
In this letter they have indicated below details for your ready information.
[On a scrutiny of the details furnished by you, we are of the opinion that the claim of insured-patient is not admissible under the above insurance policy issued to him for the following reason.
There is non disclosure of pre existing disease - CAD/IHD/HTN PRESENT LONG BEFORE POLICY INCEPTION during inception of the policy - POLICY WOULD NOT HAVE BEEN ISSUED IF DISCLOSED, PRESENT CLAIM THUS BECOMES NULL AND VOID.
Hence, you request for authorization for cashless treatment of the above insured-patient is denied.]
I have requested Grievance department that why you have denial without did any physical verification. They have revert me on dtd 03/01/2014 that Reopen request in cashless claim.
Star Helath you have to clarify: what is meaning of your e-mail sent from you? and I have also intimated by E-mail that my mother's Discharged.
During brought Insurance policy, Star health arranged Medical treatment for my parents and same report collected by Star heath from diagnostic Centre without any information to us and Star Health issued insurance policy on 2010. So, Where, Who & Why will have hiding these kind of written above diseases information for this policy.
I have followed star health Grievance Procedure's but Grievance team late responded that written in BLUE for your ready references.
At last, I have totally disappointed and hopeless as basis of their procedure that means Grievance department not responded positively. so that I am marked this E-mail to IRDA authority for Level-4 because of they have been disappointed me.
Kindly do the needful and my mother was discharged from hospital on dtd 05/01/2014.
This policy was started on 2010 to still continuing.
Thanks & Regards,
BIJAYA KUMAR MOHANTY
Ulsan, South Korea
+[protected]
Was this information helpful?
Today Morning I have eagerly to check my status of Claimed as mentioned in aforesaid subject through your online portal.
I have found 3nos. queries you have raised at your end.
1. As per discharge summary patient is a know case of CAD-IWMI.kindly provide the previous treatment details, ECG, ECHO, when was CAD diagnosed? First consultation report.
2. Letter from treating doctor regarding duration of RA, CAD- IWMI.previous treatment details of RA.
3. Copy of indoor case papers. - Mandatory
First, I have called +[protected] to your customer care (Receiver Name-Ms. Chanda) for clarification regarding above queries from your end.
Then I have called to Cuttack branch, Mr Rajendra Sarangi, Mobile No.: +91-[protected] in same matter.
Previous & Present Claim details elucidate:
I would like to inform you that My mother admitted on Dec. 2012 (not clearly remember) in M/s Kalyani Hospital, Gurgaon under Dr. R. S. Rawat (+[protected] and Star Health Field officer Dr. Saurav Sharma (+[protected] visited for Physical verification.
After that I have submitted all the M/s Kalyani Hospital documents with duly filled Claim form to Star health Gurgaon Branch handover & got received from Mr. Shivnath Mandal and Mr. Manish Bansal (+[protected].
Since Dec, 2012 to 24th Dec, 2013, She (My Mother) were not getting any treatment outside medicals or diagnosis except medicine as prescribed by Dr. R. S Rawat.
So I have fully re-checked our self regarding raised queries documents endow to Star Health. although we are hopeless cause do not have such documents.
If my mother is feel ill then I have took immediately to nearer network hospital. First do the admission in hospital then start her treatment with informed to Health Insurance provider for Cashless facility. This is the treatment policy of my mother.
So, I hope you will do the needful as soon as possible without any delay from your end.
Thanks & Regards,
Bijaya Kumar Mohanty
Mobile : +[protected],