[Resolved]  Star Health Insurance Company — cheating with customers

Address: Firozabad, Uttar Pradesh

I WISH TO BRING IN NOTICE OF ALL CONCERNED PERSONS AND ESP IRDA AS THIS IS THE HIGH TIME THEY SHOULD TAKE ACTIONS AGAINST THESE TYPE OF FRAUD COMPANEY WHOSE MAIN AIM IS NOT TO INSURE THE PERSON BUT TO LOOT HIS OR HER MONEY BY VARIOUS STUPID EXPLANATIONS AND WANT TO EXPLOIT THE PERSON WHO IS ALREADY UNDER STRESS OF MEDICAL EMERGENCY
I TOOK ONLINE POLICY FROM STAR HEALTH IN MARCH 2011 OF MY MOTHER LAJJA BANSAL WITH POLICY NO P/700002/2011/001636 WITH SUM INSURED 1 LAC THAN IN NEXT FOLLOWING YEARS I.E. IN 2013-14 IT BECAME POLICY NO P/700002/01/2013/012426 WITH SUM INSURED 400000[4 LAC] .AT THE SAME TIME IN MONTH OF MARCH 2011 I TOOK HEALTH INSURANCE OF OTHER 5 MEMBERS OF FAMILY TOO
MY MOTHER TOOK CONSULTATION FROM DR VINOD AGRAWAL HERE AFTER HAVING LOTS OF PAIN DURING WALKING IN THE MONTH OF JULY2013 AND AFTER INVESTIGATION HE REFERRED HER TO DR ASHOK RAJGOPALAN MEDANTA HOSPITAL AND HE ADVISED B/L TKR FOR THAT WE PLAANED HER TO BE ADMIT ON 16TH DEC2013
FOR THIS TO AVAIL CASHLESS FACILITY WE PROUCED CLAIM UNDER CLAIM NO 0175328 AS WE WERE TOLD EXPENSES OF NEARLY 4.5 LAC AT HOSPITAL AND SHE WAS HAVING 4 LAC SUM INSURED
NOW HERE COMES PLAY FROM STAR HEALTH WHO WANTS TO CHEAT ONLY
1]FIRST OF ALL THEY DENIED THE CLAIM GIVING EXPLANATION THAT THE PERSON HAS ONSET OF DISEASE PRIOR TO INITIATION OF POLICY
2]ON ARGUMENT ON SAME NEXT DAY THEY AUTHORISED THE INSURANCE BUT TO ONLY 50000[FIFTY THOUSANDS] GIVING EXPLANATION THAT WE CAN GIVE 50% COPAYMENT ON SUM INSURED OF 1 LAC, , , ,
3]ON AGAIN ASKING HOW AND WHY THIS 50% APPLY? AND PERSON IS HAVING COVER OF RS 4 LAC FROM MARCH 2013 TO MARCH 2014 THEY DONT HAVE ANY SATISFACTORY REPLY
NOW I CHALLANGE DR PRAKASH SUBBARAYAN WHO IS MEDICAL EXPERT HEAD TO PROOVE WHICH DAY SHE GOT THIS DEFORMITY AND I WILL PROOVE HER DISEASE ONSET TIME SAME IN COURT OF LAW AND HOW YOU CAN CHANGE SUM INSURED FROM 2013-14 FROM 4 LAC TO 1 LAC
I THINK WE SHOULD GET FULL BENEFITS UNDER IRDA RULES AND REGULATION AND WE ARE BEING DENIED DESPITE GIVING SO HEAVY PREMIUM EVEN WHEN PERSON CONCERNED STILL BELOW 65 YRS
I DEMAND FROM IRDA AND CONCERNED PERSONS TO TAKE STRICT ACTION AS SOON AS POSSIBLE OTHERWISE I WILL TAKE THIS MATTER TO COURT OF LAW AND WILL NOT LET YOU TILL SUPREME COURT AND BOTTOMLINE PERSON TO MAKE AWARE NESS
DR AMIT BANSAL
199 JALESAR ROAD
FIROZABAD
U.P
MOB-[protected]
CLAIM NO 0175328 (STAR HEALTH]
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Aug 13, 2020
Complaint marked as Resolved 
 
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Insurance Claim

Star health medi claim co. Mi dad was hospitalised n we were trying to claim the hospital expenses but they declined our claim for no reason I want to sue this co. n I want mi money back 34k...
This is to bring to your notice that we have one Family Medical policy from Star Health Comprehensive for 5 Lacs insurance cover. The policy was ported to Star health and with the due approval from Star health team, our policy was issued .This is also to inform you that, before porting this policy, we have been running our insurance policy for last 4-5 years from Apollo Munich health .

In 2017, We are approached by Insurance Agent ( Mr Aggarwal) and one branch manager (Ghaziabad branch i suppose) from Star Health, who told that our benefits will continue and policy also, if we port to Star health From Apollo Munich and in case required, our claims will not be hold as we have been running health policy from last 4-5 years..They assured me all benefits under Star Comprehensive .I hold them responsible and Star Health team who has given approval to port my policy .Just to make commission, they made fake statements, above all, if the policy was ported with all last 4-5 years policy statement, Why my claim was denied.

During last 5-6 months, my wife got ill and and i got several test done, where Anemia was indicated / diagnosed . However, when i got this checked with Gastroenterologist Dr Subhashish Sir, we got to know that there was internal bleed at upper gastrointestinal, Duodenal Dielafoy's lesion with active ooze and Endotherapy was done and patient is now OK and discharged ( Reports sent to Star also ). My wife was admitted in BLK hospital, New Delhi where the treatment was done .The reports shows this all which was sent to TPA Star Health.

The hospital department has informed the Star TPA in time and to my surprise the Claim was rejected. When i tried to check with claim department, they only informed that we don't give Anaemia procedure claim and i can write mail to authority. This was 8 pm in night and arranging money at this point of time was a pain which has come up suddenly on me. I have undergone so much mental pain that i can't express this in my words. Next day, when i checked with claim department, they checked that my policy was Ported (with Approval ) and Live ( and NCB case for last company for 4-5 years ), they went mum and just informed to write a mail. Afterwards, i didn't recd anything from them.
Till date, i have been writing mails and answering them on various issues which are being raised again and again. I have been asking the team to visit the hospital, check details and speak to Dr if required .But every time, i get repeat mails..Claims Medical Query - CLI/2019/161132/0116964

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