Star Health And Allied Insurance — Grievance for repudiation of claim no cli/2016/700002/0275617

Address:	400610
Website:	www.starhealth.in

I have taken a mediclaim insurance for my parents from STAR HEALTH starting February 2015, my mother was admitted to the hospital in the month of December for Acute Pyelonephritis, AKI, SAIO.

The company took almost 35 days to revert on the claim status, finally after regular follow up I was informed that my claim was rejected due to the following reason:

Although the present admission of the insured patient is for treatment of Pyelonephritis, AKI, SAIO, it is
observed from the letter dated 06.02.2016 furnished by the son of the insured which is also countersigned by
the insured patient and the discharge summary of Lok Hospital for the admission from 28.09.2007 to
12.10.2007 furnished during the course of claim verification arranged by us, the insured patient has
undergone total knee replacement surgery in 2007 for bilateral end stage OA which is prior to inception of
medical insurance policy.
At the time of inception of your policy which is from 21-FEB-2015 to 20-FEB-2016, you have not disclosed
the above mentioned medical history/health details of the insured-person in the proposal form which
amounts to misrepresentation/non-disclosure of material facts.

what is the correlation between the two as the nee replacement is not a desease.

I have sent them a response email and registered letter, however there has been no response the calim amount is for 2 lakhs.

Can anyone help