[Resolved]  Insurance Policy — Denial of Claim

Address:

Thane, Maharashtra

I am giving you full details of my grievance case against Star Health And Allied Insurance Company Ltd. You are requested to telecast this on your news channel.
I was hospitalized in the month of July 2009, in the three hospitals. Two hospitals from Mumbai and one from Bangaluru. The following were the details of my claims with the Star Health & Allied insurance Company.
Insurance Claim No Name of Hospital Period of Hospitalization Claim
Amount in Rs. Status
12522 Jay Anand Hospital, Thane 2nd July to 4th July 2009 12,399.86 Rejected
13619 Kokilaben Dhirubahi Ambani Hospital, Mumbai 4th July to 8th July 2009 53,946.07 Rejected
14494 Narayana Hrudalaya, Bangaluru 15th July to 18th July 2009 25,082.00 Sanctioned

My disease was diagnosed as “Primary Pulmonary Hypertension”. This type of disease is very rare i.e. one in million as explained by the doctors.
At the time of admission in the hospital I had told my past history to all the doctors that I was hospitalized in Dubai for catheterization test two years back and reports were found clean. Also, I have proof of the CD given by the Hospital for the test carried out. The doctors in Dubai advised me for the catheterization test in order to take the advantage of my full medical insurance.
On this basis my claims were rejected by the Insurance Company. Even after submitting the confirmation in writing from the doctors in Jay Anand Hospital, Thane and Kokilaben Dhirubahi Ambani Hospital, Mumbai, that the “Patient had no past History of this disease” the Insurance Company is not giving me the claims. Even in the discharge cards from these two hospitals, it is mentioned that the “Patient had no past history”.
Mr. R. Subramaniyam – Head of Claims Star Health and Allied Insurance Company is a very adamant person and he replied me arrogantly on the phone that I will not sanction your claim and now the Company is claiming the amount refunded to me against the third claim.

I need your help in telecasting this genuine grievance on your news channel.

Thanking you,

Pratap M. Pathak
Phone –[protected]
Cell - [protected]