[Resolved]  Star Health And Allied Insurance — Denial of Cashless Claim

Address:

West Delhi, Delhi

This is with regards to my mediclaim policy (Customer ID No[protected] which I took on 16/10/2012. I had a medical condition on 6th Feb - I felt numbness in one side of my body (arms & legs) - I visited the doctor nearby my home & doctor referred me for the following tests ECG, Lipid, blood sugar, uric acid etc. I got these tests done & the reports came out to be clear. On 14th Mar, I again had a black out for which doctor recommended MRI of the brain. Report of the MRI revealed hetrogenous lesion in right parietal lobe.

We had applied for cashless surgery for removal of the tumor from the brain - the claim has been rejected citing reasons like there is suspicion that the patient might be suffering from the ailment before coverage of the policy. I have been following up with the Chennai Unit - [protected] (Anandi) requesting to help in expediting the approval process as we were waiting in the reception of Fortis Hospital in Gurgaon; however all the communication has been in vain.

As the last resort I spoke to Mr Rajnish Kohil ([protected]) whose details were mentioned on the website for customer grievances as well.

We have been told that this claim is rejected as cashless & I can apply for reimbursement - the entire series of events has been a mental harrasment for me, delaying start of my treatment in Fortis Hospital (I am scheduled for the surgery on 18th Mar).

Hope someone responsible person in Starhealth goes through the mail & helps me during this distress. I would be forced to take a legal route for mental harrasment, lack of support from Starhealth, & artifical reasons for rejection of my claim.

Thanks
Sunil Tandon