| Address: Ghaziabad, Uttar Pradesh |
I am Vineet and i have a madiclaim policy no.- P/161121/01/2011/000357 with star health.. In the month of march 2011 i went to Shroff Eye Center, New Delhi after having some problem in my right eye. They detected it as Retinal Detachment with a giant retinal tear & an emergancy surgery was done the same day. It was a major surgery & i was discharged next day from the nursing home after my post operative checkup, bendage,instructions & with prescribed medicines. I didn't carry my cashless mediclaim card with me so i paid my operation fee & room rent(discharge fees) by the help of my relatives which was around rs. 75000 & medicines extra. After reaching home i informed my agent & he at once informed the company's office at Noida & got the claim no. that is CLI/2011/161121/0107357. After some days the company send some quary to me to be filled by the Dr. & my Dr. quenched their thrust by every knowledge & information about the surgery which they asked in their questionaire. Afterward, the company did not respond even after giving several reminders by me at Noida office on phone for 3 months. Now, in the first week of july, i received their claim rejection letter on my e-mail that they have treated me as an OUT PATIENT as there is no active line of management done.I even didn't understand their point of rejection of claim of my surgery.This is a complete herassment of a patient by the medical company. Even,the company have charged about 4000/- more then the previous year's as policy renew fee,or can say, as a panelty of demanding the claim & even then they are not interested in settling the claim.But i will not leave them so easily. Just tell me,when i was admitted for a major surgery in the renouned nursing home for a night in the dr's observation then how can they treat me as out patient. My experience with Star Health is not good.I think, that all the health insurance company only allouring the people by their tempting fake promises.They want to collect the money by the people but dont want to give back as a claim to their client even after getting all the documentry proof they want.
Aug 13, 2020
Complaint marked as Resolved
MAY I CONCERN THAT I HAVE BROUGHT FAMILY HEALTH OPTIMA IN YOUR COMPANY AT 11 52011.MY POLICY NO - P171217 12012 00804.WHEN I TAKE A POLICY OF STAR BEFORE MY POLICY IN RELIANCEGENERAL INSURANCE.AND YOUR COMPANY EXCEPTED MY POLICY WITH PORTEBLITY.MY PREVIOUS POLICY NO - [protected].AFTER THAT I HAVE ADMITTED IN SHEELA
A SHAH HOSPITAL SURAT FOR PNEUMONIA AT 18 12012.MY CLAIM INTIMETION NO - 0123058 HOSPITAL AND MEDICINE BILL I HAVE CLAIMED AMOUNT WAS Rs.17,988.BUT YOUR CLAIM SETTLEMENT IS ONLY OF Rs.10,765.CLAIM AMOUNT WHICH I HAVE RECIEVED IS NOT DIGESTABLE AS PER YOUR POLICY TERM & CONDITION THERE IS NO SUCH LIMITS.KINDLY LOOK INTO THE MATTER & GIVE MY DEDUCTED AMOUNT Rs.7,223 AS EARLY AS POSSIBLE.OTHERWISE I AM GOING TO COMPLAIN IN CONSUMER FORUM & ALSO IN "IRDA".
THANKING YOU
YOUR'S FAITHFULLY
HARSHAD M PATEL