My mother has been having chronic vomit issues because of some gastrointestinal issues and after multiple consultations, we decided to consult her at JP Hospital at Noida, where doctor has advised us to admit her after looking her condition.
We've Senior Citizen health insurance policy since 2017 and never claimed anything so this was our first experience, where it was very clear from the moment we requested pre auth that Star Health is not interested to approve the claim and finding reasons to reject. Below were the documents, which were requested -
We require the following documents / details also :
1.Submit duly filled pre-auth form with exact diagnosis ., estimation for further processing
2. As per submitted documents, patient has h/o RFA in 2015 - submit its first consultation papers, discharge summary, prior treatment
records (MANDATORY FOR FURTHER PROCESSING )
I didn't understand why some condition which was diagnosed in 2014 can be important in 2023 and basis of rejecting the claim.
Not only denial, Star has cancelled our policy saying that we didn't intimate her condition of 2014 so cancelling the policy -
"As per the documents received by us, it is observed that the insured patient has been suffering from PSVT which is prior to inception of
the first policy. Hence it is a pre existing disease. But the insured has failed to disclose this in the proposal form at the time of inception of
the first policy. This amounts to concealment of material facts."
My brother had faced the same challenge and his claim was rejected and decided to move away from Star health insurnace.
My recommendation to everyone who is looking for Health insurance not to subscribe any policies from this company as they are never going to approve your claim since they don't care about patients and family.
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