[Resolved]  Star Health And Allied Insurance Co Ltd — Non provision of No Claim Bonus and Proper Medical Contract

Address:

Mumbai City, Maharashtra

Caveat Emptor. Star Health and Allied Insurance Co Ltd. This is for the benefit of Indian citizens who avail of medical insurance. I had recently taken an Individual Medical Insurance from Star Health Assurance vide their agent in Mumbai, India. This was to oblige an agent of theirs who was very helpful to me with regard to purchase of some consumer electronic items and their repairs. I was covered by a medical insurance taken through Oriental Insurance Company for the past three years. I decided to discontinue that and shifted to Star Health Assurance on his request and advice, since I was told that the Star Health policy was cashless and accepted at Hinduja Hospitals where I had been for my medical checkups. The cover was for Rs 300, 000/-(Rupees Three hundred thousand only). One year passed and this year, in September 2013, I renewed it for Rs 5, 00, 000/- ( Rupees Five Hundred Thousand only). I have never been hospitalized and have no diseases as indicated in my medical records. The company mentioned that I would be entitled to a no claim bonus. This meant that my policy would be for Rs 5, 75, 000/-( Rupees Five Hundred and Seventy Five Thousand Only). Now, when the policy came to me, there is no mention of any No Claim Bonus and the policy was not the formal contractual document that is provided, but a single sheet of paper called a schedule which mentioned the cover amount at Rs 500, 000/- ( Rupees Five Hundred Thousand Only). My repeated requests for a revision of the documents went unheeded for two months and even after I approached a senior manager of Star Health by the name of Tarakeshwar Mishra, who argued in my favor. The response was lukewarm. I got a letter vide email, which was titled "endorsement" and mentioned some amounts which included Rs 515, 000 and also Rs 10, 00, 000/-. This did not make any sense and I approached the IRDA Ombudsman. The Ombudsman did not respond for a fortnight or so and I called them up. They responded on the second call and a token number was given. The response from Star Health to this is attached below. It is ridiculous for the following reasons: It has been sent by courier and states that I did not register my email id in my complaint with the IRDA.This is a blatant lie. The complaint itself was filed from my email id to the IRDA and forwarded by them. Star Health themselves had been corresponding with me vide my email id!! Secondly they claim that "due to some technical problems, the no-claim bonus is not getting reflected in the policy"!!! This raises the question of whether Star Health Assurance is actually qualified to be a medical insurance provider? If they do not have the systems to identify policies accurately, the amount insured correctly, how can they process cashless payments to policy holders? I think Mr T.S. Vijayan should suspend their license till they are ready to function with all their systems intact and functional. Else the company will be violating recent Supreme Court Judgements regarding provision of medical insurance beneifts. ENDS