Star Health And Allied Insurance — Pending Reimbursement claim

I am writing this regarding our Mediclaim policy namely "Family Health Optima Insurance-2017", the reference number of which is P/191138/2021/000968. We are associated with the company since February 2016. However, we never raised a claim against our policy until the month of July 2020 when my dad was hospitalized due to viral fever. I admitted him to a local Non-COVID hospital which is one of their network hospital on 5th July 2020 and the same was duly intimated to the insurance company within 24hrs of admission on 6th July 2020 vide intimation number CLI/2021/191138/0144711.We had requested for his cashless treatment because as per the policy, it was eligible for complete cashless treatment with claim number CLMG/2021/191138/0144534. Please note that there was an error on the part of the hospital to mention the admission the admission date as 04th July 2020 which actually was 5th July 2020. But the papers clearly mentioned the admission date as 5th. Hence we understand that the same be overlooked. In order to get the claim processed, the hospital authorities duly submitted all the required papers to the company on 07/07/2020 but the claim was rejected by Star on account of a baseless and stupid reason that the eligibility claim needs to be further analysed by them and requested us to file a reimbursement claim. Later on, we got to know that my dad was Covid positive and that he required immediate treatment as his health was deteriorating and he was facing difficulty in breathing. Hence, we were as suggested by the hospital authorities to transfer him to a COVID hospital where he would get proper treatment and medications. However we were not getting beds anywhere. Hence, after continuous efforts of around 2-3 days we got one and immediately transferred him to a renowned COVID hospital from the earlier hospital on 11th July 2020 regarding which the insurance company was intimated vide number CLI/2021/191138/0159796. Now, he got the discharge from this hospital on 28th July'2020 after he was declared stable by the doctors. We thereafter filed a reimbursement claim for the hospital expenses with all the original reports and hospital documents nad bills. Later, after 1 month, we were queried for the Internal case papers of my dad which were submitted online within time. But we kept on receiving email reminders for submission of query documents despite being already submitted online. Further, we even submitted the hard copies of the ICP requested to the office on 16th September 2020. Thereafter, to our surprise, we received the claim rejection email on 16th October for non submission of documents despite submitting all the proper documents. On contacting the customer care we have been informed that the claim has not been rejected an the mail was a system generated mail. So my question is..is this the way the company treats its genuine customers and deal with insured? You have always been paid the premiums on time and now it is your duty to complete your promises.

And a suggestion: Please stop making false claims to the people and fool them. They is not going to help you in anyway. You wont be able to reach heights cheating us..and stealing hard earned money of citizens.
Was this information helpful?
No (0)
Yes (0)
Star Health And Allied Insurance customer support has been notified about the posted complaint.
Complaint comments 

Post your Comment

    I want to submit Complaint Positive Review Neutral Comment
    code
    By clicking Submit you agree to our Terms of Use
    Submit
    Star Health And Allied Insurance
    customer care contact
    Customer satisfaction rating Customer satisfaction rating is a complex algorithm that helps our users determine how good a company is at responding and resolving complaints by granting from 1 to 5 stars for each complaint and then ultimately combining them all for an overall score.
    Read more
    21%
    Complaints
    564
    Pending
    0
    Resolved
    118
    Star Health And Allied Insurance Phone
    1-800-1024477
    1-800-4252255
    +91 44 2828 8800
    Star Health And Allied Insurance Address
    No.1, New Tank Street, Valluvar Kottam High Road, Chennai, Tamil Nadu, India - 600034
    View all Star Health And Allied Insurance contact information