Star Health And Allied Insurance — Rejection of Claim after Surgery

Address:

Plot no 5-R-C/796 ,Gokul plots,SVR CoPlot no -5-R-C/796, HSNR Residancy,GGokul plots,SVR Colony, Serilingampally,Hyderabad,500049.

Dear sir/Madam,

Im S.Uday kiran resident of india.And im from Hyderabad.
I accidentally fell at my home on 26/7/21 i felt severe pain in my left shoulder and a little dislocation in my left shoulder which i relocated my self in pain . Since the pain was severe i got to consult a near by hospital (ARCHANA HOSPITAL) at Madhinaguda. Doctor asked me for MRI reports and after further evaluation of MRI he found there is bankarts injury and ligament tear and need to undergo “Shoulder Aurthoscopic Surgery”
Which is my i need to go for my insurance(STAR HEALTH INSURANCE) claim.when the hospital billing department sent all the required documents for claim they intitially approved the claim due to which doctors proceeded further for surgery.

And the surgery was done successfully and i was about to discharge that immediate next day after surgery.And suddenly hospital billing department says that i “your claim has been rejected due to long standing injury” which is not a long standing injury .Even doctors also certified that he has no past dislocation history as per Reports.

I tried to call the customer care and my insurence agent aswell but there i got no proper response from them . I even asked for a call back from concern personal or doctors team who evaluated my condition to be a long-standing.i even wrote main to the grievance department and still I didn’t get any response.They are not even showing any proof that my condition is long standing

I have been stuck here since 4days without getting discharged .And hospital management is asking me to pay all the bill and go for reimbursement for which i have no funds .

This insurence company is worst in responding to customer and insulted me, and they are torchering me without responding and approving.
My agent was also said that your documents are all clear to be approved, i dont know why did they reject your claim .He said that he also raised complaint from his end .And after that even he is not responding my calls and messages .