Star Health And Allied Insurance — Star Health dishonest behavior - Intimation No: CIR/2022/161127/3040348

Address:

India

Regarding Star health Insurance:
Intimation No: CIR/2022/161127/3040348

I've submitted a claim on 23rd August with all documents, however, the investigation forms and medicine receipts were not carefully examined. Some of them are considered, others are not even in consideration for reimbursement.
Total claimed amount: 13340.
Considered claimed amount: 10, 000
approved amount: 5500

There are many discrepancies at their end in evaluating the claim.

#1: 2400/- deduction from final bill: PFA - the documents confirmed that 2400/- is deposited to the hospital.
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#2: Investigation and diagnostics: the approved amount is just 1950 which is taken from the Indoor patient bill. The other amount is 1800/- which was spend on the test and was not taken into consideration (the soft and hard both is submitted for all investigations)

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Here is the bill of 1800/- spent on the PPE kit, RFT, CBC, and chest PA view. Why is this not considered? All the related reports are submitted.
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#3: Medicine bill: based on their report, the total claimed amount is 2676 and the 1444 is not payable due to the below reasons::
GLOVES, MASK, CANNULA, FLAMIGRIP, SET, BETAKIND NOT PAYABLE - I totally agree with this.

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However, the claimed amount for medicine and the bills I've submitted: 4190.89
6 medicine bills of 4672 and 1 return receipt of 481.11 = 4190.89/-
Attached all the bills for your reference (physical copies were also sent):
The question is why just 1 bill was considered and not others?

PS: I've not received any DD for the approved amount as well. The final settlement was without my consent, is not accurate.

Very important note:
The hospital (Asarfi Hospital, Ballia) where my spouse was admitted is listed as a cashless hospital in starthealth website, unfortunately the hospital denied any such relationship from starhealth and I had to pay them instead of a cashless facility.