Sir,
Star health has denial for the claim mad by hospital and after by us against illness expenses of my son. The reason Insurance company has given us the period between the day issuing policy and the day of treatment or admit in hospital is less than one moth of your patient.
I had purchased floater insurance plan at 23- March -10 for my entire family and the validity period display on the Identity card of star Health is 14/04/2010 to 13/04/11. I have admitted my Son (Name is Mr. Lakshay Sharma) in Swastic Maternity and Medical Centre in Gurgaon dated 06th May-2010 because of his illness.
Legally the period between policy purchase (19-03-2010) and patient admition date (06-05-2010) is near about 1 month and 25 days. So we are liable to take my claim from Star health please help out us in this case. All the detail mentioned bellow-
Insurance company name:
Star Health and Allied Insurance Company Ltd.
Reference Claim No – 0008140
Policy No –P/161117/01/2011/000001
Patients name : Lakshay Sharma
Date of invoice : 19.03.10
Date of issue : 19.03.10
Validity from on policy identity card : 14.04.2010 to 13/04/2010
Amount claimed-Rs. 8192.0
Regards,
Ho. No -229/20 Om Nagar Gurgaon (Near shivaji nagar Hanuman Mandir)
Mobile No- 9971599740, 09466991009

Dear Sir,



Star health has denial for the claim made by hospital and after by us against illness expenses of my son. The reason which Insurance company has given us "the insure got admitted with in 30 days from the commencement of the policy (denial letter also attached).


As per me I had purchased floater insurance plan at 23- March -10 for my entire family and the validity period display on the Identity card of star Health is 14/04/2010 to 13/04/11. I have admitted my Son (Name is Mr. Lakshay Sharma) in Swastic Maternity and Medical Centre in Gurgaon dated 06th May-2010 because of his illness.

Legally the period between policy purchase (19-03-2010) and insure admitted date (06-05-2010) is near about 1 month and 25 days. Star Health doing fraud by mentioned a wrong validity period at card received from Star health, is from 14.04.2010 to 13/04/2010 even I have purchase policy on 22 March-2010 from their executive Mr. Dusheyant and the same date of payment collection mentioned mentioned in policy is 19 March-2010.

So we are liable to take my claim from Star health please help us in this case. All the detail mentioned bellow-


Insurance company name:

Star Health and Allied Insurance Company Ltd.
Reference Claim No – 0008140
Policy No –P/161117/01/2011/000001
Patients name : Lakshay Sharma
Date of invoice : 19.03.10
Date of issue : 19.03.10
Validity from on policy identity card : 14.04.2010 to 13/04/2010
Amount claimed-Rs. 8192.0
Regards,

Neeraj sharma
Ho. No -229/20 Om Nagar Gurgaon (Near shivaji nagar Hanuman Mandir)
Mobile No- 9971599740, 09466991009

I had proposed Senior citizen policy to my uncle Sathish Kini which was valid from 18/06/2010 to 17/06/2010 (policy no : P/141220/01/2011/000677 ).

On 25 April’2011 the policy holder got admitted to KMC hospital with symptoms of Benign Prostate Hypertrophy. As I was aware of the policy exclusions during the first year of the policy, I suggested the patient to use his cashless ‘Manipal Arogya Suraksha’ policy to meet the hospital expences as we had estimated it to be below Rs30000. The following day the patient underwent trans urethral resection and was supposed to be discharged in a day or two.

Unfortunately, the patient developed sudden right sided hemiparesis and all necessary actions and treatment was taken up. The patient passed away on 5th may’2011 despite being on ventilator all appropriate treatment, medication. Due to this unexpected health conditions the final bill came upto Rs 99,599/- of which Rs 30000 was approved and paid by ‘Manipal Arogya Suraksha’ respectively.

As per the policy exclusion, the bill amounted to rs99,599/- due to treatment of sudden right sided hemiparesis and other complication developed and not disease such as Benign Prostate Hypertrophy.

Request the concerned to Advise.

Chandramouli Shenoy M
98802 95995
mcshenoy@gmail.com