Fraud : Star Health and Allied Insurance Co. Ltd
Dinesh Bhutada
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Hello everyone
I am writing this case related to a health insurance claim for one of my relatives. He purchased Star Health and Allied Insurance Co. Ltd health insurance policy in July-2022 with premium of INR 30000. On 27th Feb-2023 he met with bike accident and Doctor has suggested an operation. We called Star Customer Care and intimated about the case. They have requested to send some documents that we sent to them initially. Patient was operated on 9th March and got discharged on 12th March-2023. On 15th March we sent all claim documents to Star Nanded branch in detail. On 25th March we got a rejection letter saying we are unable to process your claim due to document discrepancies. in the month of April-23 we have raised claim to STAR grievance department, they have requested to submit few documents that we submitted on 11th April.
Later it was investigated by a third party, we got call, they have visited Hospital too and suddenly on 2nd June again we got email saying rejection stands.
There were some dates overwritten in couple of documents that we realized later, and it was just human error. We took the doctor’s letter for this too. My purpose of writing this post is:
1.?????Can company reject claim with just generic statement without specifying which document has problem, being human there are always chances of mistake and should get chance to correct it , at least they should be aware what document has discrepancies. It’s not that we have not submitted any specific document, all relevant documents are submitted, verification also done and it’s a purely accidental case.
2.?????My humble request to everyone not to purchase STAR policy considering company just interested in selling polices and not to provide proper service even if we are purchasing it through agent. Customer will remain loyal to company if company is loyal with customer and understand pain customer is facing from last 4 months.
Dear Anand Roy
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Please make such organization which are loyal with their customer and not just selling the policy to increase the revenue, with this claim we may lost around INR 1,60,000 but I am sure with the power of social media and LinkedIn family your company will lose 100 times of this amount in revenue. Do not forget that it’s your customer base who is serving your company and your employees.
If you really understand pain of customer who purchase health insurance policy keeping in mind that it will be help us during their bad time my request is revisit claim number CIR/2023/151127/1564470 .We are ready to provide all documents which are require and also you can discuss with treating doctor/Hospital before you again reject claim with generic statement that we found some document discrepancies .
There are several customer base from India’s small villages/town who purchase health insurance policy those even does not know what all documents are require to submit and even small hospital also not much aware about it. Being a health insurance company it’s your responsibility to understand the situation and help your customer.
@Debashish panda Insurance Regulatory and Development Authority of India , please see if we can remove such insurance company from India those are just selling the policies and making customer frustrated while claim reimbursement
Hi, I have recently renewed my policy and I want to terminate the policy with immediate effect and need complete refund of the money paid since Nov-2023 to till date. I was a happy customer with care insurance and your sales executive named Nisha did follow up for months to port my policy from care to star by offering some discount in 2023.During the time, I have informed all the pre existing disease (BP,sugar & hyper tension) & surgeries happened for cataract and knee surgery on call. She has asked me to confirm the medical condition on email & informed not to mention about knee surgery as it is not required.I have repeatedly asked her whether is she is sure as I don't face any challenge during hospitalisation.she said not worry and the policy & waiting period will be considered from 2020 as per care policy and there is no waiting period hence I have submitted the email. I have planned knee surgery tomorrow and your claim department denied the cashless claim as they found PED as my mother had knee surgery in 2023. This is cheating..Star health only required sales and they can cheat and fraud with customers for a sale conversion.
Management expert worked in Senior Manager capacity handled F&A, Administration & operations in Pharmaceuticals,KPO,Chemical & Garments industries with over 2+ decades of expertise includes working in India & Abroad.
1 个月Star Health is by far the most disgusting insurance organization in the country. They take money from customers for years and then abandon customer in tough situation after rejecting genuine claims with lies/lousy excuses. Their so-called top management is nothing more than a bunch of crooks without a shred of professional ethics.??
Consultant Orthopedic Surgeon at Global Hospital-Parel, Lilavati Hospital-Bandra West,Hinduja Health Care-Khar West.
2 个月i have had a similar experience and as a practicing surgeon I realized that star is fraud no 1 company. Rather than posting comments about them the best route is to port to a better company. I personally wrote to Mr Anand roy but never got a reply, ditto with their claim settlement officer. IRDA is a toothless tiger. I have seen a lot of my patients going through this.
Management expert worked in Senior Manager capacity handled F&A, Administration & operations in Pharmaceuticals,KPO,Chemical & Garments industries with over 2+ decades of expertise includes working in India & Abroad.
2 个月Star health insurance faills to deliver on its promises-endless dealys & no resolutions.Save yourself from the hassle & choose a better provider.