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Wrong rejection of my mediclaim.

This is a discussion on Wrong rejection of my mediclaim. within the Medical Insurance forums, part of the Insurance category; I have taken mediclaim policy from Star Health through Shri Ram Fortune (a distribution co. for which I m working ...

  1. #1
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    Default Wrong rejection of my mediclaim.



    I have taken mediclaim policy from Star Health through Shri Ram Fortune (a distribution co. for which I m working as agent too).

    My wife was admitted in hospital on 06/2/2011 as per doctor's advise and she has been discharged on 07/02/2011 after 24 hours of hospitalization.

    They rejected my claim wrongly by saying that their authorized panel doctor has visited the hospital and he has reported that patient is discharged before 24 hours of hospitalization which is compulsory for eligibility for claim.

    His report is totally wrong because my claim is genuine and I have submitted all the evidences required by them showing enough time for hospitalization.

    Below is the correspondence from the beginning I have made with Shri Ram Fortune and Star Health.

    Please help me to get my claim as early as possible. I will be greatful to you.

    Thanks n Regards,

    Vimal Dubal

    Email id. : dubalvimal@gmail.com

    Cell. No.9510141481.

  2. #2
    Junior Member
    Join Date
    Mar 2012
    Posts
    2

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    I have taken a personal mediclaim floater policy from Star Health for my parents. The policy was taken on July 2008 and renewed all through out. My mother was detected with Liver disease in May 2009. However I decided to use my employers' mediclaim policy (Bajaj Allianz) which covers my parents as well and it worked well till this year. Unfortunately, my mother went through couple of hospitalization in year 2011-2012, which exhausted my employers' mediclaim limit. Also my mother was diagnosed with Knee problem just about 6-9 months back and was suggested by doctor to go through Knee replacement surgery, which we decided to take up using the personal insurance of Star Health. Initially Star Health rejected to give us Cashless facility for Knee Replacement Surgery because of Liver disease. Later when we submitted the claim, it rejected it, saying we did not disclosed the Liver disease which existed before July 2008.

    I have requested to reconsider the claim based on the ground that knee replacement has nothing to do with Liver disease. Also I provided the first consultation letter for Liver disease when my mother was first hospitalized way back in May 2009. I am awaiting for response from the Star Health for reconsideration of claim.

    I am seeking help to recover my claim and also wanted law to take severe action against the Medical Insurance policy companies for troubling genuine holders during their critical times. The reason I say this is because, although I have provided them with all the documents which states the medical history, they denied the claim. Hence I seek severe punishment / action on such companies.

 

 

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