PRELIMINARY: I along with my wife were to travel To USA in May 2013 Star Health through its executive & local agent contacted us. Completed all the formalities & issued us two cashless policies with conditions:’Exclusion nil & no co pay"
ILLNESS IN USA: We traveled to USA well assured. As ill luck would have it my wife got TIA(Transient Ischemic attack) We contacted their subsidiary through mail & on phone in USA. Response was, ’ Get treated & send the reports & bills etc to them later against a CASHLESS POLICY It was our good luck that my son was there to take care. Otherwise we would have been thrown to wolves in a foreign land begging for money for treatment or to die.
USA RESPONSE: There was no response from parent company or its subsidiary. Treatment in USA was too costly -(an example only MRI IN A HOSPITAL quoted COST$7000)My son, Indian Doctor helped us a lot. Seeing the cost of treatment very high, no response from Insurance company even for the sake of name & my wife getting tolerable recovery we rushed to India on In Dec., 2013. Mean while I had submitted all the bills etc Complete in all respects To the company through E mail & priority physical mail. Initially they even did not acknowledge the receipt. When I pulled up the agent & wrote some hard letters through desperation They acknowledged the receipt & Delhi office informed that our papers have been forwarded to their head office.
STORY IN INDIA: On 6th Dec I got a letter rejecting our claim saying that my wife was having hypertension & she did not disclose the same at the time of insurance. I contested their version saying in the form we filled that hypertension was duly mentioned in our application form. When I demanded the copy of the application form, they refused. Later I came to know that they have replaced our original forms with our signatures with duplicate one. When I found that they along with their seniors are adamant on their stand I moved the consumer court.
LEGAL BATTLE PROCEEDINGS: Case was contested & finally the court banged star health on both the issues, hypertension & Pre existing disease argument & decided the case in our favor. Today I have received the payment draft from the company with Compensation amount as per the order of Hon. Court.
RESULT: We got the payment but the problems in foreign land & harassment of four years can not be forgotten
SUMMARY: THESE COMPANIES THRIVE ON PREMIUMS> ABOUT 80% POLICIES TURN OUT TO BE NON CLAIMING. 2 TO 3% ARE HONORED. REMAINING ARE REJECTED OVER FRIVOLOUS GROUNDS. OUT OF THESE 17 - 18% Majority of persons forget due to fear of court procedure. & those who approach the court get benefit but after a unbearable harrassment