I had taken medical insurance for my father on 3rd January 2012 online through their website https://starhealth.in/. On the same day I got the policy document online after paying the premium amount online. The policy details of my father are:
Policy Number: P/700002/01/2012/004071
Policy Start Date: January 04, 2012
Policy End Date: January 03, 2013
Unfortunately, my grandmother expired in the same month and my father went from Bhopal to Raipur. As per hindu rites, he along with my uncle went to Allahabad on 6th for asthi visarjan. They took a boat service at sangam ghat for this purpose. While offboarding from the boat, due to bad condition of the wooden plank and slippery floor my father’s leg stucked between cracks of wooden plank and got injured. Somehow my uncle managed to bring him back to the place where they stayed in Allahabad. They just took first aid treatment from a near by clinic and next day took train for Raipur.
As soon as he reached Raipur on 8th Jan 2011, he went for xray after which we came to know that the knee cap got fractured. We contacted Ram Krishna Care hospital in Raipur where they adviced to get hospitalized on 9th Jan for operation. On 9th Jan, after my father was hospitalized, we had applied for the cashless facility of Star Health and hospital has sent all the reports for approval of the cashless claim.
Thereafter, doctor from star health visited my father and verified actual situation. The hospital got a cashless denial letter from Star Health with reason as “Symtomatic prior to policy has been taken”. I called the customer care to understand the reason for which there was no satisfactory reply and they very politely advised me to go ahead with the treatment and submit the medical bills along with xray and other documents for cash settlement. Since anyhow my father had to be operated, so we went ahead with the treatment.
After my father got discharged, I submitted the documents on 21st Jan 2012 at the Raipur branch of Star health as advised by their call centre. After this started a series of mental harassment by Star health and their investigation persons. Since my home address is in Bhopal, the file was transferred to Bhopal’s branch after a month of keeping that in Raipur’s office. The investigation officer visited my father in Bhopal and asked for following proofs:
1) To and fro tickets to Allahabad: We don’t had any tickets. My father and uncle took the latest available train to Allahabad as after their return they again had to complete other rites. Also they are least aware that there would be any accident and they have to undergo all the things which later happened in future. The insurance company should be sensible to consider the mental pressure a person can undergo when his mother expires, will he be in a sound position to think of such things.
2) Contact information of the boat where the accident took place: Is it fare to ask a person such kind of irrelevant questions. Do we ask for contacts numbers of auto drivers, bus or such public service.This is just to discourage the customers and to establish a very bad excuse for non settlement of claim.
Apart from such irrelevant questions for which my father has clearly mentioned that we don’t have any such proofs, again after a month, we received a letter asking clarifications for same set of questions which we already had answered to the investigation officer 2-3 times when he visited in person. My father was so irritated by that time and also mentally tortured by their indefinite calls for same questions that he had not even replied to their letter.
We had furnished all the reports, medical records etc, they had not asked about any of them anytime because all the medical documents are correct and proper. They took more than 4 months to frame such non sense questions just to deny the claim finally. They just want to escape by putting questions for which we already responded and for which they are aware we can not provide any proof.
Is this a fair practice. Later I checked the policy and found that the policy covers all the pre and post illness.The insurance company should understand that we would not have told them all the story, but instead just told them that my father slipped in bathroom then what proof does the company would have asked. May be they would have asked, who is the person who did the bathroom flooring?
I will surely escalate this matter to consumer court and all the consumer forums till Star Health will not apologize for the mental harassment.
While taking the policy they make such big promises but in actual situation they harass customers a big time. I really don’t want anyone to undergo such mental trauma and hopeless hope of claim settlement from Star Health.