Insurance Fraud

Dear Fellow Friends.

Please read the below email i have sent across to Star Health with regards to my fathers claim. Please send me an email to [email protected] and i shall send the attachments proofs which clearly proofs how i was mislead.

Hello Sir,

This is in regards to my Fathers subject Policy.

I was handed over a letter advising rejection of my claim submitted.

Claim Number CLI/2020/700001/0037731

I differ with your findings. There is no concealment of information over here.

i am not a Dr and wouldn’t know, however referring to the discharge summary received on 29/04/2019 it’s been mentioned (known case of CKD and DM on treatment since last 1 year).

Regardless i had an earlier claim in June 2018 ( Claim number CLI/2019/700001/0077966) at that point in time Mareeswari the Sales Rep through whom i had bought the policy did advise that CKD would be covered from the 2nd Year of renewal.

I had clearly articulated i would not be interested in the policy if CKD is not covered and she did advise on the chat message that this is covered.

Further to this, quite recently on multiple occasions i got the confirmation from Avinash (Assistant Team Leader Star Health) that CKD would be covered from 2nd year onwards.

Upon my claim rejection, i again approached Avinash’s Manager [email protected] Health who has confirmed to me that CKD would be covered from 2019 with 50% of co-payment.

I have attached my email conversations and WhatsApp chat messages confirming that this is covered. If this wasn’t covered i wouldn’t had continued with your company.

This is ridiculous that upon receiving my claim your team rejects it. If this is not settled i would be approaching the Ombudsman. i hope we resolve this amicably. Thankyou

Please Note – According to Section 65 (B) of Indian Evidence Act
“any electronic act which can be printed on a paper, stored, recorded or copied in optical or magnetic media produced by a computer shall be deemed to be a document.”

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