Complaint Against Star Health Insurance – Partial Claim Rejection for Maternity Hospitalization

Policy Name
Raghavendra H S
Company Name
Star Health Insurance
Customer Care Number
18004252255
Loss Amount
20000
Ratings
1.00 star(s)
Opposite Party Address
Jayanagar 1Shree Thulasi
Towers, 672/43, 3rd Floor
11th Main Road
Jayanagar 4th BlockBengaluru
560011
Bengaluru City Karnataka
560011
Respected Sir/Madam,
I am writing to lodge a formal complaint against Star Health Insurance regarding the unjust denial of my rightful insurance claim amount.
I have been a loyal customer of Star Health Insurance for the past 8 years, holding Policy Number: 8536111907060327 since 21st June 2018. In 2020, I included my wife Ms. Suraksha in the policy post our marriage, and later in 2022, I added my son as well by paying the additional premium.
During all these years, we have never made any claim and have been prompt in paying our premiums.
On Thursday, 31st July 2025, my wife was admitted to TMA Pai Hospital, Udupi, for her second delivery. On the same day, I contacted Star Health Insurance to confirm the coverage. I was informed by their executive that the policy provides:

  • ₹20,000 coverage for normal delivery, and
  • ₹40,000 coverage for C-section (Cesarean) delivery.

On Friday, 1st August 2025, my wife delivered our baby via C-section. The hospital initiated the insurance claim process accordingly. However, to our shock and disappointment, Star Health Insurance approved and released only ₹20,000, citing it as the maximum limit—despite the delivery being C-section, which should have qualified for ₹40,000 as per their earlier assurance.

The Claim Intimation Number for this case is: CIR/2026/141125/0668477.

Repeated follow-ups with the customer care, executives, and even senior managers have not yielded any resolution. The responses have been unprofessional, vague, and unhelpful. I feel cheated and deeply let down by this unethical and irresponsible behavior.

I, therefore, request the Online Consumer Court to kindly intervene and direct Star Health Insurance to:
  1. Release the remaining ₹20,000 as per the policy terms.
  2. Take appropriate action against the company's misleading communication and poor service.

Enclosed with this complaint are the following:
  • Copy of the Insurance Policy
  • Claim documents

I seek your kind support in ensuring justice and protecting consumer rights.

Sincerely,
Raghavendra
 
Dear Sir/Madam,
Yes, as per the policy document, it is clearly mentioned that Star Health customers with a claim amount of ₹7.5 lakhs are eligible to receive ₹40,000 for a C-section delivery. I had also confirmed this with insurance advisors, who clearly stated that I am entitled to ₹40,000.
Despite this, Star Health has played an unfair game by approving only ₹20,000. My policy is 8 years old, and I have never made a claim before.
I humbly request you to provide me justice.
 
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