Jairaman Vaidhyanathan
New member
- Policy Name
- V Jairaman
- Company Name
- Star Health Insurance
- Customer Care Number
- 18004252255
- Loss Amount
- 10000
- Ratings
I am writing to formally complain about the inconsistent and unfair settlement of claims under my health insurance policy with Star Health Insurance. Despite multiple attempts to seek clarification and resolution, I have received generic responses stating that the "maximum amount has been paid as per policy conditions," which does not align with the actual discrepancies observed in my claim settlements.
My grievances are as follows:
Inconsistent Payment for Medicines: In some claims, the full cost of prescribed medicines has been reimbursed, whereas in others, the same medicines have only been partially paid.
Inconsistent Payment for Procedures: There have been instances where the full cost of medical procedures was covered in some claims, while the same procedure was deducted in others.
Inconsistent Room Rent Reimbursement: In certain claims, the room rent has been paid in full, whereas in other cases, it has been only partially paid with the justification that the "maximum amount under policy conditions" has been reached.
These discrepancies have occurred despite all claims of the same patient, the same hospital, and the same treatment procedure. When I visited their office and presented evidence of these inconsistencies, your representatives acknowledged the errors and assured me that they would be rectified. However, all email communications continue to provide the same generic response without any corrective action.
This inconsistent and arbitrary practice not only causes financial distress but also raises serious concerns about the transparency and fairness of claim processing by Star Health Insurance. I request:
A detailed clarification regarding the discrepancies in my claim settlements.
A reassessment and fair adjustment of all claims where discrepancies have occurred.
A written assurance that such inconsistencies will not be repeated in the future.
My grievances are as follows:
Inconsistent Payment for Medicines: In some claims, the full cost of prescribed medicines has been reimbursed, whereas in others, the same medicines have only been partially paid.
Inconsistent Payment for Procedures: There have been instances where the full cost of medical procedures was covered in some claims, while the same procedure was deducted in others.
Inconsistent Room Rent Reimbursement: In certain claims, the room rent has been paid in full, whereas in other cases, it has been only partially paid with the justification that the "maximum amount under policy conditions" has been reached.
These discrepancies have occurred despite all claims of the same patient, the same hospital, and the same treatment procedure. When I visited their office and presented evidence of these inconsistencies, your representatives acknowledged the errors and assured me that they would be rectified. However, all email communications continue to provide the same generic response without any corrective action.
This inconsistent and arbitrary practice not only causes financial distress but also raises serious concerns about the transparency and fairness of claim processing by Star Health Insurance. I request:
A detailed clarification regarding the discrepancies in my claim settlements.
A reassessment and fair adjustment of all claims where discrepancies have occurred.
A written assurance that such inconsistencies will not be repeated in the future.
