Fingure crossed on following email to STAR insurance, lets see their response.
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Dear Star Health Insurer, I have star Health insurance policy and was admitted in hospital for 2 days, however due to my serious health condition I was unable to inform my agent regarding my admit. At the same time I had discussion with my agent regarding my health condition 2 days before my admit date and told him I may admit looking at my health condition. After a week I claimed and have submitted all documents along with bills and receipts and agent said he will try this as one of case due to patient serious condition and he submitted the claim to local branch. After 25 -30 days he returned all document and informed that he cannot claim as I was unable to intimate during my admit. I understand it is company policy that patient / their relatives need to inform insurer / agent for verification of admit in respective hospital, however due to such serious condition we were unable to do so looking at health condition. This process is set as objective to verify whether the same insurer is admitted in the hospital / might be chances that the case is not genuine. In my case hence it is genuine case and star can verify the same from hospital and can take undertaking from respective doctor and verify this from hospital and whatever verification they would like to conduct from hospital and they can also check all original receipts with patient name. it is my sincere request to process the claim and deposit the complete claimed amount in provided bank details given in policy.
CASE BACKGROUND DETAILS
Policy No. P/171121/01/2015/001869
Date of admit: 24th August& 25th August 2015
Date of documents handed over to Agent for submission: 1st to 5th September 2015
Documents returned to me: 1st -6th October 2015
Insurer: Star Health Insurance
Agent Name: Narendra Haryani cod: BA0000201942
Office Code:171121
Star local Branch Agent: Vinod Jagaisi(Ulhasnagar Branch Health Manager)
Patient Name: Ashok Ahuja
Hospital: Shivneri hospital(Ulhasnagar -421004)
Branch Manager: Rohit Mishra 987064xxxx Call Discussion between Narendra / Rohit and myself(Nilesh Auja – son of Ashok Ahuja) on 16th October 2015 4.20pm Mr. Narendra submitted my claim documents to Vinod Jagaisi and he denied to process the application due to unavailability of intimation number while submission. However mr. Rohit Mishra suggested on the call that Mr. Vinod Jagaisi could have processed application to Mumbai reimbursement department without having intimation number loking at the case and could explained the background. However this was not done and it is decided on the call that my claim will be submitted again with all documents and processed immediately. First of all I don’t understand why it took 20 - 30 days to hear “NO” from Mr.Vinod for submission of documents without intimation number. Hope you all will support now. Looking forward for your complete support and help to close this at the earliest. Thank You for your cooperation Regards,
Ashok Ahuja
Mobile:+91 808717xxxx
