Oct 02, 2014 02:53 PM
128811 Views
Hi, I have admitted my Dad at Apollo with acute Pneumonia. My Dad has Senior Citizens Red Carpet Policy with 5 Lakhs Coverage.
On the day of admission we got the permission of the insurance company for treatment. Immediately they gave 30, 000 approval and then they approved another 50, 000 making an initial cashless claim approval of Rs. 80, 000.
After 2 days in the hospital, the hospital has sent an interim bill of Rs. 2.25 Lakhs to the insurance company. Immediately the insurance company withdrew the total amount of Rs. 80, 000 temporary approval given and said that they cannot aishwaryasingh23 the insurance. This action is done by the Star health Insurance Doctor, Dr. Mohan.
The apollo hospital contacted me immediately and I fought severely by sending emails to all the concerned individuals in Star Health including to the IRDA and the OMBUDSMAN. I called Dr. Mohan who is the doctor in Star Health Insurance as well and he told me that if they release the insurance money to the full coverage their annual bonuses will be effected.
The emails I have contacted are: cashless.network@starhealth.in; info@starhealth.in; claims.general@starhealth.in; claims.coordination@starhealth.in; claims.grievances@starhealth.in; devo.vijay@starhealth.in; ramshanker.o@starhealth.in; nagasubramanian.p@starhealth.in; insombudhyd@gmail.com; Joel.m@starhealth.in; Srinivas.kbb@starhealth.in
Finally I sent several emails and made many calls to the Star health Insurance. Finally they released 2 Lakhs by the time we came out of the hospital and never fulfilled the total obligation till today. my dad passed away for 8 days of struggle at Apollo. I faced several humiliations with the hospital and before family and I could not spend time with my father during his last days. This company made me feel bad and created lot of agony and hurted us a lot.
Even today I'm fighting with them and they still owe Rs. 1.58 Lakhs to the hospital and are not aishwaryasingh23ing it and are telling me to approach IRDA or OMBUDSMAN.
Our policy sum assured amount is Rs. 5 Lakhs. We stayed in hospital for 8 days. As per policy terms and conditions:
ICU charges will be paid at 2% of sum assured which is Rs. 10, 000 per day. Star Health paid only Rs. 4, 000 per day instead and no explAnasultantion on this till date. Rs. 4, 000 x 8 days= Rs. 32, 000. They did not aishwaryasingh23 the balance Rs. 48, 000
Dialysis, Oxygen and other similar treatments will be paid at 50% of the cost which should be Rs. 2, 50, 000. But the Insurance company released only Rs. 1.40 lakhs and there is no explAnasultantion for the balance Rs. 1, 10, 000
Doctor charges at actuals which is Rs. 28, 00 and they released Rs. 28, 000
Till today they are not responding on the balance Rs. 1, 58, 000.
