Motto is to cheat. They never give cashless. Review on STAR Health Insurance

Dear Friends/Well-wishers,

I am writing this review to not fall in trap with Star Health Insurance. Every plan tells that "Cashless authorization will be provided in network hospitals". When the real need comes, they simply ask for hell lot of queries and upon providing all the queries. The final weapon for them is to denial cashless and will ask to come for reimbursement, which you will never get the amount after submitting the bills. Friends, my advice is to fight for your rights of cashless and don’t go for reimbursement.

My Factual Story:

My father, aged 59 years, had taken'SUPER SURPLUS INSURANCE POLICY' in the year March 2011 and paying the premium regularly till date. In June 2011, he visited general physician for edema on his legs. After couple of tests, the physician referred to corporate hospital in Hyderabad. Upon further review by specialists, they confirmed that he is suffering from Chronic liver disease. From June 2011 to till date(5.4 years) he is in medication. Recently, the treating doctor suggested undergoing liver transplant.

Here the actual story twist starts:

We raised pre-authorization cashless from the network hospital. As usual they started asking queries. Queries 1, 2, 3, …. Almost we have provided all the documents from 1st consultation to till date reports. They simply rejected the cashless and asking to come for reimbursement, which I am fighting for. I contacted the grievance department through emails and calls, but no one is responding. I received an email that they stand still on the decision for cashless denial. Later, I have registered my concern in IRDA portal. Waiting to hear from IRDA staff on my complaint.

Couple of things why I am not willing to go for reimbursement:

1. Transplant surgery costs more than 20+ lakhs and we cannot effort that much cash payment and come for reimbursement.

   
   




2. If the insurance company is not approving cashless in their own network hospital, how come they will reimbursement the claim after the surgery.

   
   

My final advice to all:

1. Never go for star health insurance because their claim settlement ratio for 2014-15 is around 63% and 47 percent they will reject your claims.

Meaning:  For every Rs.100 premium paid, they will accept claim of Rs.63

1. If you compare other insurers, they pay more than the premium collected.

Source: https://policyholder.gov.in/indian_insurance_market.aspx