Health Insurance Complaint against Star health and Allied Insurance Claim deartment

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Policy Name
Star health assure
Company Name
Star health and Allied Insurance Comp Ltd
Customer Care Number
18004252255
Loss Amount
10477
Ratings
2.00 star(s)
Opposite Party Address
Star Health and Allied Insurance
Sapphire House, 240 Sapana Sangita Road, Indore(MP) 452001
This is regarding deduction of Rs. 10479/- towards reimbursement claim of Rs. 28854/- (approved Rs 18375/- only).
The above deductions were made saying not eligible for payment as per policy clause).
On going through the policy clause we don’t find such reasons of non eligibility as Star health has not mentioned any such relation of clause/ conditions in their reply letter.
For your ready reference the following documents are attached here with.
1. Copy of policy document.
2. Copy of policy conditions.
3. Reply mail of Star health for deductions.
4. Reply mail for denial of re-consideration for short paid amount.
Kindly do needful for settlement of short paid amount of Rs 10479/- as the treatment was done from Apollo hospital Indore, which in their network.
Subhash Dubey(Proposer)
 

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On going through the policy clause we don’t find such reasons of non eligibility as Star health has not mentioned any such relation of clause/ conditions in their reply letter.
In such a situation, we suggest that you proceed by sending a legal notice to the Chairman and Managing Director (CMD) of the Star Health and Allied Insurance, formally requesting to pay the ₹ 10479/- . Kindly allow them a 15-day period to respond to the notice.

If you do not receive any response within this timeframe, please revert to us. We will then guide you through the process of filing a case in the Consumer Forum.

Please let us know if you need assistance in drafting the legal notice or have any further questions.

Best regards,
 
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