Sunil Tripathy
New member
- Policy Name
- Star health assure insurance policy
- Company Name
- star health
- Loss Amount
- 500000
- Ratings
- Opposite Party Address
- 18004252255
Dear Sir/madam,
I am writing to formally and strongly object to the rejection of my health insurance claim on the grounds of an alleged pre-existing disease, which has been inferred by your team from doctor prescriptions. This rejection is factually incorrect, medically unsound, and contractually unjustified.
Policy Number: 11251084717300
Claim Number: CIR/2026/151111/1509468
Insured Name: MADAN TRIPATHY
Date of Claim: 12.01.2026
I wish to clearly state that at no point has any doctor mentioned, diagnosed, or certified the condition in question as a pre-existing disease in any medical record, prescription, or discharge summary submitted by me. Your rejection appears to be based on assumptions drawn from symptoms noted in prescriptions.
This approach is fundamentally flawed.
Symptoms are not equivalent to a disease.
Symptoms are temporary clinical observations and cannot be arbitrarily classified as a diagnosed medical condition, let alone a pre-existing disease, without a clear medical diagnosis explicitly stating so. None of the documents submitted contain any such diagnosis or declaration.
Further:
1. There is no explicit mention in any prescription or medical document that the condition existed prior to the policy inception date.
2. There is no medical evidence submitted or cited by your team establishing chronicity, duration, or prior treatment history that would qualify the condition as pre-existing under the policy terms.
3. The rejection letter fails to specify which exact document, which exact line, and which exact policy clause has been relied upon to label this as a pre-existing disease.
A rejection based on assumptions and interpretations—rather than documented medical facts—amounts to arbitrary claims handling and defeats the purpose of health insurance protection.
Regards
Sunil Tripathy
I am writing to formally and strongly object to the rejection of my health insurance claim on the grounds of an alleged pre-existing disease, which has been inferred by your team from doctor prescriptions. This rejection is factually incorrect, medically unsound, and contractually unjustified.
Policy Number: 11251084717300
Claim Number: CIR/2026/151111/1509468
Insured Name: MADAN TRIPATHY
Date of Claim: 12.01.2026
I wish to clearly state that at no point has any doctor mentioned, diagnosed, or certified the condition in question as a pre-existing disease in any medical record, prescription, or discharge summary submitted by me. Your rejection appears to be based on assumptions drawn from symptoms noted in prescriptions.
This approach is fundamentally flawed.
Symptoms are not equivalent to a disease.
Symptoms are temporary clinical observations and cannot be arbitrarily classified as a diagnosed medical condition, let alone a pre-existing disease, without a clear medical diagnosis explicitly stating so. None of the documents submitted contain any such diagnosis or declaration.
Further:
1. There is no explicit mention in any prescription or medical document that the condition existed prior to the policy inception date.
2. There is no medical evidence submitted or cited by your team establishing chronicity, duration, or prior treatment history that would qualify the condition as pre-existing under the policy terms.
3. The rejection letter fails to specify which exact document, which exact line, and which exact policy clause has been relied upon to label this as a pre-existing disease.
A rejection based on assumptions and interpretations—rather than documented medical facts—amounts to arbitrary claims handling and defeats the purpose of health insurance protection.
Regards
Sunil Tripathy