- Policy Name
- Policy Number-2392112402050643/UIN-SHAHLIP23131V022223
- Company Name
- STAR HEALTH AND ALLIED INSURANCE CO. LTD
- Customer Care Number
- 1800 425 2255
- Loss Amount
- 1000000
- Ratings
- Opposite Party Address
- 64 Nehru Colony, Regent Park,Kolkata-40
The sequence of events narrated above raises serious concerns regarding the manner in which my father-in-law's health insurance proposal was processed, underwritten, and subsequently administered by Star Health Insurance.
The relevant facts are set out below:
23.11.2023: A health insurance proposal for my father-in-law was submitted to Star Health Insurance, and the full premium was paid.
25.11.2023: Star Health accepted the proposal, issued the policy, and provided the Policy Document and Health Card, thereby confirming that the insurance coverage had commenced.
26.11.2023: Star Health sent an email raising the following underwriting query attached:
"DUPLICATION(S) PED - HYPERTENSION AND PROSTRATE SURGERY IN 2015. NO MALIGNANCY OF SURGERY. KINDLY SHARE THE DISCHARGE SUMMARY WITH TURP BIOPSY REPORT. ANY IMPENDING SURGERY."
The email further stated that if the requested documents were not submitted within 15 days, the policy would be cancelled.
the insurer had only two logical and permissible courses of action as per their letter mentioned above:
However, the reference to prostate surgery in 2015 was entirely inconsistent with my father-in-law's actual medical history. He underwent prostate surgery only in 2021. Since no surgery had been performed in 2015, it was impossible to furnish any discharge summary or biopsy report relating to that year.
29.06.2026: After collecting premiums for three long years, Star Health repudiated my claim and cancelled the policy on the allegation that my father-in-law had concealed his urinary disease.
This is to clarify theat Enlargement of the prostate is a urological condition that commonly causes urinary symptoms, and the diagnosis, treatment, and surgical records are intrinsically linked to the underlying urinary disorder. Any medical professional would appreciate this relationship.
If the insurer had in fact obtained and examined the discharge summary from us during the underwriting process, it could not subsequently allege concealment of the same medical condition.
05.07.2026: Having developed serious doubts regarding the manner in which the proposal had been processed, I requested Star Health to furnish copies of all documents (Hospital discharge summary, Biopsy Report) allegedly submitted in response to its underwriting query dated 26.11.2023.
09.07.2026: Instead of providing the requested records, Star Health furnished irrelevant documents and vague, evasive responses. Even today, the insurer has failed to produce the documents that allegedly satisfied its underwriting query and formed the basis for its decision to continue the policy for nearly three years despite its earlier warning that the policy would be cancelled if those documents were not furnished.
I also have a reasonable apprehension that some Star Health official acted negligently, collusively, or in violation of applicable regulatory requirements while processing or continuing the policy just to make money from it, otherwise this policy would have been cancelled 3 years back due to absence of documents by us w.r.t query dated 26/11/2023 by Star Health.
It’s a clear and severe financial hardship, mental agony, and prolonged harassment caused by Star Health and its officials. I request that the investigating authority to identify the officials responsible for processing and approving the proposal, and take such action as may be warranted if any irregularity, manipulation of records, or regulatory violation is found during the course of the investigation.
The relevant facts are set out below:
23.11.2023: A health insurance proposal for my father-in-law was submitted to Star Health Insurance, and the full premium was paid.
25.11.2023: Star Health accepted the proposal, issued the policy, and provided the Policy Document and Health Card, thereby confirming that the insurance coverage had commenced.
26.11.2023: Star Health sent an email raising the following underwriting query attached:
"DUPLICATION(S) PED - HYPERTENSION AND PROSTRATE SURGERY IN 2015. NO MALIGNANCY OF SURGERY. KINDLY SHARE THE DISCHARGE SUMMARY WITH TURP BIOPSY REPORT. ANY IMPENDING SURGERY."
The email further stated that if the requested documents were not submitted within 15 days, the policy would be cancelled.
the insurer had only two logical and permissible courses of action as per their letter mentioned above:
- Obtain and evaluate the requisite medical records before continuing the policy; or
- Cancel the policy in accordance with the position stated in its own communication if the documents were not furnished.
However, the reference to prostate surgery in 2015 was entirely inconsistent with my father-in-law's actual medical history. He underwent prostate surgery only in 2021. Since no surgery had been performed in 2015, it was impossible to furnish any discharge summary or biopsy report relating to that year.
29.06.2026: After collecting premiums for three long years, Star Health repudiated my claim and cancelled the policy on the allegation that my father-in-law had concealed his urinary disease.
This is to clarify theat Enlargement of the prostate is a urological condition that commonly causes urinary symptoms, and the diagnosis, treatment, and surgical records are intrinsically linked to the underlying urinary disorder. Any medical professional would appreciate this relationship.
If the insurer had in fact obtained and examined the discharge summary from us during the underwriting process, it could not subsequently allege concealment of the same medical condition.
05.07.2026: Having developed serious doubts regarding the manner in which the proposal had been processed, I requested Star Health to furnish copies of all documents (Hospital discharge summary, Biopsy Report) allegedly submitted in response to its underwriting query dated 26.11.2023.
09.07.2026: Instead of providing the requested records, Star Health furnished irrelevant documents and vague, evasive responses. Even today, the insurer has failed to produce the documents that allegedly satisfied its underwriting query and formed the basis for its decision to continue the policy for nearly three years despite its earlier warning that the policy would be cancelled if those documents were not furnished.
I also have a reasonable apprehension that some Star Health official acted negligently, collusively, or in violation of applicable regulatory requirements while processing or continuing the policy just to make money from it, otherwise this policy would have been cancelled 3 years back due to absence of documents by us w.r.t query dated 26/11/2023 by Star Health.
It’s a clear and severe financial hardship, mental agony, and prolonged harassment caused by Star Health and its officials. I request that the investigating authority to identify the officials responsible for processing and approving the proposal, and take such action as may be warranted if any irregularity, manipulation of records, or regulatory violation is found during the course of the investigation.