Nov 17, 2016 08:41 PM
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Star Health and Allied Insurance Co Ltd Cares
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I have gone through some comments regarding rejection of, refund of premium, denial of claim of insured by the star health insurance company. In this regard I wish to explain as follows.
1) Rejection of policy by the insurers: After receipt of every proposal form, the same will be scrutinized by under writers, after that policy will be issued & if for any reason insurer reject the proposal, the insurer will have to refund the premium & there is no need to furnish the reason for the same. Further in case of insurer wishes to cancel the policy if T&Cs of insurer not according to promises made, the same can be cancelled within free look period i.e.within 15 days from the dt of receipt of policy, then insurer has to refund the premium amount without any delay other wise the insurer is liable to pay interest on total premium due till payment at the rate of 10.5% P.A .Non refund of premium in these cases is very bad & deficiency of service to customer. 2) Rejection/denial of claims: Insurer can reject claims in respect off following a) if there is a pre existing one prior to issue of policy which has not been disclosed in the proposal form b) In few cases like diabits, heart attacks, brain tumors, cancer & severe orthopedic problems, which are not developed suddenly in a day or two or 2 to 3 months after issue of policy other than heart attack if insured is able to prove that the above are first one after issue of policy with medical documentary evidence there is no way to deny the claim by the insurer. Therefore proposal form will form an important document which will decide the fate of claim if any arises.It is required to be disclae all health issues prior to proposal then if proposal is accepted disclosed ones are excluded for 24/36/48 months depending on varient opted. It is always not desirable to buy policy on line through bulk policy sellers or from company in which some hidden terms may not be available.