May 12, 2022 04:09 AM
4215 Views
(Updated May 12, 2022 11:02 PM)
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My Star-Health policy is 4 years running and I never claimed a penny before. I also had group mediclaim policy from Vipul MedCorp. My wife is undergoing Eye treatment called Macular Edema. Doctor advised for 3 injections out of which 1st OT was done successfully and I got cashless claim through Vipul MedCorp instantly. After one month doctor suggested for 2nd OT.
This time I asked Star-Health for cashless.
Then the real face of Star-Health revealed.
Now the worst battle started. On the OT day, hospital sent doctor's report and required documents to Star-Health. The Agent and local branch office said, we are processing your cashless, don't worry. I keep on waiting for post OT with patient for 3 hours, they keep promising me please wait for 30 min, and I kept waiting hour after hour. At the end, they wanted clarification from hospital the reason of disease is not mentioned clearly. I asked doctor and hospital to share clarification. Hospital instantly shared satisfactory clarification in their letterhead. In spite of that, Star-Health did not approved the cashless claim showing the reason unless we get proper clarification, casless claim will not be approved. Means they are not even convinced even after satisfactory clarification.
I then formally wrote Star-Health stating the whole episode and harassment to patient. They hardly bothered and said you can settle the claim through Claim Settlement process. I had no other option rather than paying hospital and discharged patient.
Now, coming to the main point. A lame excuse raised by Star-Health the patient (my wife) had anxiety issue 14 long years back during childbirth and after childbirth there was no issue. She got completely free from anxiety. Usually, doctor asks for medical history, and it is a very common issue many mother suffers anxiety during childbirth. The surgeon clarified this point to star-health, Macular Edema has no connection with anxiety, it is age related disease. After giving so many clarification, star-health keep asking the same clarification again & again which has no relevance at all with eye. It is almost more than a month by now, claim settlement is not through. I raised grievances to their grievance cell also raised complaints to lok adalat. As usual - NO RESPONSE. The grivance cell & lok adalat is again another nexus, it is just an escape root.
Most interestingly, the first OT was cashless without any hassles from other Mediclaim company while treatment was done by the some doctor and same hospital. When I quoted this point, StarHeath kept quit, no comment on that but keep sticking to their illogical excuses.
In this forum, I was going through many patient parties reviews about worst services of Star-Health and many said Star-Health just try to harass patient parties and deliberately avoid payments by showing some lame excuses. They take unilateral & unethical decision just to plot a tricks how to stop payment by raising some lame excuses. Even after submitting all original documents, reports their clarification journey is on.
As a customer, we have all choice to port out and break contract with unsatisfactory services provided by a Mediclaim organization. Second, seek for legal proceedings.
I would rather plead Govt. Of India to revisit customer complaints seriously and cancel the licence of such unethically practised Mediclaim service providers and protect health safety & security of Indian citizen.
I just shared my recent worst experience, now it is your call to decide whether to avail service from such ruthless company who doesn’t at all cares maintaining Medical Service ethics and suck customer money.
I pay premium Rs.42, 000 annually and till today Rs.1, 62, 000 paid, total coverage 15 lakh out of which the cashless claim was only Rs.28, 000. To pay 1/6th of the payment Star Health has put full effort as how to dishonor the claim.
Actually, they will establish a fact by showing some existing disease and cancel the claims if your policy is within 4 years. After 4 years they will come up with some new tricks and dishonor the claims. This is how this company cheat people.
As of now, there are 6248 review comments, out of that 96% of people are unhappy. Rating 1.5 out of 5. This is enough to clarify that Star Health is a below substandard company.