Star Health Deduction in Cashless

[wiizzard]

My father has a Star Health Insurance Policy and had to be hospitalized for a few days.
Star Health deducted nearly Rs7500 from the pharmacy bills claiming "Consumables/non reimbursable items" , but I have checked the bills and there is any non-allowed items as per the policy.
I have repeatedly raised complaint to Star Health to provide details on the disallowed items, but they refuse to share anything further

Any tips on how to deal with this ?

 

[Shvmchhbr]

It's my humble request to everyone, please read IRDAI's annual status report wrt claim payments before buying health insurance policies. Do not just blindly follow marketing gimmicks by these companies. Star health has the worst claim payment ration amongst all . PSU general insurance companies has the best amongst all. Attaching latest ie article for reference.

 

[CCFinvest]

It is because of the policy chosen. You need to select the right policy to get the worry free cashless claim.
If you buy policy with capping, sub-limit and co-payment option for cheaper premium, insurance companies will not settle full claims.
Key reasons for reduced payouts
Policies have several exclusions and limitations. “If the policyholder does not take these into account at the time of purchase, it can result in a lesser claim settlement amount and an unpleasant claims experience,” says Parthanil Ghosh, director and chief business officer (CBO), HDFC ERGO General Insurance.
If you want best suitable policy for you across all the insurance companies, you may contact me with your details. I will be happy to help!

 

[wiizzard]

Thanks folks
Do understand that policy company choice is also a function of what kind of risk different companies are ready to take.
HDFC Ergo doesn't issue a policy for my father since he is a diabetic. Only Star was ready to take the risk
I am looking for tips on how to deal with such a company than advise that I should not have bought this policy in the first place !

 

[CCFinvest]

You are welcome. Even your father is diabetic, you may port to many other SAHI companies with great claim settlement experience. For diabetics, Star is not the only option. If you want to port to a better policy without any waiting period, I can help to find out other options.

 

[anujdit]

My father has a Star Health Insurance Policy and had to be hospitalized for a few days.
Star Health deducted nearly Rs7500 from the pharmacy bills claiming "Consumables/non reimbursable items" , but I have checked the bills and there is any non-allowed items as per the policy.
I have repeatedly raised complaint to Star Health to provide details on the disallowed items, but they refuse to share anything further

Any tips on how to deal with this ?

Check the detailed bill from hospital (Submitted to insurance company) for diet charge/consultancy(per day), syringe, gloves, sanitizer, toiletries, canola, administration or admin charges, TPA charges etc. these are not covered in insurance.

After validation, if you see there is gap then you can file for reimbursement with Star