Star Health Insurance - Renew or Port ?

[Half Human]

New India insurance has room rent limit (1-1.5%) and sub-limit of different operation/surgery (Cataract etc). Please go through the policy carefully. I would recommend to port to HDFC Optima secure as chances of health issues are high at this age and better to pay higher premium to get claims.

Take a example: If you pay 60-70k premium every year and in 5 yrs you get claim of 4-5 lakhs then also it is saving.

Understood.. thanks Lot brother

 

[Half Human]

@sjmajumder

While filing a dispute with Insurance Ombudsman, should I approach the ombudsman, under whose jurisdiction the hospital where I took treatment comes under?

Or to that Ombudsman, under whose jurisdiction my current address comes under.

Example: I am a doctor, from Kerala, working in Odisha. I have my health insurance registered to my work address in Odisha. But I took the treatment from a hospital in Kerala. So to Bhubaneswar Ombudsman/Kochi Ombudsman should I mail to?

 

[m4b]

I see Star Health, immediate ans was to port.

 

[sjmajumder]

@sjmajumder

While filing a dispute with Insurance Ombudsman, should I approach the ombudsman, under whose jurisdiction the hospital where I took treatment comes under?

Or to that Ombudsman, under whose jurisdiction my current address comes under.

Example: I am a doctor, from Kerala, working in Odisha. I have my health insurance registered to my work address in Odisha. But I took the treatment from a hospital in Kerala. So to Bhubaneswar Ombudsman/Kochi Ombudsman should I mail to?

You can file either with your current address or permanent address. I recommend using your current address. The address you give will be used by Ombudsman to send you any communication. Also you have to attend the hearing in the office of the Ombudsman in whose jurisdiction you are filing the complaint.

 

[Half Human]

You can file either with your current address or permanent address. I recommend using your current address. The address you give will be used by Ombudsman to send you any communication. Also you have to attend the hearing in the office of the Ombudsman in whose jurisdiction you are filing the complaint.

Will go with my Odisha address. Thanks for the response brother. You really help.

 

[Half Human]

I have a Young star policy of 10L
I took it when I was 28 y old. Now 30.

3 w back, I had to undergo a surgery for my shoulder labrum rupture repair, bicipetal tenodesis and corrective surgery for severe AC joint arthritis. All on right shoulder.

I opted for cashless claim. The entire bill came to 2.495 lakhs. Star sanctioned 2.13 lakh. Had to pay 36500 from hand. Under the remark section they noted 20600 was deducted from ortho implants due to lack of invoice provided by the hospital.

Hence, after the discharge, I got the implant invoice from the hospital store, and submitted at the Star health office for reimbursement, along with prehospital, post hospital and hospital wellness benefit.

After 1 week, they approved the prehopital and post hospital expenses amount of 2.3k against actual of 3.9k, again citing several deductions, and wellness benefit of 1000 per day for 3 days= 3000.

However they did not consider the reimbursement of the implant, despite attaching it's invoice, stating that I did not fill that particular part of the claim form.

Hence, raised a request to grievance redressal. Let's see how they reply.

So for a total of 254000, I had to pay a total of 35000 (including the 20k for the implant). Hence I got 86% of my claim covered.

The annual premium (when paid Biennially is 15.2k), is around 7.6k.

Now due to this sudden turnaround stories of star rejecting/partially accepting claims, should I continue with Young star policy?

Or should I port to Assure/Comprehensive plan from Star?

Or should I move to any other company?

Also what are the chances that Grievance team would refund the entire 20600 rupees?

People with good insight, please reply?

@K Sundar

Update March 18

I had contacted the GRO, they promptly requested copy of the invoice, despite me submitting it already. Since I did not have any copy, I contacted the home branch to which I had submitted the documents to. They mailed me back the original scanned copy, which they claim, was originally uploaded to their server

With this copy, I mailed back to GRO, on March 3.

From March 3 to Match 18, I recieved no further contacts from their team.

On March 18, I recieved their mail, that they have received the documents and are considering the reimbursement and the documents are now under scrutiny.


Update 26/3/25

By March 21, my start health had shown the reimbursement has been approved. To my surprise, I got the entire 20607 rupees approved

Yesterday, On 25/3/25 the amount was credited to my bank account

I had to wait 20-25 days to get this thing..

Net expense 2.5 Lakh, Net amount that I finally paid 14.5k

Hence Percent of Amount Totally Approved 94.5%.

Hence I am sticking to Young star only for the time being

Update 26/3/25

By March 21, my start health had shown the reimbursement has been approved. To my surprise, I got the entire 20607 rupees approved

Yesterday, On 25/3/25 the amount was credited to my bank account

I had to wait 20-25 days to get this thing..

Net expense 2.5 Lakh, Net amount that I finally paid 14.5k

Hence Percent of Amount Totally Approved 94.5%.

Hence I am sticking to Young star only for the time being

 

[sjmajumder]

Update 26/3/25

By March 21, my start health had shown the reimbursement has been approved. To my surprise, I got the entire 20607 rupees approved

Yesterday, On 25/3/25 the amount was credited to my bank account

I had to wait 20-25 days to get this thing..

Net expense 2.5 Lakh, Net amount that I finally paid 14.5k

Hence Percent of Amount Totally Approved 94.5%.

Hence I am sticking to Young star only for the time being

Did you file a complaint with the Insurance Ombudsman?

 

[Half Human]

Did you file a complaint with the Insurance Ombudsman?

No.. I did not...
Just to GRO only