Complaint Details

Status	:	Closed
Complaint No	:	0002228/2012
Category	:	Insurance
Date	:	18-08-2012
Subject Line	:	Claim Repudiation of Claim No. CLI/2012/171200/0127031 under the policy no. P/171200/01/2012/001506
Complainant	:	Alpesh Kantilal Kapasi
Address	:	206-Noopur Tower,Nr. Vishal Tower,Prahaladnagar, Satellite,
Complainee	:	STAR HEALTH & ALLIED INSURANCE CO. LTD.
Address	:	Corporate Office: No.1, New Tank Street, Valluvar Kottam High Road, Nungambakkam,

Complaint Details
With reference to above subject, I undersigned Alpesh Kapasi has taken Mediclaim policy from STAR HEalth company & our policy no. P/171200/01/2012/001506.

We had put my daughter “Vrusha” claim file in Feb-12 for Tonsillitis .We have just come to know that our claim has been repudiated by stating that” Our Medical team has observed from the field visit report by our doctor, insured patient has symptoms of above disease for 2 Years which is prior to inception of policy.”

But If you look the fine print of the policy no P/171200/01/2011/002124, policy period 2010-11, Earlier policy was with National Insurance co. Ltd. and in the policy of Star Health 2010-2011, previous policy details has also written 301200/48/09/8500005157 ( Policy Period 24/07/2009 to 23/07/20010) With National Insurance and it was continue from 24/07/2008.

Requested to refer the docket of policy no. P/171200/01/2011/002124.

Continuity was granted at the time of switching policy from National Insurance Co. Ltd. to Star Health & Allied Insurance co. Ltd. It is seems that Continuity has been ignored by the company. This is total in justice to me.

Further, Query was raised by the Star Health company regarding when suffering from the Tonsillitis. And Treating doctors has given written letter and it was mentioned in query reply letter that the patient was suffering from said disease was last 5-6 months. So no question of pre-existing arises.

Pls find all the years policy copies as an attachment for your reference.

Looking at above facts and figure,

Requested to give us Natural Justice.


Thanking you
Yours truly,

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