Insurance claim
Ramakrishna
(Querist) 13 June 2017
This query is : Resolved
I have done mediclaim insurance in starhealth insurance on 27.03.2016 for 1 year for the first time.
During the policy period, i have got injured while playing cricket. the effect of the injury is hard dislocation in my right shoulder. Checkup up with doctor, doctor suggest to do athroscopy surgery which costed 1.52 Lakhs. I have submitted the claim to star health. they have rejected the claim saying that the MRI scanning shows the injury for existing before the policy made. Hence rejected.
but The right shoulder joint got little dislocation 5 to 6 years back due to fall on ground while playing shuttle cock. But it was normal, I could do the all the work.
I request your help and suggest me to get my claim from star health insurance.
ADV-JEEVAN PATIL, MUMBAI
(Expert) 14 June 2017
1)Unfortunately u should have read deceased n ancillary treatment covered. 2) If u r sure, file consumer complaint
krishna mohan
(Expert) 14 June 2017
You can approach Ombudsman for remedy. You can represent your self or file case before district consumer forum either in person or through a legal counsel.
Rajendra K Goyal
(Expert) 14 June 2017
Discuss with local lawyer and file consumer complaint.
Kumar Doab
(Expert) 14 June 2017
The claim is rejected citing a pre existing disorder.
Hope you have copy of the proposal form signed by you.
Did you declare the accidents and injuries and previous treatments!
Kumar Doab
(Expert) 14 June 2017
It shall be better to consult a very able local counsel of unshakable repute and integrity specializing in consumer matters, before entering into written communications.
Advocate Bhartesh goyal
(Expert) 15 June 2017
You can file complaint before District Consumer Forum but you have to prove by cogent and expert evidence that injury caused to you was not existing when policy was taken.
