Of the many battles in life there is one with Star Health. This post is about this ongoing encounter with the specialist health insurance company. They can be all that and mine could be a one off case, however, this is my truth and I can’t take no for an answer.
The story begins here – 9 ain’t that magical after all for me…
August 12, 2010 – I was detected with cellulitis and admitted.
August 16, 2010 – I was operated for cellulitis in the right leg.
Star Health was informed in the evening of August 12, 2010 and I (oh that was my FIL) was promptly given a number. That was where the efficiency factor finished.
The doctors went about their job, Star did not bother to come and check if there was a patient there in the hospital. To cut the long story short (well not exactly, just that I do not wish to type again) here is the mail that I sent to Star.
Date: Mon, 13 Dec 2010 14:18:58
*To Whom This May Concern
Dear Sir / Ma’am,
This is in reference to my medical claim number 0035917. Intimation date 12/08/2010 via mobile number 98100 74039 (Mr. Dinesh Sharma – Relationship: Father-in-Law).
I would like to bring to your notice that the claim has yet not been settled. I was assured by the Insurance Company, Star Health, that all claims are settled within a timeframe of 40days when I purchased the insurance for my family (Policy No. P/161112/01/2011/000301). This is my second year running with your company (Previous Policy No. P/161112/01/2010/000242) and is my first claim.
I believe that I opted for your company as you focus only on ‘Health Insurance’ as opposed to the others who diversify to other insurance domains. I was convinced that that would mean better service and sensitivity to individual needs. However, I am sorry to say that I have been let down on both counts.
After having been a customer for 2 years, the company seems to doubt my intention and genuineness. I say this as; I was called upon by an investigation agent (not an employee of Star Health) last week and he asked me questions like – “How many days were you at the hospital?” – He had the hospital records which I had submitted with him. “Why did you choose a hospital that was so far from your place of residence?” – Isn’t it my prerogative to choose which doctor I choose or where I want to get treated?
He also took all those details in writing from me and was kind enough to sign a receipt.
In between I have also logged a ‘Grievance’ on your website and have a receipt email from your tracking system as well.
I also tracked the Chennai number and spoke to a lady there (name not disclosed) who asked for a time limit for a week. She called after a week to tell Mr. Dinesh Sharma (as that was the original number from which the claim was lodged) that she will need another week. Later she also spoke to me. It is over 3 weeks now and somehow Star does not have any clue or control on or about the investigation.
I thought that all was sorted and I will get the dues. But all was not over as the investigation agent landed at my workplace on 01/12/2010 (without an appointment) and asked my HR Manager for my attendance details. We asked him to send us a letter by post which is awaited till date. Is this not taking the matter a little too far? As it seems, No, as this gentleman also (finally) visited the hospital on 04/12/10. Investigate by all means, but when it is due. I was in the hospital from 12/08/10 – 26/08/10, not a short duration and no one had the time to come and see if I was actually there!
And now, people are trying to witch hunt my whereabouts during that period.
It is time the matter is dealt with urgently and resolved in a suitable manner. I await your response with clear action items and dates for the resolution of this case.
I have not contacted the ombudsman at (email@example.com) as I think this can be settled without their interference.
+91 98104 01435
PS: Copies marked to my contact Mr. Sardana from Risk Managers and Mr.Sharma
Action: Response – We will get back to you shortly. This was not an automated response and I responded to Mr. Boopathy with a Thanks note.
Cut to – Sun, 26 Dec 2010 09:53:45 I send them another mail, as I did not hear from them. Read on…
It’s been over two weeks since we last communicated.
I am surprised at the appauling lethargy that your department displays in case of reimbursements.
I have not heard from them and neither from you.
The follow back and customer support is either non existent or a lot of people who really do not know what customer care is about.
On Tue, Dec 14, 2010 at 12:08 AM, Ananda Gupta <firstname.lastname@example.org> wrote:
> Dear Boopathy,
> Thanks for the acknowledgement. Awaiting response from the claims department.
> On Mon, Dec 13, 2010 at 4:30 PM, info info <email@example.com> wrote:
> Dear sir,
>We have forwarded your mail to the claims department and we will revert you soon
>> Boopathy M
>> Customer Care
>> Star Health and Allied Insurance
>> visit us : www.starhealth.in
Action: NO Response.
Cut to – Sat, 5 Feb 2011 10:15:07
Without wasting words I wish to inform you that I would be compelled to move the Consumer Court and also inform the Delhi Ombudsman in case I don’t get the reimbursement by 14/02/2011.
See mail chain for clarity.
Today is Feb 18, 2011 and till I write this I have no information.
If this is the state of health insurance, then we are better off without one, at least we know that we will have to fend for ourselves and there will be no backup.
I am left speechless and waiting…