Respected Sir/ Madam,
I am a doctor by profession and currently practising in Maharashtra.
Policy no- P/700002/01/2022/020717
Claim no- CIR/2022/700002/3112561
I am a Corona Rakshak policy holder with Star Health and I was tested positive on 3rd Sept 2021, after which i tried staying home quarantine for two days but still there was persistent weakness and fever with chills which was unbearable, thats why i got admitted to the hospital on 6th Sept 2021 owing to detoriation of my general condition.
I was admitted for 4 days and discharged on 10th Sept 2021.
My policy is denied saying that admission was not indicated.
I do not accept the reason for rejection.
As I am fulfilling all the conditions necessary to approve my claim as mentioned in your policy brochure i.e
-Lump sum benefit equal to 100% of the Sum Insured shall be payable on positive diagnosis of COVID, requiring hospitalization for a minimum continuous period of 72hours.
-The positive diagnosis of COVID shall be from a government authorized diagnostic centre.
MY points are-.
1. I was admitted to the Government authorized Covid dedicated centre and my admission was under an Intesivist.
2. The doctor advised me admission for which the emergency admission certificate is already submitted.
3. I was on Intravenous medications which are mentioned in the discharge card.
INJ Monocef 12 hourly and
INJ PANTOP 40 MG IV ONCE A DAY
How is it possible to take intravenous medications at home?
4. When doctors at that hospital felt that now it can be managed at home then thedischarge was given on 10th Sept 2021 on oral medications.
5. You are saying that according to the Ministry of Health and Family Welfare’ my condition was manageable at home, but the hospital where I was admitted comes under ‘Ministry of Health and Family Welfare’ . That means you are contradicting your own statement.
All necessary documents regarding Govt. Approved Covid Centre are also been submitted.
When the whole purpose of the policy was to insure the person during the times of covid why and how has it become just a money making business for star health taking advantage of the current pandemic.
The policy (corona rakshak) clearly mentions the criteria to be eligible to be benifited, and if i fulfil those criteria i dont see any point here in rejecting the claim for baseless reasons. https://www.starhealth.in/sites/default/files/brochure/Corona-Rakshak-Insurance-Brochure.pdf
If a person is sick and not feeling well, should he/she wait for star health's validation to get afmitted or not. Do i have to risk my life and succumb to death inorder to get hospitalized.
An open question to all star health owners and officials, if your parents/children are sick and weak (covid positive), would you admit them for appropriate care or wait for their reports to worsen and let them be miserable and then admit then in a later stage?
I am a doctor myself and have given my services for covid patients so please dont tell me what this disease is and what all can it do to your health. And there is no way one can determine a subjective symptom. Pain, weakness are subjective, you cant comment on how much weakness did i have.
All my authentic documents are submitted to you so please go through it carefully.
Link to open Maharashtra covid hospitals under Ministry of Health and Family Welfare https://t.co/mc2JPzxLSw
I am sincerely requesting Complaint Portal/ IGMS/ IRDAI to look into the matter as i have been mailing star health officials but still the problem is not resolved. Hoping you to sanction my claim and grant me justice and do the needful.
Thank you and Regards,
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