I have a health insurance policy
1 year ago
I have a health insurance policy of Star Health Insurance of Rs. 1500000 since 1 Sept 2016 for a family of 3. We never never had any claim for first five years till Dec 2021. My wife was admitted to hospital for epilepsy in Dec 2021.While giving history I informed person at hospital counter that she has issue of epilepsy since 2017 ( it is not pre existing one year after taking policy). The person at hospital counter by mistake wrote in his history as 2012 instead of 2017 which was his mistake. There was no signature of mine on that paper endorsing what was written. The insurance company rejected the claim treating it as 2012 disease ( pre existing). I filed complaint stating that year is 2017 and it is topographical mistake by hospital . Finally the insurance company approved the claim ( claim amount Rs 1.5 lac) with my undertaking that the year is 2017 and not 2012.Now when I paid premium for next year, they issued a policy stating that the my wife is permanently excluded from coverage for all neurological diseases. It is one sided decision. I have filed complaint with company and insurance agent policy bazaar for exclusion. Com. What is rule position? Please guide for my future course of action.
You have two options. First option to approach Insurance Ombudsman or directly go to Civil Court or High Court.