Purchased a health insurance policy
4 months ago
I have purchased a health insurance policy for my parents in star health from 2018-2023 i was paying premium for start health family optima policy . and in 2023 i have migrated the policy to star health assure with in star health insurance itself . In oct 2023 my dad had a thyroid enlargement and operation had to be in urgent manner and operation was also done we have applied for the insurance the insurance company is saying we can get the benefits of star health optima plan only not to the star assure plan which i have migrated recently . to enjoy the benefits of star health assure i have to wait 2 year for the past 6 years i have paid the premiums promptly and with out any claims . this was our first claim .
my question is it real that i cant use the benefits of the star assure policy which i paid premium .
if i can enjoy the benefits please do send me the sections and rules
Migration is the process of shifting your existing health insurance policy to a similar policy within the same insurance company. As defined by IRDAI, Migration means, the right accorded to health insurance policy holders (including all members under family cover and members of group health insurance policy), to transfer the credit gained for pre-existing conditions and time bound exclusions, with the same insurer. In view of the above definition of migration of policy, once you renewed the policy continuously for 6 years all the waiting period and time bound exclusions clauses are waived and policy holder is entitled full coverage whenever a claim arises. So, rejection of your claim by the Insurance Company is highly arbitrary and unjustified. You need to file a grievance before Grievance Redressal Officer of the Insurer and on receipt or non-receipt of suitable reply, make an application before the Insurance Ombudsman for a resolution in the grievance. If these attempts yield no result, file a complaint against the Insurance Company before the Dist. Consumer Commission under Sec.35 of the Consumer Protection Act, 2019 for deficiency in service and unfair trade practice claiming the entire claim amount along with compensation for harassment and cost of litigation. Complaint should be filed before the Consumer Court within two years from the date of cause of action. i.e, the date of repudiation of claim.
Regarding insurance claim rejection
Hospital avoiding cashless treatment
Medical Insurance cancelled after 3 years
Legal Liability for Helper Covered If Death occurs by Gun Firing
Review of award by Insurance Ombudsman
