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icon Central Govt Pensioner

My Mother-in-Law was covered under Star Health Insurance from 2021. Pre-existing Disease 1) Hypertension 2) Diabetis was disclosed. She was admitted for OAD (Obstructive Airway Disease) during Nov.2


A. Dear Client,
It is important to disclose all your medical conditions and disorders while availing a health insurance policy. The terms and conditions of an insurance policy are vital to raise a claim under the policy. Further, non-disclosure of a pre-existing disease (PED) may be the reason to repudiate your claim as the same might not be covered under the policy. So, in this situation, you can file a consumer complaint under Section 35 of the Consumer Protection Act before the District Consumer ...ReadMore

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icon Regarding insurance claim rejection

i am the 2 years customer for starhealth comprehensive star health,recently i added my spouse..i applied for maternity claim..& request to insurer to reconsider the claim due to my family situation.bu


A. Dear Client,
In the health insurance policy, some pre-existing diseases(PED) are covered after24 months from the date of inception of the policy and some are covered after 48 months on continuous renewal of the policy. Since the claim arose before the 24 months, the Insurer has repudiated or rejected your claim for lack of coverage of PED as per terms of the Insurance Policy.

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icon Hospital avoiding cashless treatment

Even with implementation of new rules for cashless treatment at every hospital regardless of hospital network tie-up, the hospital is denying cashless treatment for insurance holder saying that the pr

1 Response(s)

3 months ago


A. Dear Client,
In the given situation, bring the matter to the notice of the Grievance Cell of the concerned Insurance Company endorsing a copy to the insurance regulatory authority, IRDIA. In case, no suitable reply is received or received a reply denying your claim, then file a complaint before the Dist. Consumer Commission against the concerned hospital and the Insurance Company on the grounds of deficiency and unfair trade practices claiming the entire medical treatment cost incurred for the ...ReadMore

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icon Medical Insurance cancelled after 3 years

My mediclaim was cancelled on grounds of non disclosure of pre existing diseases. I fell from the stairs and had a nerve pain which used to come and go. During the 4th year during home excercise sudde

2 Response(s)

4 months ago


A. Dear Client,
In cases where an insurer cancels a mediclaim due to alleged non-disclosure of pre-existing diseases, you can explore legal options to challenge the decision. It is essential to gather all relevant medical records, including the MRI and X-ray results from seven years ago, to demonstrate that there was no conclusive diagnosis at that time. Engaging with a lawyer who specializes in insurance or health law can help you navigate the legal aspects. Presenting your case based on the lack ...ReadMore

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icon Legal Liability for Helper Covered If Death occurs by Gun Firing

Motor Insurance Legal Liability for Helper Covered If Death occurs by Gun Firing, Helper just opened the door and running at that time One Fired in him and he died

3 Response(s)

4 months ago


A. Dear Client,
Motor insurance covered only accidental death and disabilities arising out of an accident duly reported and investigated by the concerned authorities. Death by gun firing does not come under the purview of accidental death, As such, a claim even if filed, may be repudiated by the Insurance Company.

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icon Review of award by Insurance Ombudsman

Complainant purchased the policy -ULIP plan on 24.11.2017. She paid premiums for 5 years i.e. till the lock in period. Thereafter, she applied for surrender due to her personal reasons and wanted to i

2 Response(s)

4 months ago


A. Dear Client,
An insurance policyholder can surrender, migrate and port his insurance policy or invest with another Insurer that suits his or her situation following the policy condition and regulations of the regulatory authority, IRDA. An Insurer cannot force an insured to migrate into their existing policies on surrender of an insurance policy. Such an action of an Insurance Company is termed an unfair trade practice and a violation of IRDA(Protection of Policyholder Interest) Regulations, 200 ...ReadMore

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icon Term policy

Sir, loan agent who was watching my home loan document applied for term insurance policy on my loan without consulting me. And now I received a call says that my policy generate some commission amount

1 Response(s)

5 months ago


A. Dear Client,
Regulation 4 of the IRDAI (Appointment of Insurance Agents) Regulations, 2016 deals with the appointment of insurance agent by the Insurance Companies. Only candidates who have qualified in the Insurance Agency Examination and who hold a valid pass certificate issued by the examination body shall be eligible to be considered for appointment as insurance agent by the Insurer. So, the information received by you on the subject from the socalled informer is totally wrong and misleading ...ReadMore

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icon Raject my claim

Dear sir My driver lost his balance and got driven car into the water due to rain, there may be less possibility of external impacts/damages. And the insurance company deny my claim due to any extern

3 Response(s)

5 months ago


A. Dear client
Carefully read through your insurance policy to understand the terms and conditions, especially those related to coverage in case of accidents, damage, or loss. Communicate with the insurance company to seek clarification on the denial of the claim. Ask them to provide specific details on why they believe the incident is not covered. Gather evidence and document the incident thoroughly. This may include photos of the accident scene, any relevant weather conditions, and statements fro ...ReadMore

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icon Regarding refund of ported policies

I paid for insurance policies with Star Health Insurance by mistake, which have been ported to another insurance company as per portability guidelines. Payment was made on 11th oct and request for ref

3 Response(s)

6 months ago


A. Dear Sir,
You may approach insurance ombudsman if fail to get any positive result then approach Consumer Court.

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icon Reimbursment from blacklisted hospital

I have a corporate MediAssist policy and got my mother operated for spine surgery at one of the blacklisted hospitals which I have to came to know after 10 days of discharge. The insurance team is c

2 Response(s)

6 months ago


A. Dear Client,
In the given situation, Apart from the settlement of the insurance claim, there is an alternative way to resolve your grievance. All the hospitals, nursing homes and other clinical establishments are issued licenses by the Licensing Authority and the Chief Medical Officer of Health of the District under the Clinical Establishment Act of the respective State. In the said governing Act, there is a chapter for contravention of the provisions of the Act and a penalty to be imposed for ...ReadMore

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