Request for look into the matter of Medical Reimbursement
Complain ID : CCN028819 35
Insurance Complaint
Complaint Date: February 19, 2018
Modified date: February 23, 2018
- State : Andhra Pradesh
- City : Vijayawada
- Address: F No 304, Potluri Residency-6, Kamaiahthopu, Vijayawada-7
Respected Sir,
Sub: Request for look into the matter of Medical Reimbursement. Regd.
Dear Sir,
I P Srinivasulu has taken the Star Health Insurance Policy on Dt 14-Oct-2017.
Later my daughter admitted in local Sravanthi Hospital in Vijayawad on Dt 15-Nov-2017 due to stomach pain.
There she has been tested and taken MRI Scan and In that it is found some mass formed and then made surgery on 17-Nov-2017. She discharge on 19-Nov-2017.
I have submitted all the reports and necessary document to the Local star health insurance company in Vijayawada. There they delayed nearly one month and repeatedly asked about our reimbursement. It was found that delayed in Vijayawada and finally submitted the our application to chennai office.
After one month I received information regarding the reasons for delay and summary report. I have submitted them immediately. After another 15 days I received a call and asked me the reason for hospitalization and I told them due stomach pain we have admitted our daughter in the hospital.
Again another day they called me and they told your case is rejected.
I asked the reason for rejection, that they told minimum waiting period is 30 days as per clause 3 (i).
When I check it is 30 days waiting period. We I see it that waiting period is over on 12-Nov- 2017. But our date of Admission is 15-Nov-2017.
They are telling me that one week earlier disease is there in the submitted hospital report. We found the disease only after MRI Scan. Ladies may have different pains. This is found only after MRI Scan. They reject our medical reimbursement with this reason.
Kindly help us if we are correct in this issue.
Thanks & regards
Dr. P Srinivasulu
Professor.
CSE Department,
MIC College of Technology,
Kanchikacharla,
Mobile : 9490 5055 95
e-mail : drspamidi@gmail.com
Sub: Request for look into the matter of Medical Reimbursement. Regd.
Dear Sir,
I P Srinivasulu has taken the Star Health Insurance Policy on Dt 14-Oct-2017.
Later my daughter admitted in local Sravanthi Hospital in Vijayawad on Dt 15-Nov-2017 due to stomach pain.
There she has been tested and taken MRI Scan and In that it is found some mass formed and then made surgery on 17-Nov-2017. She discharge on 19-Nov-2017.
I have submitted all the reports and necessary document to the Local star health insurance company in Vijayawada. There they delayed nearly one month and repeatedly asked about our reimbursement. It was found that delayed in Vijayawada and finally submitted the our application to chennai office.
After one month I received information regarding the reasons for delay and summary report. I have submitted them immediately. After another 15 days I received a call and asked me the reason for hospitalization and I told them due stomach pain we have admitted our daughter in the hospital.
Again another day they called me and they told your case is rejected.
I asked the reason for rejection, that they told minimum waiting period is 30 days as per clause 3 (i).
When I check it is 30 days waiting period. We I see it that waiting period is over on 12-Nov- 2017. But our date of Admission is 15-Nov-2017.
They are telling me that one week earlier disease is there in the submitted hospital report. We found the disease only after MRI Scan. Ladies may have different pains. This is found only after MRI Scan. They reject our medical reimbursement with this reason.
Kindly help us if we are correct in this issue.
Thanks & regards
Dr. P Srinivasulu
Professor.
CSE Department,
MIC College of Technology,
Kanchikacharla,
Mobile : 9490 5055 95
e-mail : drspamidi@gmail.com
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