- People purchase health insurance to cover their medical costs which arise during emergency situations. The policy aims to reduce financial stress. The system creates serious problems when an insurance company denies a claim.
- The case from Lucknow established this problem as a public matter. A man stated that his mother’s health insurance claim was rejected. The matter became known to public after a social media post achieved widespread distribution. Star Health and Allied Insurance later issued a response.
Claim Filed After Mother’s Illness
- The man purchased a health insurance policy in his mother’s name. He paid an annual premium of ₹50,000.
- He visited Star Health and Allied Insurance office in Lucknow to submit his claim after his mother fell sick. He reported that he waited for several hours. The claim was later rejected.
- According to his statement, an agent allegedly responded that the policy had been taken without proper consultation. A social media user shared a video about the incident. The post gained wide circulation. The writer Nilesh Mishra shared the material again while he pointed out the problems which made more people aware of the situation.
Star Health Issues Official Statement
- Star Health published an official statement after the post became popular online. Star Health announced that the business was providing incorrect information about the case details.
- The assessment process for the claim showed that the applicant had a medical issue which existed before the claim. The insurer requested supporting medical documents. The claim was denied because the requested documents were not provided.
- The company explained that health-related issues require special treatment. The company denied any wrongdoing related to customer service.
Role of Pre-Existing Medical Conditions
Pre-existing medical conditions often affect claim approval. Insurance companies require full disclosure at the time of policy purchase.
In some cases, insurers approve policies with a waiting period for pre-existing conditions. If the condition is not disclosed, the insurer may reject the claim during evaluation.
Experts advise policyholders to:
- Disclose all past and current medical conditions.
- Provide accurate medical records.
- Review policy terms carefully.
- Maintain communication with the insurer during claim processing.
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