Complaint Details

Status	:	Closed
Complaint No	:	0037253/2014
Category	:	Insurance
Date	:	14-10-2014
Subject Line	:	Non Processing of Claim No 0025220
Complainant	:	Sachin Mohun
Address	:	B-306A, Gaur Valerio, Ahinsa Khand II, Indirapuram
Complainee	:	Star Health & Allied Insurance Co. Ltd
Address	:

Complaint Details
Dear All,

Please find attached call recordings for senior citizen red carpet policy by Delhi sales team. Request you to please process my claim in light of above facts.

Looking for a favorable response else I would be forced to share the recordings with print, social media and IRDA.

Thanx & Rgds,
Sachin
8860008548
________________________________________
From: sachin.mohun@barclays.com
To: reimb.delhi@starhealth.in
CC: sachin_mohun@hotmail.com; mohun_rastogi@yahoo.com; support@STARHEALTH.IN; grievances@STARHEALTH.IN; complaints@irda.gov.in; vikas.narula@STARHEALTH.IN; rupam.mishra@STARHEALTH.IN; iobdelraj@rediffmail.com
Date: Tue, 7 Oct 2014 09:55:51 +0100
Subject: RE: Claim No 0154428 & 0025220 - Kind Attn Rohit/Priyanka/Sandeep Reminder III
Hi Rohit,

As discussed, request you to please update current status.

Rgds,
Sachin

From: Mohun, Sachin : Barclays Corporate India
Sent: Wednesday, October 01, 2014 10:30
To: 'reimb delhi'
Cc: 'sachin_mohun@hotmail.com'; 'mohun_rastogi@yahoo.com'; 'support'; 'grievances'; 'complaints@irda.gov.in'; 'vikas.narula'; 'RupamMishra'; 'iobdelraj@rediffmail.com'
Subject: RE: Claim No 0154428 & 0025220 - Kind Attn Rohit/Priyanka/Sandeep Reminder II

Requesting revert.

Rgds,
Sachin

From: reimb delhi [mailto:reimb.delhi@starhealth.in]
Sent: Monday, September 22, 2014 17:38
To: Mohun, Sachin : Barclays Corporate India
Cc: sachin_mohun@hotmail.com; mohun_rastogi@yahoo.com; support; grievances; complaints@irda.gov.in; vikas.narula; RupamMishra; iobdelraj@rediffmail.com
Subject: RE: Claim No 0154428 & 0025220 - Kind Attn Rohit/Priyanka/Sandeep Reminder I

Dear Mr. Sachin,



We are looking into your case & we will update soon.

Regards,

Priyanka
Star Health & Allied Insurance Co. Ltd
Reimbursement
1st Floor, Himalaya House,
23, Kasturba Gandhi Marg,
New Delhi-110001
Phone Number 011-23464612,23464678

________________________________________
From: sachin.mohun@barclays.com [sachin.mohun@barclays.com]
Sent: Saturday, September 20, 2014 4:54 PM
To: reimb delhi
Cc: sachin_mohun@hotmail.com; mohun_rastogi@yahoo.com; support; grievances; complaints@irda.gov.in; vikas.narula; RupamMishra; iobdelraj@rediffmail.com
Subject: RE: Claim No 0154428 & 0025220 - Kind Attn Rohit/Priyanka/Sandeep Reminder I
Requesting revert.

From: Mohun, Sachin : Barclays Corporate India
Sent: Wednesday, September 17, 2014 17:16
To: 'reimb delhi'
Cc: 'sachin_mohun@hotmail.com'; 'mohun_rastogi@yahoo.com'; 'support'; 'grievances'; 'complaints@irda.gov.in'; 'vikas.narula@starhealth.in'; 'rupam.mishra@starhealth.in'; 'iobdelraj@rediffmail.com'
Subject: RE: Claim No 0154428 & 0025220 - Kind Attn Rohit/Priyanka/Sandeep

Requesting revert.

From: Mohun, Sachin : Barclays Corporate India
Sent: Monday, September 15, 2014 17:35
To: 'reimb delhi'
Cc: 'sachin_mohun@hotmail.com'; 'mohun_rastogi@yahoo.com'; 'support'; 'grievances'; 'complaints@irda.gov.in'; 'vikas.narula@starhealth.in'; 'rupam.mishra@starhealth.in'; 'iobdelraj@rediffmail.com'
Subject: RE: Claim No 0154428 & 0025220 - Kind Attn Rohit/Priyanka/Sandeep

Hi Priyanka,

Today, I got a call from Harsh Kumar Ph # 66530700 at around 4:38pm from Star Health for insurance policy. I enquired about any health policy for senior citizens and he suggested Senior Citizen Red carpet policy.

Please find enclosed summary of recorded conversation available with me:

1. Claimed to be calling from corporate office
2. Policy can be made available despite recent hospitalization. No medical tests. Pre-existing covered after 12 months

I cross checked the validity of the call and found the below on the web site:
1. Co-Payment : 30% for other than claims for Pre-Existing Diseases and 50% for Pre-Existing Diseases claims

Pre-Existing Diseases / Illness :

1. Are covered after 12months of continuous Insurance with any Indian Insurance Company where the person has been availing treatment for the diseases

Pre- Acceptance medical screening

1. There is no pre-acceptance medical screening

Request you to please process the reimbursement in light of the above facts.

Rgds,
Sachin

From: Mohun, Sachin : Barclays Corporate India
Sent: Friday, August 01, 2014 14:33
To: 'reimb delhi'
Cc: 'sachin_mohun@hotmail.com'; 'mohun_rastogi@yahoo.com'; 'support'; 'grievances'
Subject: RE: Claim No 0154428 & 0025220 - Kind Attn Rohit/Priyanka/Sandeep

Hi,

Please note that I have submitted duplicate payment receipts against your query no. 2(refer attachment) as I am not able to locate the original receipts. Also, I confirm that we have not taken any other policy from any service provider other than Star Health. The same can be verified from the reimbursement form already submitted to you.

Rgds,
Sachin

From: Mohun, Sachin : Barclays Corporate India
Sent: Thursday, July 10, 2014 16:55
To: 'reimb delhi'
Cc: 'sachin_mohun@hotmail.com'; 'mohun_rastogi@yahoo.com'; 'support'; 'grievances'
Subject: RE: Claim No 0154428 & 0025220 - Kind Attn Rohit/Priyanka/Sandeep

Hi Rohit,

As discussed, I am sending the original documents thru courier today. Scan copy attached for reference.

Rgds,
Sachin

From: reimb delhi [mailto:reimb.delhi@starhealth.in]
Sent: Friday, June 20, 2014 16:49
To: Mohun, Sachin : Barclays Corporate India
Cc: sachin_mohun@hotmail.com; mohun_rastogi@yahoo.com; support; grievances
Subject: RE: Claim No 0154428 & 0025220 - REMINDER IV

Dear sir,

Kindly submit the original documents ( Discharge summary, final bill, payment receipt, investigation reports, if any x ray or CT or MRI done then Reports & films, One cancel cheque of Insured ) along with completely filled claim form & NEFT form.

Regards,

Priyanka
________________________________________
From: sachin.mohun@barclays.com [sachin.mohun@barclays.com]
Sent: Friday, June 20, 2014 4:33 PM
To: reimb delhi
Cc: sachin_mohun@hotmail.com; mohun_rastogi@yahoo.com; support; grievances
Subject: RE: Claim No 0154428 & 0025220 - REMINDER IV
Hi Priyanka,

Thank you for your response. Please send the format/s to submit reimbursement claim.

Rgds,
Sachin

From: reimb delhi [mailto:reimb.delhi@starhealth.in]
Sent: Friday, June 20, 2014 16:30
To: Mohun, Sachin : Barclays Corporate India
Cc: sachin_mohun@hotmail.com; mohun_rastogi@yahoo.com; support; grievances
Subject: RE: Claim No 0154428 & 0025220 - REMINDER IV

Dear Sir,

We have reviewed both the mentioned claims but since the discharge Summary of the patient for the admission from 31.12.12 to 1.1.13 is mentioning that the patient was having complaints of Hoarseness from one & a half months so the rejection in the claim no. 154428 stands. For claim no. 25220 kindly submit the reimbursement documents so that we can process this claim.


Regards,

Priyanka
________________________________________
From: sachin.mohun@barclays.com [sachin.mohun@barclays.com]
Sent: Friday, June 20, 2014 11:40 AM
To: grievances
Cc: sachin_mohun@hotmail.com; mohun_rastogi@yahoo.com; support; reimb delhi
Subject: RE: Claim No 0154428 & 0025220 - REMINDER IV
Please revert

From: Mohun, Sachin : Barclays Corporate India
Sent: Wednesday, June 18, 2014 14:53
To: 'grievances@starhealth.in'
Cc: 'sachin_mohun@hotmail.com'; 'mohun_rastogi@yahoo.com'; 'support'; 'reimb delhi'
Subject: RE: Claim No 0154428 & 0025220 - REMINDER III

Please revert

From: Mohun, Sachin : Barclays Corporate India
Sent: Monday, June 16, 2014 12:51
To: 'grievances@starhealth.in'
Cc: 'sachin_mohun@hotmail.com'; 'mohun_rastogi@yahoo.com'; 'support'; 'reimb delhi'
Subject: RE: Claim No 0154428 & 0025220 - REMINDER II

Please revert

From: Mohun, Sachin : Barclays Corporate India
Sent: Tuesday, May 27, 2014 15:37
To: 'grievances@starhealth.in'
Cc: 'sachin_mohun@hotmail.com'; 'mohun_rastogi@yahoo.com'; 'support'; 'reimb delhi'
Subject: RE: Claim No 0154428 & 0025220

Please revert

From: Mohun, Sachin : Barclays Corporate India
Sent: Tuesday, May 20, 2014 17:47
To: 'grievances@starhealth.in'
Cc: 'sachin_mohun@hotmail.com'; 'mohun_rastogi@yahoo.com'; 'support'; 'reimb delhi'
Subject: FW: Claim No 0154428 & 0025220

Request you to please review my claim basis attached documents. I have spoken to Priyanka, Rohit, Feroz & Noor in last few days and written mails trying to highlight the discrepancy while processing claims.

Your immediate attention would be highly appreciated. I once again request you to please review and let me know the amount for reimbursement post which I would send the original documents.

Rgds,
Sachin

From: Mohun, Sachin : Barclays Corporate India
Sent: Monday, May 19, 2014 15:55
To: 'reimb.delhi@starhealth.in'
Cc: 'sachin_mohun@hotmail.com'; 'mohun_rastogi@yahoo.com'
Subject: RE: Claim No 0154428 & 0025220

Please find attached discharge summary for claim no 0154428. Please note that the past history has already been updated with you then why claim no 25220 has been rejected??

From: Mohun, Sachin : Barclays Corporate India
Sent: Monday, May 19, 2014 12:37
To: 'reimb.delhi@starhealth.in'
Cc: 'sachin_mohun@hotmail.com'; 'mohun_rastogi@yahoo.com'
Subject: FW: Claim No 0154428 & 0025220

Hi Priyanka,

As discussed, I am enclosing the mail sent earlier. Please get the corrections done.

Also, attaching the discharge summary with detailed bill for hospitalization done on 05.05.2014. Request you to please review and let me know the amount for reimbursement post which I would send the original documents.

Previous Policy No: P/161112/01/2013/006256
Current Policy No: P/16112/01/2014/007251

Rgds,
Sachin

From: complaints IRDA [mailto:complaints@irda.gov.in]
Sent: Tuesday, March 12, 2013 11:29
To: Mohun, Sachin : Barclays Corporate India
Cc: complaints@starhealth.in
Subject: Fwd: Claim Status - Policy No P/161112/01/2013/006256

Dear Sir/Madam,
We acknowledge your mail.
Your complaint has been registered and forwarded to the Insurer (Email ID copied herein).
You may follow-up with the Insurer at the given email ID and/or revert to us (our call center 155 255) if not attended within 15 days.

Your grievance application No is: 03-13-017952 which may be quoted in future correspondence with IRDA and further follow-up with Insurer.
Regards,
Consumer Affairs Department
IRDA
Basheerbagh
Hyderabad

---------- Forwarded message ----------
From:
Date: Fri, Mar 1, 2013 at 3:04 PM
Subject: RE: Claim Status - Policy No P/161112/01/2013/006256
To: complaints@irda.gov.in
Please investigate as below does not even exist

“We have perused the claim records sent to us relating to the above insured-patient seeking reimbursement of hospitalization expenses for treatment of osteochondritis dessecans left knee”

Rgds,
Sachin

________________________________________
From: complaints IRDA [mailto:complaints@irda.gov.in]
Sent: Wednesday, February 27, 2013 10:16 AM
To: Mohun, Sachin : Barclays Corporate India
Subject: Re: Claim Status - Policy No P/161112/01/2013/006256

Dear Sir/ Madam,
We acknowledge your mail.
As we found information to be incomplete to register your complaint, we request you to send the complete details in the below mentioned format or you can contact 155255 (Toll Free) to register the complaint.
* Mandatory Fields
*Name of Complainant Mr Sachin Mohun
Communication Details
*Door No./ Bldg/Name/ Floor Flat No 306A, Block B, Gaur Valerio
Street / Area Ahinsa Khand II, Indirapuram
*City/Town/Panchayath/Village Ghaziabad
Taluk/Tehzil
District Ghaziabad
*State Uttar Pradesh
*Pin Code 201014
E- Mail Sachin_mohun@hotmail.com

Telephone No 01204567042
*Mobile No 918860008548
Fax No
*Insurance Type (Please mentioned Insurance Type Non Life
*Life
* Non Life
*Insurance Company Name Star Health
*Date of Birth of Policy Holder 18/06/1942
*Policy No: P/161112/01/2013/006256
Cover Note:
Other Reference No:
Policy serving Brach Code/Address 161112/CS - 8, IInd Floor, Ansal Plaza, Vaishali, Ghaziabad
*Details of the Complaint (Please type the full details of the complaint) Request you to please look into the reimbursement claim status of above policy as the investigation status updated online by your medical team is false and incorrect
*Have you Approached Insurance Company Regarding This Grievance (If Yes Provide Ref No ) CLI/2013/161112/0154428

Regards,
Consumer Affairs Department
IRDA
Basheerbagh
Hyderabad

On Fri, Feb 22, 2013 at 2:43 PM, wrote:
Dear Mr V Vasudevan,

Request you to please look into the reimbursement claim status of above policy as the investigation status updated online by your medical team is false and incorrect. I request you to re-investigate the same and honour my reimbursement.

Thanx & Rgds,
Sachin
8860008548
____________________________________________
From: Mohun, Sachin : Barclays Corporate India
Sent: Tuesday, February 05, 2013 3:03 PM
To: support@starhealth.in
Cc: sachin_mohun@hotmail.com
Subject: Claim Status - Policy No P/161112/01/2013/006256

Hi,

Please let me know claim status and intimation number for above policy.

Rgds,
Sachin
8860008548


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Internet communications are not guaranteed to be secure or virus-free.
The Barclays Group does not accept responsibility for any loss arising from unauthorised access to, or interference with, any Internet communications by any third party, or from the transmission of any viruses. Replies to this e-mail may be monitored by the Barclays Group for operational or business reasons.

Any opinion or other information in this e-mail or its attachments that does not relate to the business of the Barclays Group is personal to the sender and is not given or endorsed by the Barclays Group.

Barclays Bank PLC.Registered in England and Wales (registered no. 1026167).
Registered Office: 1 Churchill Place, London, E14 5HP, United Kingdom.

Barclays Bank PLC is authorised and regulated by the Financial Services Authority.


"This mail may contain confidential or proprietary information intended only for the use of the addressee(s) named above or may contain information that is legally privileged. If you are not the intended addressee, or the person responsible for delivering it to the intended addressee, you are hereby notified that reading, disseminating, distributing or copying this mail is strictly prohibited. If you have received this mail by mistake, please immediately notify us by replying to the mail and delete the original mail and any copies immediately thereafter.’

Caution: “The Insurance Regulatory & Development Authority is the Regulator for the insurance sector and does not carry out any prospecting or sales. Please do not respond to such offers however official or attractive they may look. These are spurious offers/calls. ”
This e-mail and any attachments are confidential and intended solely for the addressee and may also be privileged or exempt from disclosure under applicable law. If you are not the addressee, or have received this e-mail in error, please notify the sender immediately, delete it from your system and do not copy, disclose or otherwise act upon any part of this e-mail or its attachments.
Internet communications are not guaranteed to be secure or virus-free. The Barclays Group does not accept responsibility for any loss arising from unauthorised access to, or interference with, any Internet communications by any third party, or from the transmission of any viruses. Replies to this e-mail may be monitored by the Barclays Group for operational or business reasons.
Any opinion or other information in this e-mail or its attachments that does not relate to the business of the Barclays Group is personal to the sender and is not given or endorsed by the Barclays Group.
Barclays Bank PLC. Registered in England and Wales (registered no. 1026167). Registered Office: 1 Churchill Place, London, E14 5HP, United Kingdom. Barclays Bank PLC is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority (Financial Services Register No. 122702).
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Finally, the recipient should check this email and any attachments for the presence of viruses. The company accepts no liability for any damage caused by any virus transmitted by this email.

This e-mail and any attachments are confidential and intended solely for the addressee and may also be privileged or exempt from disclosure under applicable law. If you are not the addressee, or have received this e-mail in error, please notify the sender immediately, delete it from your system and do not copy, disclose or otherwise act upon any part of this e-mail or its attachments.
Internet communications are not guaranteed to be secure or virus-free. The Barclays Group does not accept responsibility for any loss arising from unauthorised access to, or interference with, any Internet communications by any third party, or from the transmission of any viruses. Replies to this e-mail may be monitored by the Barclays Group for operational or business reasons.
Any opinion or other information in this e-mail or its attachments that does not relate to the business of the Barclays Group is personal to the sender and is not given or endorsed by the Barclays Group.
Barclays Bank PLC. Registered in England and Wales (registered no. 1026167). Registered Office: 1 Churchill Place, London, E14 5HP, United Kingdom. Barclays Bank PLC is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority (Financial Services Register No. 122702).
_____________________________________________________________
 Please do not print this email unless it is absolutely necessary.

This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you have received this email in error please notify the sender immediately. Please note that any views or opinions presented in this email are solely those of the author and do not necessarily represent those of the company.
Finally, the recipient should check this email and any attachments for the presence of viruses. The company accepts no liability for any damage caused by any virus transmitted by this email.

This e-mail and any attachments are confidential and intended solely for the addressee and may also be privileged or exempt from disclosure under applicable law. If you are not the addressee, or have received this e-mail in error, please notify the sender immediately, delete it from your system and do not copy, disclose or otherwise act upon any part of this e-mail or its attachments.
Internet communications are not guaranteed to be secure or virus-free. The Barclays Group does not accept responsibility for any loss arising from unauthorised access to, or interference with, any Internet communications by any third party, or from the transmission of any viruses. Replies to this e-mail may be monitored by the Barclays Group for operational or business reasons.
Any opinion or other information in this e-mail or its attachments that does not relate to the business of the Barclays Group is personal to the sender and is not given or endorsed by the Barclays Group.
Barclays Bank PLC. Registered in England and Wales (registered no. 1026167). Registered Office: 1 Churchill Place, London, E14 5HP, United Kingdom. Barclays Bank PLC is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority (Financial Services Register No. 122702).
_____________________________________________________________
 Please do not print this email unless it is absolutely necessary.

This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you have received this email in error please notify the sender immediately. Please note that any views or opinions presented in this email are solely those of the author and do not necessarily represent those of the company.
Finally, the recipient should check this email and any attachments for the presence of viruses. The company accepts no liability for any damage caused by any virus transmitted by this email.

This e-mail and any attachments are confidential and intended solely for the addressee and may also be privileged or exempt from disclosure under applicable law. If you are not the addressee, or have received this e-mail in error, please notify the sender immediately, delete it from your system and do not copy, disclose or otherwise act upon any part of this e-mail or its attachments.
Internet communications are not guaranteed to be secure or virus-free. The Barclays Group does not accept responsibility for any loss arising from unauthorised access to, or interference with, any Internet communications by any third party, or from the transmission of any viruses. Replies to this e-mail may be monitored by the Barclays Group for operational or business reasons.
Any opinion or other information in this e-mail or its attachments that does not relate to the business of the Barclays Group is personal to the sender and is not given or endorsed by the Barclays Group.
Barclays Bank PLC. Registered in England and Wales (registered no. 1026167). Registered Office: 1 Churchill Place, London, E14 5HP, United Kingdom. Barclays Bank PLC is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority (Financial Services Register No. 122702).

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