- Health Insurance Reimbursement not done ^Open

Akshay Rathnavas filed this complaint against Star Health Allied Insurance Company on Aug 21, 2024

I am writing to file a formal complaint regarding the mishandling of my mother's health insurance claim and the subsequent lack of response from Star Health Insurance.
Background
My mother was hospitalized for treatment of a neuro infection and hypertension. Following her treatment, I submitted a claim for reimbursement of her hospital expenses. The chronology of events is as follows:
Last week of June: I sent all the original documents and bills along with ID proof, cancelled cheque etc.
On July **, ****, I received an email from claims.query@starhealth.biz requesting additional documents.
I immediately responded, informing that all requested documents were already enclosed with the original reimbursement form, including over *** pages of medical records, investigative reports.
On July **, ****, I received another email from zoca.support@starhealth.in listing the same document requirements.
On July **, ****, I sent a detailed response with Google Drive links to the requested documents, as the file sizes were too large for email attachments.
Star Health responded that they cannot access external links due to security reasons.
On July **, ****, I resent the documents as email attachments, specifically the doctor's statement and comprehensive medical reports.
Star Health acknowledged receipt of these documents on the same day, promising a prompt response.
In the end, I submitted Indoor case papers and a separate detailed statement from the treating doctor with his signature and the hospital seal.
Issues of Concern

Repeated Requests for Already Submitted Documents: Despite sending all required documents with the original claim, Star Health repeatedly asked for the same information.
Lack of Document Management: There appears to be a significant issue with document management at Star Health. The company seems unable to locate or properly catalog the extensive medical records and reports that were initially submitted.
Communication Barriers: The inability to accept documents via secure file-sharing services, coupled with email attachment size limitations, created unnecessary obstacles in the claims process.
Lack of Follow-up: Despite acknowledging receipt of the resent documents on July **, ****, and promising a prompt response, Star Health has not provided any updates or decisions regarding the claim as of August **, **** (nearly a month later).
Customer Service Issues: During this process, I experienced rude behavior from a customer care representative who terminated a call without addressing my queries.

Requested Resolution

Immediate Review and Processing of Claim: I request an immediate and thorough review of all submitted documents and prompt processing of the claim.
Explanation of Delays: Please provide a detailed explanation for the repeated document requests and the prolonged silence following the July ** acknowledgment.
Improvement of Internal Processes: I urge Star Health to review and improve its document management and communication processes to prevent similar issues for other policyholders.
Compensation for Distress: Given the undue stress and time investment caused by these issues, I request appropriate compensation or consideration in the claim settlement.

I have been a loyal customer of Star Health Insurance, and this experience has been deeply disappointing. I expect a higher standard of service and professionalism from them..

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