Health Insurance claim complaints | Procedure for complaint

If your cashless claim is rejected then you can claim via the reimbursement process.
If your reimbursement claim is rejected the company will mention on what basis they've rejected the claim.
You're not satisfied, and you believe that you deserve to be given the claim write to the Grievance cell with all the details.
If you don't get a satisfactory reply write to the Nodal officer concerned.
Normally here your claim will be reconsidered.
If still there's no response, complain to the IRDA, this does the trick.
If still there's no response, then you need to complain to the Insurance Ombudsman.
In my experience, most awards by the ombudsman are in favour of the insured and not the Company.
#DeepakRKhemani #rejection #claim #healthinsurance #insurancepolicy #grievance #cell #IRDA #ombudsman #complaint

[niranjjvj]

Thank you Sir for sharing this useful information .Senior Citizens are normally being troubled more.Appreciate your video on this to educate us.

[rajudeshmukh]

Thank you Sir! Great information given in 2.25 min. You are realy great.

[sreevanin]

First i would like to tel thanks to to god and Thank you somuch for ur information its helped me alot to get back my rejected claim thanks to irda 🙏

[MR.MAYUR]

Maine irdai main shikayat ki hai 1 week ho gaya hai.. Insurance walo ne wapas reopen new claim id generated karke 10-15 din main response karenge Aisa bol rahe hai...iska matlab

[Marketmasala]

Superb sir
Thank you for nice information 🙏🙏

[sureshsugave]

Plz all friends not buy Star insurance policy

[vaschouhan]

Very nice n useful information sir ji 🙏

[AnmigaBharatham]

Thank you Sir, My post treatment insurance claim was rejected and the nodal grievance officer just read out the same mentioned in the letter. I approched the Ombudsman who ruled the case in my favor and instructed the insurance provider to pay me the claim. Its been more than 15 days since the letter was issued, my insurance provider (star health) hasn't paid me anything. I have plans to visit the Ombudsman to file a complaint. Will the nodal Ombudsman be able to force the company to pay out or should I need to file case with the Consumer court? Please guide me. Many Thanks.

[PhysicsBangla]

Hello Sir, I have claimed for a reinbursement to star health, but they have rejected due to 'pen through 'on indoor case paper where the duration of disease is written. A copy of clarification about the 'pen through' portion is further submitted. Again the claim has been rejected. What could I do?
please advice me. Thanking you

[Rahulwaghumbare]

From my personal experience don't buy Star Health insurance,

[imperialclasses_VinaySodhi]

I have sent all Hard copy to one health insurance company but from the last 2 months they have not acknowledge and put my claim on
hold ..what should I do

[ALLINONE-jqvh]

Sir, my claim is under query. Tpa want the discharge certificate in proper format . Hospital give me a discharge certificate which was I have send to tpa. But tpa says this is not the proper format so we can not process your claim. And hospital authority said we have given to you which was the final. So in this case what should I do? Please guide me.

[Amit_KumarSingh]

Hello Sir, thanks for the informative video. Its really very helpful.

If a healthy person has a health insurance policy where hiv is not covered, will the company pay the claim for kidney stones surgery, incase if the policy holder is recently diagnosed with hiv. He/ she was hiv negative at the time of inception of the policy. Pls relpy...

[rachanamishra]

Thankyou for the information sir, whom to blame when agents give us the police and they leave the insurance company. When we call insurance company, they simply say agent left the company, insurance company does not have any responsibility of the agent's work. what to do in this matter. Thankyou

[techlead...]

Maxlife Insurance company not giving the application /Proposal form as I asked them to check whom my deceased father have registered nominee in policy. Can I file complaint to IRDAI in this matter?

[sameerk]

Does, health insurance policy reimburse paritoneal dialysis cost?

[manasakb]

Sir. How many days does it take for grievance cell to respond to our mail ?

[IhOps]

Hi Sir,
I have oriental insurance, after getting treatment my claim partially settled only 30% amount received. Reason given is proposionality rate applicable on entire bill, I have been admitted for 1 day. Shall i raise grivience? Kindly advise

[codecrafts]

Sir same thing happened to me. I submitted all the documents asked for but still they rejected the claim stating "documents were missing". I wrote email to their grievance cell but it did not work as well. Now, how do I get nodal officer's contact and how do I approach him?
After that I am planning to move to IRDAI. Please help me.

[viveksharma-mcob]

Sir mera star health ne claim reject kar diya. What i m do