STAR HEALTH AND ALLIED INSURANCE CO.Ltd.

,
No.15, SRI BALAJI COMPLEX,1st FLOOR, WHITES
LANE,ROYAPETTAH,CHENNAI-600014.
Toll Free No: 1800 425 2255 / Toll Free Fax: 1800 425 5522, www.starhealth.in

DATE 20/02/2020
To
Mr.PATIL SACHIN BHIMRAO
SHIVRAM NAGAR
OMKARESHWAR TEMPLE
VASMAT ROAD PARBHANI
Parbhani (M Cl)
Pincode : 431401
Parbhani
Maharashtra
9595720097

Dear Customer,

Sub :Repudiation of Claim.

We refer to the mediclaim preferred by you. Details are briefly given below:

Claim Intimation number : CLI/2020/151115/0669388

Name of the insured-Patient : MR.PATIL SACHIN BHIMRAO
Age / Sex : 34 years 2 months / Male
Product name : Star Comprehensive Insurance - 2015
Policy number : P/151115/01/2019/012037
Policy period : From : 01-MAR-19 To : 29-FEB-20
Diagnosis : VIRAL FEVER
Date of admission : 13/10/2019
Name of the Hospital and : SPANDAN ICU MULTISPECIALITY CRITICAL CARE CENTER -
Location PARBHANI

We have processed the claim records relating to the above insured-patient seeking reimbursement of
hospitalization expenses for treatment of viral fever.

It is observed from the indoor case records of the above hospital that the insured patient’s vital signs are
stable and general condition is normal throughout the period of hospitalization. Our medical team is of
the opinion that the insured patient could have been treated as an outpatient and hospitalisation is not
warranted for the above diagnosis.

We are therefore unable to settle your claim under the above policy and we hereby repudiate your claim.

The above decision has been taken as per the terms and conditions of the policy and based on the claim
details/documents submitted.

We are always at your service.

... 2 ...
IRDA Regn.No.129
Corporate Identity Number U66010TN2005PLC056649
Email ID : info@starhealth.in
 STAR HEALTH AND ALLIED INSURANCE CO.Ltd.,
No.15, SRI BALAJI COMPLEX,1st FLOOR, WHITES
LANE,ROYAPETTAH,CHENNAI-600014.
Toll Free No: 1800 425 2255 / Toll Free Fax: 1800 425 5522, www.starhealth.in

Yours faithfully,

Authorized signatory
rd

PS:
In case you are not satisfied with the above decision, you may wish to represent to our Grievance
Department at the following address:
Grievance Redressal Officer,
Corporate Grievance Department,
Star Health And Allied Insurance Co. Ltd.,
No.1,New Tank Street,
Valluvar Kottam High road, Chennai 600034.
Contact number : 044-2824 3925
Mail ID:- grievances@starhealth.in

Thereafter if you wish to pursue the matter further, you may represent to the Office of the Insurance
Ombudsman whose address is given below:

Office of the Insurance Ombudsman,

Jeevan Darshan Bldg., 3rd Floor,
C.T.S. No.s. 195 to 198,
N.C. Kelkar Road, Narayan Peth,
Pune - 411 030
Tel : 020-41312555
bimalokpal.pune@ecoi.co.in

SM Code / Name : SH6710MR.PANKAJ G.PATIL

Intermediary Code / Name : BA0000054761NIRAJ GIRIDHAR
POUL

COPY TO : Branch Office - Aurangabad

2nd Floor,BLOCK 6 & 7,Suyash Complex,Baba Hardas Nagar , Kalda Corner
,,Aurangabad-431001

IRDA Regn.No.129
Corporate Identity Number U66010TN2005PLC056649
Email ID : info@starhealth.in