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 13/03/2020
To
DATTATRAYA JAGANNATH SALUNKE
A/POST ZODEGAON TQ AMBAD
DIST JALNA
POST CHINCHKAD
Chinchkhed
Pincode : 431121
Jalna
Maharashtra
9921155963

Dear Customer,

Sub :Repudiation of Claim.

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

Claim Intimation number : CLI/2020/151115/0922882

Name of the insured-Patient : ISHANT SALUNKE
Age / Sex : 3 years / Male
Product name : Family Health Optima Insurance - 2017
Policy number : P/151115/01/2020/013792
Policy period : From : 11-FEB-20 To : 10-FEB-21
Diagnosis : BALANOPOSTHISIS
Date of admission : 20/02/2020
Name of the Hospital and : KALPATARU ADVANCED PEDIATRIC SURGERY CENTRE -
Location AURANGABAD

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

It is observed from the submitted medical records that the insured patient has undergone circumcision for
balanoposthitis.

As per Exclusion No.1 of the above policy, the Company is not liable to make any payment in respect of
expenses incurred at hospital for circumcision.

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.

... 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

2
We are always at your service.

Yours faithfully,

Authorized Signatory
k
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 : SH28486MS.SWAPNALI S PIMPLE

Intermediary Code / Name : BA0000309856MR.PRATAP
KACHRU DEKHANE

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