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 12/02/2020
To
ARTI ASHOK MALIK
B-77 RAILWAY QUARTER
RAILWAY QUARTER
AURANGABAD
Aurangabad (M Corp.)
Pincode : 431003
Aurangabad
Maharashtra
7350231204

Dear Customer,

Sub :Repudiation of Claim.

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

Claim Intimation number : CLI/2020/151115/0839742

Name of the insured-Patient : ARTI ASHOK MALIK
Age / Sex : 25 years 7 months / Female
Product name : Mediclassic Individual - Revised
Policy number : P/151115/01/2020/006467
Policy period : From : 09-SEP-19 To : 08-SEP-20
Diagnosis : EXTENSIVE TAENIA OVER ABDOMEN
Date of admission : 20/01/2020
Name of the Hospital and : Sahara Hospital - AURANGABAD
Location

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

It is observed from the submitted medical records that the insured patient's general condition and vital
signs are stable throughout the period of hospitalization. Our medical team is of the opinion that the
insured patient could have been treated as an outpatient and hospitalization is not warranted.

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
... 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
details/documents submitted.

We are always at your service.

Yours faithfully

Authorized Signatory
d.a
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 : SH6642MR.SAGAR SURESH RAPATWAR

Intermediary Code / Name : BA0000046734UMESH
GULABCHAND DOSHI

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