A social media post by a son claiming that his mother’s health insurance claim was unfairly denied has now received a firm response from Star Health and Allied Insurance, with the insurer rejecting what it called an “inaccurate and incomplete portrayal” of the incident.
The case, which began with a post on X, triggered strong reactions online and raised wider concerns about whether paying premium regularly guarantees support during medical emergencies.
In a post, the man said he had been paying around Rs 50,000 every year as premium for his mother’s health insurance policy. When she fell ill, he went to the Lucknow office of Star Health and Allied Insurance to seek claim support.
He alleged that he was made to wait for hours and that the claim was denied. He also claimed that an agent told him, “humse poochkar policy thodi li thi” (you did not take the policy after consulting us).
The post questioned why premiums are collected on time but objections arise during claim settlement. It received strong reactions from several users, some of whom shared their own concerns about health insurance claim experiences.
STAR HEALTH REJECTS ALLEGATIONS
In response to the story, Star Health issued an official statement to India Today.
The company began by saying, “We recognise that health matters can be emotionally challenging.”
However, it went on to state, “We reject the inaccurate and incomplete portrayal of the Lucknow claim, which omits material facts.”
Addressing the reason for the claim decision, the insurer said, “During the assessment, the available medical information indicated a potential pre-existing medical history relevant to the claim.”
It further added, “Supporting documentation was formally requested but was not furnished despite follow-up communications.”
Clarifying its position on the rejection, the company said, “The decision was taken strictly in accordance with the policy terms and conditions.”
It concluded by stating that the decision “is fully supported by documentary evidence.”
By placing these points on record, the insurer has maintained that the claim was evaluated based on medical records, disclosure history and contractual terms.
THE CORE ISSUE: PRE-EXISTING CONDITIONS
In health insurance, non-disclosure or incomplete disclosure of a pre-existing disease can become grounds for claim rejection, depending on policy wording and waiting period clauses.
Insurers assess hospital records, past prescriptions and medical history at the time of claim. If records suggest a condition existed before policy purchase and was not declared, it may lead to dispute.
Such cases often become contentious because customers may believe they disclosed all relevant details, while insurers rely strictly on written documentation in the proposal form and medical evidence.
The episode highlights a larger issue in India’s health insurance market: paying premium regularly does not automatically guarantee claim approval. The claim stage involves scrutiny of medical records, disclosure history and policy terms.
For families facing hospitalisation, rejection can feel sudden and unfair. For insurers, claim settlement is governed by contract language and regulatory norms.
With both the viral allegation and the insurer’s official response now on record, the matter underscores the importance of accurate disclosure, proper documentation and written communication at every stage of policy purchase and claim filing.
The dispute also reflects a wider anxiety among policyholders who fear that technical grounds such as pre-existing conditions could affect claim outcomes.
As the conversation continues online, the focus has shifted from one family’s experience to a broader question: in health insurance, is buying the policy the easier step, and claiming the harder one?
