Personal Experience – Warning About Star Health Insurance

[HumorSimpson]

These are the things I know but the things can be known better when someone claims (ground reality).
But from my understanding, never choose coinsurance, room caps & Ambulance limitations. In addition, if taking policy in groups or for elders then restoration should be there.

Whats a restoration and coinsurance ?

 

[OptiCard]

Whats a restoration and coinsurance ?

Restoration means -->
Let say the coverage is 10L --> if someone admits and took 8L claim then in next admit again the coverage amount will be 10L (not 10L - 8L = 2L). Unlimited restoration --> Consider this as most important factor when the parents are in senior citizen band.

Coinsurance means --> a part of bill amount that everytime you need to pay.
Let say the bill is of 5L and the coinsurance is of 20% --> then need to pay 1L from the pocket and remaining will be on insurance company

Never choose deductible & coinsurance. Even deductible is somehow better but I strongly oppose both.

 

[sunit123]

Could you please tell the procedure to complaint to IRDAI ?

on following portal

https://bimabharosa.irdai.gov.in/

 

[Mekala ManojKumar]

Thanks again for all your responses. I want to understand stand the ground reality of other insurances as well. No bother about the premium but I want to be safe when it comes to claim. And want to know the port procedure as well.Thanks advance

 

[Zacobite]

Thanks again for all your responses. I want to understand stand the ground reality of other insurances as well. No bother about the premium but I want to be safe when it comes to claim. And want to know the port procedure as well.Thanks advance

Ergo / icici / tata / birla/ care are better in that order

 

[sunit123]

Thanks again for all your responses. I want to understand stand the ground reality of other insurances as well. No bother about the premium but I want to be safe when it comes to claim. And want to know the port procedure as well.Thanks advance

check claim settlement ratio through following link....Among old and established companies, HDFC and Reliance General insurance has 99%+ claim settlement ratio...Personally i have reliance as its premium is very less compared to others and has best features..Reliance health is different company and its claim settlement is low....I have health insurance from reliance general

Avoid birla/care/niva bupa/tata etc

Latest claim settlement ratio of health and general insurance companies released by IRDA in 2025, Navi, Acko take lead, Star Health, Zuno fall below 90% - The Economic Times

In 2025, IRDAI's handbook on Indian insurance statistics highlighted that Acko General Insurance lead amongst all general and health with a 99.91% claim settlement ratio within 3 months. Among public sector insurers, United India Insurance stood at 96.33%. However, at 82.31%, Star Health and...

economictimes.indiatimes.com

 

[SnowLucifer]

Same happened with me. My fathers claim for a heart stain got rejected because he is taking some neurological medicine ( neuro problems started after we took the policy). Kuch relation nhi bas unko reject karne ka bahana chaiye. Prior to that we got 60k cashless approval for eco and epf study. But when the claim for stain got rejected they denied the previous approved amount too. Thankfully we had sastasaathi ( west bengal health insurance scheme for everyone) so we got the satin covered. But for eco and epf study we paid 70k. The agent told the amount will be reimbursed in our account by filling some documents no update yet. But one thing for sure health insurance of some type is must. If we had to pay for the stain the amount would have been 3 lakhs hospital told. But we got message that 56k cashless has been allotted in sastasathi ( west bengal health scheme). So you can imagine how much hospitals loot from patient without insurance .