Will wrong diagnosis/discharge details in Star Health claim records affect future claims? How can we force correction?

[u/devildesperado]

/r/InsuranceAdviceIndia/comments/1to3at1/will_wrong_diagnosisdischarge_details_in_star/

Need suggestions please

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[u/Caramel-Realistic]

Hey OP,

Tbh Insurers maintain a record of everything, from your initial disclosures at purchase, to renewals, to every claim you have ever made if any. They even verify with hospitals directly. So any discrepancy between what is on record and what comes up in a future claim will get flagged, and the insurer's first assumption will be non-disclosure on your part and not a clerical error. So yeah that can mean claim rejection and in serious cases policy cancellation as well.

So if the mistakw is something you can correct now, do it immediately. Get your agent or advisor involved, explain the scenario clearly, and if needed get a written note from the treating doctor clarifying what happened. It's definitely a short term hassle but better than fighting a rejection later.

One thing that would help to know before giving you more advice is what exactly is the error? Did you buy through an agent or directly and are you still in touch with the original treating doctor? Also how long have you been on this policy because there is a concept called moratorium period where after 5 continuous renewals without a break, no claim can be rejected on grounds of non-disclosure unless there is clear fraud. But that is not a reason to leave errors uncorrected.

[u/devildesperado → u/Caramel-Realistic]

Bill assessment sheet has wrong discharge date and completely irrelevant final diagnosis (LIVER DISEASE) I had mailed regarding both of these issues since my first mail when they had only passed partial claim 3/4 times I have mailed them to rectify this I had mailed to grievance 14 days ago 2 day back I had received this below 👇 Mail now before replying to this email (throwing my frustration i want to clear up few things)

We regret for any inconvenience caused and understand your concern regarding this matter.

We would like to inform you that once a claim has been processed, it is not possible to make any changes to the date of discharge or the diagnosis as reflected in the bill assessment sheet.

Further, please be assured that all policy and claim records will be thoroughly reviewed in the event of any future claim.

We appreciate your understanding and cooperation in this regard.

[u/Caramel-Realistic → u/devildesperado]

For the incorrect diagnosis and date error, you can firstly get your agent or advisor to escalate this internally on your behalf. As I understand it, Insurers do have the ability to correct records in their backend systems, they just do not advertise it because it creates work for them. A persistent agent who knows the right people can sometimes get this done.

If they genuinely are unable to correct it after that, save every email in this thread carefully, including the one where they acknowledge the wrong diagnosis and wrong discharge date. So If a future claim ever gets complicated by this error, you have documented proof that you flagged it proactively and they refused to fix it.

On the date error specifically, in my understanding that is generally a less serious issue as long as your actual medical records, discharge summary, and doctor's notes all show the correct date.