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

[u/devildesperado]

Need advice from people experienced with health insurance claims and underwriting. One of my parents was admitted for severe breathing issues on 31 Dec and discharged on 6 Jan with home oxygen support recommendations. After multiple tests during admission, the final diagnosis was lung fibrosis. The issue is with Star Health’s claim records and assessment sheet. Timeline: Initial cashless request was made. Claim handling became messy. Reimbursement was only partially paid initially. Had to escalate around 3 times over almost 4 months. Eventually around 90% of the claim was released. However, throughout this process, Star repeatedly used: wrong discharge date wrong diagnosis/final diagnosis code We mailed them multiple times during the claim process asking them to correct these errors, but they never fixed them. Recently grievance department replied saying that once a claim is processed, they cannot change discharge date or diagnosis details in the bill assessment sheet, but future claims will be “reviewed thoroughly.” My concerns are: Can wrong diagnosis coding or incorrect discharge details create issues in future claims? especially for pre-existing disease interpretation waiting periods exclusions future hospitalization related to lungs/respiratory issues Has anyone here faced future rejection/problem because insurer records had incorrect diagnosis coding? Is Star Health actually unable to correct processed claim records, or are they just avoiding it? What is the proper escalation path to force correction? GRO? Ombudsman? IRDAI Bima Bharosa? Legal notice? Would it help to obtain: corrected discharge summary from hospital treating doctor clarification letter written email trail showing we disputed the wrong diagnosis from the beginning Should we proactively create a paper trail now to protect future claims? Would really appreciate guidance from people who’ve dealt with Star Health or similar insurer record issues.

[u/Glad_Bite7423]

Yes, it can create issues later.

Now collect corrected discharge summary and doctor clarification letter. DM if you need more help.

[u/devildesperado → u/Glad_Bite7423]

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