- This topic has 15 replies, 4 voices, and was last updated 1 year, 4 months ago by
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UHey everyone, I need some legal guidance regarding **Star Health Insurance** and potential misrepresentation of policy benefits.
# The Issue
I purchased the **Star Women Care Insurance (₹50L Sum Insured)** [**(POLICY LINK)**](https://www.starhealth.in/health-insurance/women-care/) in **September 2023** through **PolicyBazaar**. Their agent clearly told me that **room rent is separate from the ₹75,000 maternity limit** and that I could opt for **any room with no sub-limits** under the ₹50L plan. I have **Whatsapp recordings of this conversation.**
However, when I recently contacted **Star Health customer care (31 Jan 2025)** to confirm, they escalated me to one of the senior executive one **Ms. Raji**, who told me that **room rent is INCLUDED in the ₹75,000 maternity limit**—meaning if I take a ₹50K room, I’ll only have ₹25K left for delivery expenses.
This directly **contradicts the policy document**, which states:
* **”For Sum Insured ₹50,00,000/- and above: Any Room”** (no sub-limits mentioned)
* **Maternity expenses up to ₹75,000 per delivery** (but no clear mention that room rent is part of this cap)
* **Room rent is listed under “Room, Boarding, Nursing Expenses” as a separate benefit under hospitalization.**# Possible Misrepresentation?
1. **PolicyBazaar agent gave me incorrect information at the time of purchase.**
2. **Star Health’s policy document does not explicitly mention room rent is deducted from the ₹75K maternity limit.**
3. **If they enforce this limitation without disclosing it in the policy, could this be considered misrepresentation or an unfair trade practice under IRDAI regulations or the Consumer Protection Act?**# My Next Steps & Legal Questions
* **Can I file a complaint with IRDAI or the Insurance Ombudsman regarding this discrepancy?**
* **Does the Consumer Protection Act, 2019 apply here, since I was misled by both PolicyBazaar and Star Health?**
* **Would this qualify as a breach of contract if the policy doesn’t explicitly state the room rent deduction?**
* **What legal recourse do I have to ensure they honor the policy as written?**I am thinking of senting a **formal complaint to Star Health**, demanding a written response within 5 business days, failing which I plan to escalate.
Any insights on how to proceed legally would be greatly appreciated! Thanks in advance. 🙏
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NThis is standard terms with all insurers. Any sub limit for a disease ( or maternity) includes all types of charges – room rent, pre and post hospitalization….
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NYes, it will be good if they clearly mention it. But none of the other insurers also mention it explicitly in their policy wording. So it will be difficult to win this argument.
The real issue is policy bazaar misleading you. You may want to explore that angle.
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UAlso I get that many insurers follow this practice, but my issue is **lack of transparency in Star Health’s policy wording**. If room rent is deducted from the ₹75K maternity cap, then:
1. **Why does the policy explicitly state “any room” with no sub-limits for ₹50L coverage?**
2. **Why doesn’t the maternity section clearly mention that room rent is included in the ₹75K cap?**
3. **Why is room rent listed separately under hospitalization benefits if it’s actually part of maternity coverage?**If insurers enforce hidden sub-limits without clear disclosure, isn’t that **misrepresentation** under IRDAI guidelines and consumer protection laws?
Would love to hear legal perspectives on this.
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UIt’s not just **PolicyBazaar**, but also **Star Health’s policy wording** that’s misleading. If room rent is part of the ₹75K maternity cap, **why isn’t it explicitly mentioned in the policy?** They clearly list other exclusions, so why leave this open to interpretation?
PB misled me, but **Star Health is also enforcing a hidden sub-limit** that isn’t clearly disclosed. Shouldn’t both be held accountable?
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LI’m a lawyer in Delhi high court. I’ve fought cases against star health. This is their usual thing.
File a consumer complaint. That’s the only option you have. -
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