I am filing this complaint against Care Health Insurance for wrongfully denying a valid cashless hospitalization claim for Ms. Gxxxxi Yxxxxv, under the excuse of a “pre-existing condition” — without providing any medical evidence or proof.
I have submitted complete diagnostic reports dating back to 2014, which clearly show there was no such pre-existing condition related to the current ailment. The hypothyroid condition was declared at policy inception, and the waiting period has already passed.
Despite multiple requests, the insurer has failed to provide any proof or explanation for the denial. This appears to be an intentional delay and misuse of policy terms to avoid paying valid claims.
My Demand: Immediate re-evaluation of the claim based on submitted documents. A written explanation with medical proof of the alleged pre-existing condition. If no valid evidence is found, the claim must be approved without delay.
This kind of treatment shows a serious lack of ethics in how Care Health Insurance handles its customers. I will be escalating this complaint to IRDAI, and sharing this experience across social media, review sites, and within my corporate network. Please take strict action and help ensure fair treatment for policyholders like us.
Krishna
Mumbai 400097, Maharashtra
Email: kxxxxxxxx1@gmail.com
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