Ashish Deshmukh
New member
- Policy Name
- care supreme
- Company Name
- care health insurance
- Customer Care Number
- 8860402452
- Loss Amount
- 51020
- Ratings
- Opposite Party Address
- Mangesh Kase
5th Floor, Siddhi Pooja Business Apartment, New Pandit colony, Saharanpur Road, Nashik, Maharashtra
Respected Sir/Madam,
I, Ashish Anil Deshmukh, resident of Gurudarshan row house, Gunjalbaba Nagar, Hirawadi Road, Panchvati NASHIK-422003, am writing to lodge a formal complaint against Care Health Insurance, Nashik for unjust rejection of a genuine Mediclaim reimbursement claim (Amount Rs. 51,020/-) related to my son’s hospitalization.
Claim Details:
On 21st March 2025, my son was admitted to Ushakiran Hospital for treatment. On the same day, a representative from Care Health Insurance visited the hospital and conducted the verification process.
However, on 28th April 2025, our claim was rejected citing the following reason:
"5.6 discrepancy in medical documents - indoor case paper poorly maintained, single stretched handwriting, OPD to IPD conversion. Discrepancy in medical documents."
To address this, we immediately took a clarification letter from the treating doctor and resubmitted all the required documents, clearly answering all concerns raised by the insurance company. I also visited the Care Health Insurance office regarding the claim rejection.
It has already been one and a half months, and despite full compliance and transparent communication, the insurance company has failed to approve our claim and continues to delay the process unnecessarily.
We are now suffering severe mental stress and financial strain due to this unnecessary rejection of a genuine claim. The treatment was taken from a reputed hospital and certified doctor, and there has been no wrongdoing or discrepancy on our part.
We believe this denial constitutes deficiency in service and unfair trade practice as defined under the Consumer Protection Act, 2019.
Enclosures (copies attached):
Thanking you,
Yours sincerely,
Ashish Anil Deshmukh
I, Ashish Anil Deshmukh, resident of Gurudarshan row house, Gunjalbaba Nagar, Hirawadi Road, Panchvati NASHIK-422003, am writing to lodge a formal complaint against Care Health Insurance, Nashik for unjust rejection of a genuine Mediclaim reimbursement claim (Amount Rs. 51,020/-) related to my son’s hospitalization.
Claim Details:
- Policy holder Name: Ashish Anil Deshmukh
- Policy Number: 92543123
- Patient Name: Aarav Ashish Deshmukh (My Son)
- Date of Admission: 21st March, 2025
- Hospital Name: Ushakiran Hospital, Nashik
- Claim Amount: ₹ 51,020/- (Fifty one thousand twenty Rupees only)
- Claim Rejection Date: 28th April 2025
- Claim ID/Reference: 95852952
On 21st March 2025, my son was admitted to Ushakiran Hospital for treatment. On the same day, a representative from Care Health Insurance visited the hospital and conducted the verification process.
However, on 28th April 2025, our claim was rejected citing the following reason:
"5.6 discrepancy in medical documents - indoor case paper poorly maintained, single stretched handwriting, OPD to IPD conversion. Discrepancy in medical documents."
To address this, we immediately took a clarification letter from the treating doctor and resubmitted all the required documents, clearly answering all concerns raised by the insurance company. I also visited the Care Health Insurance office regarding the claim rejection.
It has already been one and a half months, and despite full compliance and transparent communication, the insurance company has failed to approve our claim and continues to delay the process unnecessarily.
We are now suffering severe mental stress and financial strain due to this unnecessary rejection of a genuine claim. The treatment was taken from a reputed hospital and certified doctor, and there has been no wrongdoing or discrepancy on our part.
We believe this denial constitutes deficiency in service and unfair trade practice as defined under the Consumer Protection Act, 2019.
Enclosures (copies attached):
- Insurance Policy Document
- Hospital Bills & Discharge Summary
- Doctor’s Clarification Letter
- Claim Rejection Mail
- All Submitted Claim Documents
- Email/Communication Trail with Insurance Company
- ID proof
Thanking you,
Yours sincerely,
Ashish Anil Deshmukh
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