Care Health Insurance Limited — Wrongful Health Insurance Claim Denial and Policy Cancelleation Due to Clerical Error by Care Health Insurance

Address: 9-260/1, Near enadu tent house, indrapalem, kakinada

Respected Sir/Madam,

I am writing to lodge a formal complaint against Care Health Insurance Limited regarding the unjust denial Claim and Policy Cancellarion due to Clerical Error Despite Hospital Clarification.

The Insurer has rejected the claim citing "fraudulent claim due to non-disclosure of pre-existing epilepsy".

1) There was no history of epilepsy at the time of policy purchase.
2) The condition was recently diagnosed.
3) The rejection reason is factually incorrect and the labeling of the claim as 'fraudulent' is both unprofessional and damaging.

Initially, the insurer declined the cashless claim with the same reason but advised me to proceed with a reimbursement claim. However, later they cancelled the entire policy based on the same reason, despite receiving a hospital issued clarification.

The anesthesiologist incorrectly documented the duration of epilepsy as "3 years instead of days" due to confusion during the history elicitation process.

This note was a clerical error made by the anesthesiologist. In reality, my father experienced seizures only 2 or 3 days before the doctor's consultation, and an MRI revealed the presence of a brain tumor on 13th May 2025. Until then, we had absolutely no knowledge or symptoms indicating such a condition.

My father did not have any major pre-existing illnesses other than controlled BP and diabetes, which were clearly disclosed when the policy was purchased(February 2023). There were no signs or symptoms of neurological issues or any brain related illness prior to the recent seizures that led to hospitalization and surgery.

To correct the mistaken hospital record, I submitted an official clarification letter from Apollo hospitals, confirming that the "3 years mention was inaccurate and should have 3 days".

Despite submitting valid and verified proof from the treating hospital, Care Health did not investigate and reconsider the claim, and the policy remains cancelled.

The decision taken by the insurer has placed extreme financial and emotional strain on my family during a highly vulnerable time.

I would also like to mention that I have an active policy for my mother with Care Health, purchased along with my father's policy in February 2023, paying 23000 for my mother and 43000 for my father Annually.

My request:

1. Reopen the re-evaluate the case urgently.
2. Direct Care Health insurance to reinstate the terminated policy.
3. Order the insurer to honor the claim as per the policy terms, based on verified hospital records.
4. Review this case as a potential instance of policyholder rights violation, as no wilful misrepresentation occurred.

I am attaching the following documents for your review.

1. Pre-Anaesthetic Assessment Form(with clerical error)
2. Official Clarification Letter from Apollo Hospitals
3. Primary Doctor's Consultation Summary
4. MRI report
5. Care Health Policy Copy(Paid 3 terms around 43k per year)
6. Rejection letter from Care Health
7. Policy Termination Letter