Jul 10, 2023 02:51 PM
4772 Views
(Updated Jul 10, 2023 09:59 PM)
Care Insurance is either pure fraud or it's run by a bunch of idiots. Let me explain.
I had policy for my parents that we got two years back, paid premiums on time plus paid extra for the pre-existing condition of hypertension. Last August she had Dengue for which we of course got the treatment and since it was in an out of network Hospital, we sought help from Care Insurance rep for claiming, he said it will be a reimbursement and asked us to provide the details and such for claims intimation, which we did and also sent the NEFT mandate form signed and stamped by the bank authorities, which they asked for. God's grace my mother was fine and had her discharged once the doctors gave a clean bill of health. Paid the bills, lab checks and medications out of pocket and submitted every single one of those with original documents signed and stamped by hospital. It was a nightmare from then on.
Months passed no settlement on our claim, it was of 40000+. When we enquired that's when the idiocy and thievery of care-less insurance comes. The first thing they asked for was past history of present ailment with 1st consultation paper & all past treatment records. Dengue for anyone with less than primary education or common sense knows that is not a prolonged ailment whose past history and records will be maintained. And we had to explain this to them. Still, they weren't satisfied, they asked for all the lab reports, bills and receipts, which we had already submitted to them. When we said we had given you those, they wanted the doctor's notes, my father got those from the hospital and submitted it. Then, they asked for nurse's notes again my father got them and submitted it. Yet the care-less idiots rejected our claim saying that we did not declare about my mother having diabetes.
By the way, my mother did not have diabetes and she still doesn't have it now. The doctors themselves had mentioned that blood sugar might have some fluctuations during Dengue, for which she was treated, the objection the care-less idiots had was that she was being treated for diabetes because she was given some medications that were for diabetes. My mother never had diabetes, at least to the level that required any medications or treatment, when we explained this to the idiots and told them that the blood sugar levels never crossed the levels that required treatment but my mother was taking some ayurvedic treatment as a preventative measure. By the way, even this ayurvedic preventative treatment was two years after we purchased the policy so there was no need or requirement to declare this as a pre-existing condition. We explained all this to them, so this time the idiots asked for yet another thing, the first consultation for the diabetes treatment(the preventative ayurvedic one) my father got that document signed and dated by the ayurvedic doctor stating the date of the first time my mother was prescribed the ayurvedic medication for diabetes.
After submitting every document they asked for, clarifying every objection and worst of all making my 67-year-old father go back and forth to the hospital 12 times asking a new document every time. They have now gone completely silent, they have not settled it nor rejected the claim. It will be a year in August 2023 since our claim. I have now sued them in the consumer court, I am sure I will get justice there, we have submitted every document they asked for clarified every objection, even gave the diabetes first consultation, which was two years after we purchased the policy. And now they are ghosting us. The only thing they "care" about is getting your money but when it comes to settlement and keeping their word they are not only care-less but make the process so hard and un-necessarily difficult that you give up and pursue the claim anymore.
I will not forget though, it's not about the claim anymore for me, I don't care about the 40 thousand, they made my retiree father jump through so many hoops asking for one single document on purpose every time. They could have asked for all the necessary documents at once, why just one every time, when we provide the one they asked for they want another new one. They made the claim for dengue into diabetes. God's grace my mother still doesn't have diabetes, even the check from last week shows she is well below any required treatment. So I have now sued these frauds, idiots and good-for-nothing thieves in consumer court, will update on the judgement, which I am sure I will get. After which I will leave no stone unturned to press fraud charges on them in criminal court. Any care-less idiots, don't ask for my policy or claim number, I am not giving you that you had your chance to fix this, now I will see you in court.
And here is the twist. my cousin's husband sold that policy to me, he works for Care. He himself admitted that they are the worst and he was the one who asked me to sue to get my claim. he said almost half of the customers who get their claim only get it after suing in consumer court. They are fond of listening to the judge scolding them and ordering them to pay it seems.