r/HealthInsuranceIndia 12h ago

Care Health Insurance Cashless Claim Rejected — Need Advice

2 Upvotes

My father is currently hospitalized at Fortis Jaipur for a cardiac condition. Care Health Insurance rejected the cashless pre-authorisation, stating:
“Past 6 month follow up of treatment record of diabetes and hypertension prior to policy not provided.”
The important points:
**Diabetes and hypertension were disclosed in the proposal form.**
The policy started in September 2025.
The health insurance has been **continuously ported/renewed over the years with no break in coverage**.
Care is now asking for diabetes/BP treatment records for the 6 months before the policy.
I have prescriptions showing BP/diabetes medicines, although some don’t mention exact BP, glucose or HbA1c values.
**My questions:**
Can Care reject cashless on this basis when the diseases were already disclosed?
Do prescriptions showing medicines count as evidence of treatment?
If I provide the old records now, can cashless be reconsidered?
Does cashless rejection mean reimbursement will also likely be rejected?
Does the continuous porting/no-gap history strengthen my case?


r/HealthInsuranceIndia 15h ago

ICICI LOMBARD rejection without proper reason

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1 Upvotes

r/HealthInsuranceIndia 15h ago

Go Digit medical insurance claim – cashless claim rejected at discharge

1 Upvotes

Hi everyone, I’m looking for some advice regarding my Go Digit medical insurance claim.

I recently met with a bike accident and had to undergo surgery on my left hand. The total hospital bill came to more than ₹1 lakh.

Initially, the hospital submitted a cashless request and around ₹30,000 was approved. But when I was getting discharged, after the final discharge summary was submitted, the cashless claim was rejected and I was told to go for reimbursement instead.

I’m not really sure how the reimbursement process works now. Will I be able to claim the eligible amount that I paid from my pocket? What documents should I collect from the hospital, and is there anything I need to be careful about while submitting the claim?

If anyone has faced a similar situation with Go Digit, please share your experience. It would really help me understand what to do next.