To: GRO@careinsurance.com; cc: resolve1@careinsurance.com To, The Grievance Redressal Officer Care Health Insurance Limited Vipul Tech Square, Tower C, 3rd Floor, Golf Course Road, Sector-43, Gurugram - 122009 Date: [DD-MM-YYYY] Subject: Grievance against [rejection / partial settlement / cashless denial / delay] of claim no. [____] under policy no. [____] Sir or Madam, 1. Policyholder: [name], [mobile], [registered email]. Insured patient: [name], customer ID [____]. 2. Policy: [product name], policy no. [____], period [from] to [to], sum insured Rs. [____]. 3. Claim: claim no. [____], hospital [name, city], admitted [date], discharged [date], amount claimed Rs. [____]. 4. Earlier complaint: I complained to Care Health customer care on [date] (complaint no. [____]) [and to resolve1@careinsurance.com on [date]]. [No resolution has been received / The reply dated [date] is not acceptable because ____.] 5. Care Health's decision: [rejected on [date] citing clause ____ / paid Rs. ____ of Rs. ____ / cashless request sent at [time] on [date] was denied or not answered]. 6. Why the decision is wrong: [explain in 3 to 6 lines with facts and the policy clause]. [If rejected for documents or late intimation:] IRDAI's Master Circular on Protection of Policyholders' Interests, 2024 says no claim shall be rejected or closed for want of documents or for delayed intimation. [If part-paid:] Please give the policy clause for each deduction, as IRDAI's Master Circular on Health Insurance Business, 2024 requires. 7. Relief sought: [settle the claim for Rs. ____ / pay the balance Rs. ____ / reconsider the claim on merits], with interest as admissible. Please acknowledge this grievance and resolve it within 14 days, as stated on Care Health's grievance page. If it is not resolved, I will approach IRDAI (Bima Bharosa) and the Insurance Ombudsman. Enclosures: policy copy; claim form; rejection or settlement letter; discharge summary and bills; earlier complaint and complaint number; KYC. [Signature] [Name]