Oriental Insurance Company — Claim No. [protected]. Under Policy No. 121700/48/2014/13621

Address:

Mumbai City, Maharashtra

I have submitted the claim under the above policy on 26th Dec. 2014. FIVE MONTHS ARE OVER – STILL THEY ARE NOT SETTLING MY CLAIM. Since 1st week of March 2015, I am following with the TPA for settlement for my claim. They always said there is no requirement pending from our side. They are simply waiting for the Divisional Office to take necessary action. Initially they were telling that the DO Clarification for uninterrupted coverage is awaited. Claim will be settled only if the Divisional office gives the clarification regarding uninterrupted continuity of coverage. On 29th April we were told by TPA that the DO clarification for continuation is received but file is closed. So TPA have sent mail to Divisional office to permit TPA to reopen the file. Today more than five months are over from date of submission of claim, I am going from pillar to post but there is no hope of claim settlement. My neighbour who is from New India Assurance Co. Ltd. informed me to approach YOU and thus this letter. He said as per Law within 30 days I am entitled to receive and TPA is liable to settle my claim. If we are late in payment of premium by even ONE Day, They refuse to renew the insurance – if they renew they renew with break - interruption and now when we are asking for claim they are sending us from pillar to post. I demand delayed payment panelty from them as they have failed miserably in dealng with the claim and have harressed us. Everytime we approached them they were waiting for some or the other communication from division. !! Are there No Rules guiding the divisional office to reply within prescribed time ? I request you to please look in to the matter So atleast others will not suffer like me. Thanking you, Sincerely yours, SOHIL SHAH.