Oriental Insurance Company — Reimbursement

Address:

New Delhi, Delhi

Dear Sir/Madam I wish to complain about my health insurance policy of policy no:- 272101/48/2016/241 that I purchased on April 2003. Insured's Name:- Mr.Deepak Bhalla Insured's Code:- 4487549 I am complaining because i was told that I will get the amount of my medi claim through insurance company or TPA. I was admitted twice in hospital . Once in april 2015 and then may 2015. Firstly i was told i can claim through cashless facility and need not to submit any amount which was later paid by us only to the hospital. I submitted my file to oriental insurance kalkaji office for my april 2015 claim with all the releveant documents. I was told that i will get the paymet within 2weeks. Which again was never done. My new policy started from 8th may 2015 for which i was told the same like before . It never got the approval from t.p.a as of gap of 8 days in the policy The gap was due to techincal issue in 2012 and was not told to us by the agent. The amount for april 2015 claim was Rs.47, 911. And new cycle policy claim for may 2015 was Rs.1, 00, 000. To resolve this problem I would like you to kindly provide us or the t.p.a break condonation letter. When I first learned of this problem, I contacted Mr.Gulshan Jurani who is our agent and who is of no use. He told us to contact insurance company development officer Mr.K.C.Pandey. I submitted my april 2015 claim file to him and i was assured of geeting tge payment within 2 weeks. Later on we were told that nothing could be done about my problem. I believe that this response is unfair. I would like a written statement explaining your company's position and what you will do about my complaint. I look forward to hearing from you as soon as possible to resolve this problem. If I do not hear from you within 5 days I will file complaints with the appropriate consumer agencies and consider my legal alternatives. I am enclosing copies of my receipt. I may be contacted at the above address and phone number. Sincerely, Dr.Deepak Bhalla Mob:- +91-[protected]