Vipul Medcorp Complaints & Reviews

I have submitted claim form with all the original bills and discharge summary report through courier. They took 1 week for reviewing and approving the submitted claim form. after that frequently am following up past 2 weeks for getting money. Simply they are diverting one person to another and they are not giving proper response. i feel like Vipul Medcorp is very worst in customer services and also claim procedures.

Worst service with worst experience being a patient yourself you have to have for 6 hours for discharge they say they dont have this bill that bill other things ###.
Never trust this fraud companies they are ## sitting there advertisement and when its time to sell their insurance they are so sweet and after that when we need claim see their true faces and even not whole thing is cashless
In the name of cashless they ask for security amoumt which is refundable they say after a hard day your security amount is also deducted alot .
Fraudsters i just want to say

I had submitted my claim of delivery for partial payment in february. They raised queries and asked for documents and i provided the same to them in march and now it is june. The claim is not yet settled even when the documents are submitted to them.

Claim File No:20RB01OIA3343
Not getting claim due to irrelevant query.
I called customer care as soon as I got message if query in my claim. The customer representative talked rudely & was not ready to listen me. He said you need to submit proper bill with segregated charge. I told him that it was cataract surgery it's mentioned in the final bill breakup. But he was adamant & was not ready to.listen.
PS: Don't make customer to beg for claim as it's their hard earned money which they invested in your policy. Please don't put a genuine cases on hold. You will loose by your customers only by doing this

Dear sir

It is very unfortunate that my experience with tpa vipul at max hospital has been horrible. My spouse (Mrs. Deepa) was admitted at max hospital vaishali - ghaziabad on 28.11.2019. Cashless day care hysterectomy was already approved on 27.11.2019.

And the procedure was done by dr. Sushma dikhit on 28.11.2019. But at the time of final settlement, tpa denied full claim.
Patient mrs. Deepa was admitted in hospital at around 7 am on 28.11.2019, procedure was done thereafter. At around 5pm, hospital sent the documents like discharge summary and the final settlement to tpa. Tpa denied it fully and i was compelled to pay the hospital bill on my own. At night in max hospital don't have any choice left.
In a situation where i am paying premium every year wef 2012, i felt cheated. This was the first time i have claimed to tpa which was rejected very causally, without any query or any logical explanation. While initially at the time of approval they had clarified each and everything with doctor about their query. I want to know why they were in such a hurry to deny my claim. Is this a right practice by company where a customer is harassed. So consider this matter as my grievance.

Now it’s my humble request to review the matter as earliest as possible. My file no. Is 20cb01uih1825.

If my problem is not resolved even after sending this email, i will be force to take strict action and approach the consumer forum.

Hoping for a positive response.

Thanks & regards

Sir,
My file no.19rb01uij4369, i have submitted claim bill for rs, 7301.00 but it is surprised to know that it has been passed with only rs.4554.00.
Can i know where the amount has been deducted? For what reason it has been deducted? While the bill was submitted well in time and it was perfectly submitted as per the prescription as always it has been passed by your office without any deduction.
Kindly give me the proper reason for that and also credit the rest amount in my account as soon as possible.
Thanks.
Harinderpal singh teja.
Punjab & sind bank.
H03868.

Insurance company is not providing proper response:
Claim type - :maternity
Date[protected]Baby girl)
Card no : [protected]
Claim file number :19rb07uiq0055

See below the last internal discussion of company where i was cc, its seems company employee is totally responsible for delay..

From: [protected]@vipulmedcorp.com [mailto:[protected]@vipulmedcorp.com]
Sent: tuesday, january 8, 2019 7:02 am
To: somaiah ns
Cc: [protected]@vipulmedcorp.com; smita kumari ; vinod ; mohd lathifudeen
Subject: re: claim file number 19rb07uiq0055card no : [protected]

Dear sir,

We will update the status by tomorrow end of the day with out fail.

Thanks & regards,
Harish. L. R
Assistant manager - corporate service
Vipul medcorp insurancetpa pvt. Ltd.
Address : no 110, 4th floor, k. H. Road,
Sudahama nagar, next to suzuki show
Room, bangalore - 560027
Mobile no - [protected]
Log on to: www.vipulmedcorp.com

Respected sir

Myself rajesh kumar patnaik i claimed my wife barsharani patnaik medical bill its card number is [protected] all document received in d date 18/08/2018

Whats problem going on i dont know more days didnt work in my file we r suffering more problem from dis

So i requested to u kindly refer my file as soon as possible
Thanking you

Policy number [protected]p[protected]file no 19cb01uia3297-i was bleeding through stool continuously since 30/07/2018. I am 81 year old senior citizen shocked to seen the continuous blood and black stool four to five time on the same day. When i consult dr jaskaran at fortis hospital, upon review of ongoing bleeding and my situation he recommend to get immediate admission and start medication. Fortis hospital has immediately started the medicine through oral and through fluid in vains. I am still bleeding till 01/08/2018 morning. They have done number of test to ruleout the reason for the same and send the case for cashless approval.

But to my surprise you have deny to provide cashless approval on the ground of some exclusion 4.10 and raised some baseless queries which was duly respond by the hospital that admission is unavoidable (Copy of letter enclosed). Despite that regular response and justification, your team has rejected the cashless and force me to pay the money. Please let me know how a poor old man will get the money to pay hospital despite having valid medical insurance.

Since i have no money to pay to hospital and you have deny to pay cash less, i am in extreme tension.

My son tried to convey this number of time to your team and request to connect some senior person but you have not connected him.

If i die or suffer any heart attack just due to your un-human cruel rejection, the vipul medcorp is responsible for everything happen to me.

Again requesting you to kindly approve the cashless for a tension free day in this old age or suggest to finish the story of life in this hospital just because of vipul medcorp.

Thanks

Aeshwar prasad jain

My i d number is [protected].

Metro hospital tpa desk send pre approval request to concern persons at 10:58 am today and tat is maximum 3 hours but not getting any response after more than 6:30 hours even done many follow ups through calls to customer care executive's and sending many mails to concerns personal.... Excilated matter to higher authority also.
And now customer care phones also not pick up.

My patient still in hospital... Please guide what's the legal processor for further action.

Regards,
Reetesh agarwal
[protected]

Vipul Medcorp have been stalling to provide claim. I had asked them to claim for a 73 year old patient at 12.30 p.m. And had not recieved information about the claim till I called them at 5.30 p.m., then they sent an enquiry mail at 5.40 p.m. to Max Devki Devi Hospital in New Delhi, where the patient had been admitted.
It is 7.30 now but I haven't recieved my consent of the claim. The patient is not being able to get discharge since 7 hours and the employees are the least cooperative.

Vipul medi corp rejected post claim by saying doctor degree was bams.

Reason of hospitlization: maternity

There is no any rule mentioned on there website
http://www.vipulmedcorp.com

While intimation i told doctor name/degree.
There is no such rule clearly mentioned to reject hospital claim of bams doctor, if this is the case then bams doctor should not get the licence/hospital id/registration no.

There is no such rule mentioned on
Rule no 9 in irda circuler and the indian medical council act.
-"recognised medical qualification" means any of the medical qualifications included in the schedules.

I submitted all documents including

1.Discharge form
2.Hospital total bill
3.Breakup bill
4. Medical reports
5. Medical bills with subscriptions.
6.Pre and post hospitalization charges.
7.Filled claim form, having doctor sign and hospital stamp with registration number of hospital

Mentioned bams doctor has hospital id, registration number and its own maternity hospital which is very famous in baramati area, there are very few hospital in baramati who having master doctors.
Hospital name itself is maternity hospital. Admission taken in this hospital in emergency situation.

Please help me to get claim pass

Under policy no : 361601/46/15/[protected] fileno 16rb01naa7924.Vipul medi corp rejected cliam by saying doctor degree was bams.
Reason of hospitlization: maternity.
Doctor degree : bams
Claim amount: 45000/

There is no any rule mentioned on there website
http://www.vipulmedcorp.com

While intimation i told doctor name/degree. Please help me to pass the claim.

There is no such rule clearly mentioned to reject bams doctor, if this is the case then bams doctor should not get the licence/hospital id/registration no.

References:
Irda circuler given on http://www.vipulmedcorp.com

Rule no 9 in irda circuler...
9. Hospital
A hospital means any institution established for in- patient care and day care
Treatment o f sickness and / or injuries and which has been registered as a hospital with
The local authorities, wherever applicable, and is under the supervision o f a registered
And qualified medical practitioner and must comply with all minimum criteria as
Under:
- has at least 10 inpatient beds, in those towns having a population o f less than
10, 00, 000 and 15 inpatient beds in all other places;
- has qualified nursing staf[censored]nder its employment round the clock;
- has qualified medical practitioner (S) in charge round the clock;
- has a fully equipped operation theatre o f its own where surgical procedures are
Carried out
- maintains daily records o f patients and will make these accessible to the insurance
Company’s authorized personnel.


The indian medical council act

http://www.mciindia.org/actsandamendments/themedicalcouncilact1956.Aspx

21 : 1. The council shall cause to be maintained in the prescribed manner a register of medical practitioners to be known as the indian medical register, which shall contain the names of all persons who are for the time being enrolled on any state medical register and who possess any of the recognised medical qualifications

2: h. "recognised medical qualification" means any of the medical qualifications included in the schedules.


Please help me to pass the claim.

Vipul Medicorp is health insurer in my family for last 7 years. In total we were paying approximately 24K in the Two years back my father was hospitalized for which claim were made( approx Rs 20000). Post that in same year my father has to go hopitalization again in Dec(claim amount Rs 90000) but again the case is kept pending with unnecessary questions.Post even providing the answers the case is been pending.
In Januray 2012 we raised it in the grievance cell and still there is no response.


See the mail sent .

I would strongly recommend that nobody should take such policies and keep on paying premium thinking that they have insurance cover.


Regards
Tarun B Agrawal
[protected][protected][protected][protected][protected][protected][protected][pr...⇄
Sir/Madam,

This is to bring to your notice, that we are yet to receive any response of the grievance # C01B01GR4922, which was raised by Mr. Sanket on Jan 3, 2012.

Just to give a brief of the case, our claim 11RB05NAF0390 and 12RB05NAF0170, got rejected even after duly follow by our agent, Mr. Sanket.

We were in hope to receive our claim in due time as we had submitted all our documents at the time of intimation. Also, there was one instance when there was a requirement of additional document (alcoholic history), which were also provided in due time.

However, after long period, lot of confusion and assurances from our agent's end, we inquired with Vipul itself. Then we came to know that queries were raised on our claim, but we were not in receipt of any of the query, electronically or hard copy or of any form. And due to which the case has been closed.

To address this issue, we raised a grievance for your perusal six months back. However, there has been no reply for the same. Even we reminded Ms. Khushi of your team couple of times, but of no usage.

The case has long been pending and require your urgent intervention.

Looking forward for an early reply.

[protected][protected][protected][protected][protected][protected][protected][pr...⇄


[protected] Forwarded message[protected]
From: SANKET MEHRA <[protected]@gmail.com>
Date: Tue, Apr 10, 2012 at 12:09 PM
Subject: Fwd: Public Grievance Intimation Code : C01B01GR4922
To: khushi <[protected]@vipulmedcorp.com>




[protected] Forwarded message[protected]
From: SANKET MEHRA <[protected]@gmail.com>
Date: Wed, Mar 21, 2012 at 8:52 AM
Subject: Re: Public Grievance Intimation Code : C01B01GR4922
To: "Khushi Grievance Dept. HO" <[protected]@vipulmedcorp.com>


D/ALL

i have mailed all the required document asked by you on 8th of march 2012 to mr. santosh shukla and crcm id , please find

best regards
sanket mehra


On Fri, Jan 20, 2012 at 1:59 PM, Khushi Grievance Dept. HO <[protected]@vipulmedcorp.com> wrote:

Dear Sir,

We have received a online grievance regarding the rejected claim , Kindly arrange to send the xerox documents of the same.


Thanks & Regards,
Khushi
Grievance Dept.
Vipul MedCorp TPA Pvt. Ltd.

----- Original Message -----
From: Vipul MedCorp
To: [protected]@vipulmedcorp.com
Cc: [protected]@vipulmedcorp.com
Sent: Tuesday, January 03, 2012 8:51 AM
Subject: Public Grievance Intimation Code : C01B01GR4922

Dear Concern,

The Above Subject grievances has been intimated through web site with the following details:

Policy Number: 461406/48/08/[protected]
Name: sanket mehra
Phone Number:
Email ID : [protected]@gmail.com
Address : national insurance co. ltd. branch II delhi gate
State & City :agra( uttarpradesh )
Description :i would like to tell u that the file no. 11rb05naf0390 is being closed due to query reply is not recived , but i have send the query reply to ur t.p.a (1) i have provide u a ipd record of the hospital and alcholic history of the patent which was required for this file

Thank You,

Services-Systems Dept.
Vipul MedCorp TPA Pvt Ltd.

[protected][protected][protected][protected][protected][protected][protected][pr...⇄

I work for vcustomer pune.I met with an accidet on 13th jully and broke my leg,then after i had two major operation. I claimed the hospitals bills by the company insurance.the company hr. lost the orignal documents now its more than 4 months i have been taking the folloup from the hr. they also told me to resumbit the xerox for all the documents,I did so but there is no response from there end.i do have acknowlwgement mail that the hr. has recived the documents.

Please help me out in getting my money from the insurance company.(vipulmedicops)

I had a horrible experiance with Vipul Medcorp...... at the time of payment these guys gave us a tough time...when we send them the bills after hospitalisation.... some they gave pethetic customer service.... we send them documents through 3 fax numbers and through mail as well.... but every time they gave a new excuse that they have not received the document... than documents under process and all.... will not recommend this company to any one.....

Sir,

Please refer below mentioned mail Histroy and kindly provide necessary suggestions to company.

Thanks

Amit Sharma






Hi,

Please se below mentioned mail history and kindly look into issue and resolve it ASAP.


Thanks On behalf of Ramesh Lalchand Sharma

Amit Sharma




[protected][protected][protected][protected]
From: Sharma, Amit
Sent: Monday, August 10, 2009 11:10 AM
To: 'pooja'
Cc: 'Richa '
Subject: RE: Public Grievance Intimation Code : C01B01GR1543
Importance: High



Hi team,

This my third mail .please provide me details ASAP.

Also there is one more claim for bypass surgery which I did not received any acknowledgement.Please provide the same.


Thanks



[protected][protected][protected][protected]
From: Sharma, Amit
Sent: Tuesday, August 04, 2009 1:26 AM
To: 'pooja'
Cc: 'Richa '
Subject: RE: Public Grievance Intimation Code : C01B01GR1543


Hi Team,

Any Updates on below mentioned mail.

Kindly provide the details ASAP.
Also there is one more claim for bypass surgery which I did not received any acknowledgement.Please provide the same.


Thanks





[protected][protected][protected][protected]
From: pooja [mailto:[protected]@vipulmedcorp.com]
Sent: Thursday, July 30, 2009 5:34 AM
To: Sharma, Amit
Cc: Richa
Subject: Re: Public Grievance Intimation Code : C01B01GR1543


Richa Madam,

Kindly look into the matter and resolve it...

Regd

Grievance Dept.
Vipul MedCorp TPA Pvt Ltd.
Gurgaon

----- Original Message -----
From: Sharma, Amit
To: pooja
Cc: Richa
Sent: Thursday, July 30, 2009 2:55 PM
Subject: RE: Public Grievance Intimation Code : C01B01GR1543


Hi

All the related documents are been couriered on 15th July 2009 for below mentioned query.Please confirm.

KINDLY PROVIDE US PAST HISTORY WITH EXACT DURATION OF HTN/DM/ANGINA/IHD OR ANY OTHER RELEVENT DISEASE, SEND INFORMATION FROM TREATING DOCTOR.

Also there is one more claim for bypass surgery which I did not received any acknowledgement.Please provide the same.

Thanks On behalf of Ramesh Lalchand Sharma

Amit Sharma





[protected][protected][protected][protected]
From: pooja [mailto:[protected]@vipulmedcorp.com]
Sent: Thursday, July 30, 2009 5:16 AM
To: Sharma, Amit
Cc: Richa
Subject: Re: Public Grievance Intimation Code : C01B01GR1543


Sir,

We received your claim file in our jaipur office and your claim is in query.Our Doctor wants to know durance of following:
Kindly find below the query:and sent us reply after than we can process your claim as per terms and condition.

IN CONTINUATION OF PREVIOUS QUERY REPLY BY YOU STILL WE HAVE NOT RECD.THE FOLLOWING INFORMATION-KINDLY PROVIDE US PAST HISTORY WITH EXACT DURATION OF HTN/DM/ANGINA/IHD OR ANY OTHER RELEVENT DISEASE, SEND INFORMATION FROM TREATING DOCTOR.
Regd

Grievance Dept.
Vipul MedCorp TPA Pvt Ltd.
Gurgaon

----- Original Message -----
From: Sharma, Amit
To: pooja
Sent: Thursday, July 30, 2009 2:44 PM
Subject: RE: Public Grievance Intimation Code : C01B01GR1543


Hi,

As per your below mentioned mail i got the renewal policy details from our agent Bank of Rajestan .Would request you kindly update same on my account .

Also request you please provide details of claim which are still pending at your end and all the required documents are couriered by me on 15th July 2009

through DTDC.


Thanks On behalf of Ramesh Lalchand Sharma

Amit Sharma






[protected][protected][protected][protected]
From: pooja [mailto:[protected]@vipulmedcorp.com]
Sent: Wednesday, July 29, 2009 6:54 AM
To: Sharma, Amit
Subject: Fw: Public Grievance Intimation Code : C01B01GR1543


Sir,

We receive your grievance mail regarding the detail of policy after renewal.Kindly contact your Insurance company regarding the further information bcoz as per our system your policy expiry at dated 13 June 09 and still we didn't receive policy copy after renewal.

Regd

Grievance Dept.
Vipul MedCorp TPA Pvt Ltd.
Gurgaon

----- Original Message -----
From: Vipul MedCorp
To: [protected]@vipulmedcorp.com
Cc: [protected]@vipulmedcorp.com
Sent: Wednesday, July 29, 2009 3:57 PM
Subject: Public Grievance Intimation Code : C01B01GR1543


Dear Concern,

The Above Subject grievances has been intimated through web site with the following details:

Policy Number: 140400/48/08/41/00001085
Name: MR. RAMESH LAL CHAND SHARMA
Phone Number: [protected]
Email ID : [protected]@StateStreet.com
Address : H.NO. 54, LODHA BHAWAN,
State & City :MALEGAON, DISTT-NASIK
Description :Hi team, Kinldy provide renewal policy details for which i had already intimated.Also request you please provide details for second claim dated 17th July 2009. Thanks On behalf of Ramesh Lalchand Sharma Amit Sharma

Thank You,

Services-Systems Dept.
Vipul MedCorp TPA Pvt Ltd.