The New India Assurance Co. Ltd. — Late payment of mediclaim & unwarranted deduction from claim amount.More over award of ombudsman not implemented.

 
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 BHUPENDRA CHHABILADAS SHAH
BHUPENDRA C SHAH
M-5-4-28, Shastrinagar
Naranpura
AHMEDABAD - 380063
Date: 26/12/2008
Phone:[protected]R)
[protected](M)
REGD. A. D.[protected]O)
District Consumer Disputes Redressal Forum
Behind Bhagvati Complex
Mahalaxmi, Paldi
AHMEDABAD-380007

Respected Sir,
Re.: Grievance against
(1) The New India Assurance Co. Ltd (Sri Sheikh, Dy. Manager
Dr. J H Rushat, Chief Manager, Sri H K Vajpaee, Representative)
For Part Payment of Mediclaim & non payment of Interest for delayed
Payment. Policy No 120700/34/08/12/000000/49 of year 2008-09
(2) Insurance Ombudsman (Respected Sri Amitabh)
for making mockery of justice in Hearing and non compliance to my
grievance letters

Sir, I beg your permission to represent my first grievance against The New India Assurance Co. Ltd, Laldarwaja, Ahmedabad - 380001 and second grievance against Insurance Ombudsman through you Office.

(A) Grievance against The New India Assurance Co. Ltd, Laldarwaja, Ahmedabad - 380001
I am a member of LIC MEDICLAIM GROUP INSURANCE POLICY With The New India Assurance Co. Ltd. Premium is deducted from my salary and paid to Insurance Co. through my
Employer.
On12/08/2008 I submitted Claim Forms for Rs. 74799/- with relevant documents but only.
on 23/10/2008 I received discharge voucher for Rs. 73919/- without assigning any reason for part reimbursement as against claim of Rs. 74799/-. I submitted the same voucher duly signed and completed on 23/10/2008 but I received cheque of Rs.73919/-.only on 31/10/2008 at 5.25 p.m. (after office hours)
Thus, I received only part reimbursement which is short by Rs.880/- than claim amount of Rs. 74799/- after inordinate delay of 81 days without penal interest @ 18% p.a.
More over on 10/03/2009 I had submitted my letter showing conditional acceptance of the AWARD for payment of late fee (Interest) issued by Insurance Ombudsman to following address. Neither received payment of interest nor any reply from them:
Chief Regional Manager,
New India Assurance Co. Ltd,
Ahmedabad Regional Office,
Popular House, 5th Floor, Ashram Road
Ahmedabad-380009

Kindly resolve my grievance as detailed above and mentioned in Page No (2)


……………….. (2)
(2)

(1) Reply to my communications pertaining to mediclaim which includes

(i)….E-mail dated 2/11/2008 sent to e-mail aronia@wilnetonline.net (Sri Sheikh)
(ii)….E-mail dated 11/11/2008 sent to e-mail id jh.rushat@newindia.co.in (Dr. J H Rushat)
(iii)… Grievance letter dated 12/11/2008 sent by Regd. A D Post to Sri N C Parmar, Manager
(Now Sri Sheikh, Dy. Manager)
(iv)… Regd. Letter dated 12/11/2008 to Dr. J H Rushat, Chief Manager, Handling Grievance
Cell at H O, The New India Assurance Co. Ltd, 87. M G Road, Fort, Mumbai-400001.
(v)… Letter of award submitted on 10/03/2009 to Chief Regional Manager.

(2) Immediate reimbursement of Rs 880/- being short reimbursement along with penal interest
@ 18% p.a. from 12/08/2008 to date of reimbursement of Rs.880/-

(3) Immediate payment of penal interest of Rs.2953/- @ 18 % p.a. for 81 days on Rs.73919/-

(4) Immediate payment of Rs.5000/- towards the cost of case being taken up against The
New India Assurance Co. Ltd .which includes expenses towards Postage, drafting, Printing and Mental Stress/Harassment I am suffering since 12/08/2008 for non compliance of my grievance.

Sir, kindly make use of your good office and arrange to resolve my grievances at the earliest and arrange for payment as detailed below:

(2) SHORTFALL IN PAYMENT[protected][protected]-- RS. 880/-
(3) INTEREST FOR LATE PAYMENT OF RS.73919/[protected] RS.2953/-
(4) COST OF CASE.TAKEN UP[protected][protected]--RS.5000/-
TOTAL AMOUNT[protected][protected][protected]RS.8833/-

(B) Grievance against Insurance Ombudsman (Respected Sri Amitabh)
As per Provisions of IRDA Guidelines I Approached Insurance Ombudsman on 29/12/2008
for redressal of Grievance but the hearing was conducted with bias back ground. Justice was not
done to me. Award (Xerox Copy Enclosed) was given only for payment of interest for late payment but without mentioning rate of interest and period. I had been informed to approach other forum/court. Respected Sri Amitabh, Insurance ombudsman also not responded so far to my letters dated 04/02/2009 and 09/03/2009 (Xerox Copies enclosed for ref.).

Thanking you in anticipation of your kind co-operation in the matter.

Encl.: (1) Claim Form dated 12/8/08 (Two Sides) YOURS SINCERELY,
(2) Voucher F/W letter dated 24/10/2008
(3) E-mail dated 2/11/2008 to Dy. Manager
(4) E-mail dated 11/11/2008 to Chief Manager (B C SHAH)
(5) Grievance letter dated 12/11/2008 to Dy. Manager ASSTT. SECRETARY
(6) Grievance letter dated 12/11/2008 to Chief Manager AUDIT CENTRE, AHMEDABAD
(7) Letter of award submitted on 10/03/2009 to Chief Regional Manager
(8) Letter dated 04/02/2009 to Insurance ombudsman
(9) Letter dated 09/03/2009 to Insurance ombudsman
Complaint comments  19 Comments     Updated: Share0Tweet0Share0

Comments

New India Assurance — claim of my insurance amount

dear sir,
i purchased a nokia mobile 2300 model (invoice no 37730).on 07.08.2004 from arun watch company(yusuf sarai, new delhi)This was insured by National insurance company ltd(n/a 1934970).subsequently i gifted this mobile to my nephew. this mobile got lost in 2005 feb in Guwahati;and F.I.R was lodged there but the copy of F.I.R reaced not within 15 days to me in delhi due to postal deptt negligence.i filed for the claim almost after one month.and submitted my FIR copy along with that. But till date i have not heard any thing from the company.

The New India Assurance Co. Ltd. — claim on health insurance

RE IMBURSMENT AGAINST MEDICLAIM POLICY NO 353501/34/08/11/00000138.
PERIOD OF INSURANCE -14.5.08 to 13.5.09
DATE OF SURGERY 31.010.08
WE HAVE WRITTEN MY TIMES FOR REIMBURSEMENT.
BUT COMPANY IS NOT GIVING CLAIM
Dear

under my policy no 112500/34/07/11/00011041, member id bn1221663, insured name Rajesh kumar sinha, has made a claim in respect of vijeta sinha (wife), claim ref no: [protected](RakshaTPA) to agent code 834/89066, i have made a calim, but i could not understand about my late payment . I have tried so many time but every time i get assurance for next two days will be to settle

Can i know what is actual status and when i get chaque


Regards
R.K.sinha
Dear Sir/Madam

I require some help regarding claim. When i got policy i didnot have knowledge of last year claim so i got "no claim benefit" in my current year policy.

Now i got some accident in my car, BUT COMPANY IS NOT GIVING CLAIM



Please clarify

Regards,
Narendra Chauhan
Mobile No. [protected]
Policy no.:321100/31/08/01/00003428
To
The Proper authority H.O.
THE NEW INDIA ASSURANCE CO. LTD. Date22.7.09
87, Mahatma Gandhi Road
Mumbai – 71101


Sub.-
Your Grievance No – GC/HO/HODT/29/0352/2008
Date – 16/09/2008
Case – Status of your enquiry

Re – Our Mediclaim Policy No – 512202/34/08/0000 1562 issuing office P-4, Dobson Lane (4th floor) Howrah-711 01, Branch- 512202 and my previous policy No- 512202/34/07/20/00001767


Dear Sir,

As per the referred grievance no. – GC/HO/HODT/29/0352/2008 you have enquired about RO/DO/BO and have assured that you shall revert back soon. Since then, after passing of 10 months I have not received any response from you. Regarding this issue I called up your Howrah zonal office. But your officer over there asked me to contact Mumbai office where I lodged my complaint and literally misbehaved and disconnected my call.

I am really sorry to say that I felt extremely insulted and I ‘m willing to know whether this is the manner that personnel from branch office behaves with any client/ customer.

I‘ll be obliged if you kindly say me the fact that when I’m receiving the enquiry report and also inform me whether I‘ll make the renewal on 25.07.09 (Policy No – 512202/34/08/[protected]


With Best Regards



Abhijit Kar


C.C. -
The Grievance cell
THE NEW INDIA ASSURANCE CO. LTD.
4, Mangoe Lane (1st Floor)
Kolkata – 700 001

The Deputy Manager
THE NEW INDIA ASSURANCE CO. LTD.
4, Mangoe Lane (1st Floor)
Kolkata – 700 001

newindiainsurance — payment of claim nor give properly & in time

hello sir,
i buy new hundai i1o in may & I insurrance from new india company. then after in july we family member visit out of city & we have face accident at gandhinagar at 9th july at 11 at night so we call our car emmergency services for car toiing, in accident our car damage from 3 wheel & excel & some other part so we call sevice center & they toing our car & say all toing charge (1800 rs. ) by insurance company & we give for repairing then after all serveour visit our car for ready insurance company say all plastic metiral & tyre charge we will give 50 % & company charge to us for per type Rs. 3500 /- so total 10, 500 rs. & we have to bare 50 % so we buy tyre from market from company authorised dealer in rs. 2, 750 so as comapy rate we save 750 per tyre total 2, 250 & we save insurance company's 1125 Rs. but when all finalise payment they are pass only 2600 per tyre so that is not good. we ask him if we take tyre from compay in that case how many rs you pass they answer as there invoice (10, 500 Rs.) that is totaly chiting with us & after finishing work company ask us for scrap meterial you have to submeet to us so we bare 400 rs. chare for auto for damage part transport then the ask we have no interested for scrap & they cut 600 rs. extra from our payment for scrap metiral so scrap is for us 1000 rs. & we lose 1000 extra total we pay 37500 rs. including toing & company ready to give 28, 000 only & car compay charge us for toing 1800 Rs. & Insurance comapy give us only 1000 rs. & some other parts charge truely pay from insurance compay but he berden to us so we cant setishfied from new india insurance company & we change company from next year & main problem is that AFTER ALL WHEN WE GO FOR PAYMENT HIS ANSWER IS SO UNBELIVABLE WE CANT PAYMENT TO YOU AT THIS TIME BECAUSE WE HAVE NO FUND WHEN HAVE FUND WE PAY TO YOU THAT IS NOT GOOD & LONG LASTING COMPANY'S ANSWER SO GIVE ME GOOD RESPONCE
dear sir,


plz send as detail of mediclaim incurece polisy
Respected Sir,
Under my policy No:-221502/34/09/11/00000674, insured Name Chirag Dilipkumar Soni, has made a claim in respect of myself, claim to agent code 484/58858, i have made a claim but i could not understand about my late payment. I have tried so many time but everytime i get assurance for next week will be settle.
Can i know what is actual status and when i get cheque.pl infrom me at my postal address below: Soni Chirag Dilipkumar
40, Vrundavan Nagar-2
Bamroli Road, Godhra-389001
Panchmahal- Dist, Gujarat

The New India Assurance Co. Ltd. — Non payment of claim

Sir,
My Po. No. 130600/34/07/11/00018214 health policy of new india . I have sub. Claim dt.10/12/2008 of Rs.41622/- sett. Rs.26625/-dt 18/08/2008 till dt. vipul tpa issue only query cant set. my claim

Sampada
How to transfer the insurance for Martuti omini. & how much day transfer to 2nd owner.

The New India Assurance Co. Ltd / Mediclaim — I am not getting my mediclaim policy claim cheque since oct,2009

Subject: I am not geting my mediclaim policy claim cheque since oct,2009



Dear Sir,



My self Dilip Kalathiya, I have Mediclaim Policy of "The New India Assurance Co. Ltd" since 2001.

Policy No.: 210400/34/08/11/00020706, Policy Period: 27/03/2009 To 26/03/2010



In Last Oct,2009 my father had cataract in one eye and he Made operation

I have submited all the documents, bills and all that things whatever their criteria and demands.



My Claim No.: 883801 in EMEDITEK.



But problem is that I made many call at company but I didnt got proper answer and I didnt got my

Claim cheque also.



I am requesting you, Please guide me what can I do for it.



Please do needful as soon as posible



Thanks,



Regards'

Dilip Kalathiya

Mob: [protected]
Dear sir my father had a assurance company make a policy no is[protected] but we dint get any mony till now why can u tell me
December 17, 2010

The Manger - Grievance Cell
The New India Assurance Co. Ltd.
5th Floor, Jeevan Bharti Building
Connaught Circus
New Delhi-110 001


Sub: Hospitalization Benefit Policy No. 310904/34/08/11/00001688–Reimbursement of treatment charges pending since March, 09.
Reg: CLAIM IDS– 33680/33950.



Sir,

I am covered under the Hospital Benefit Policy of New India Assurance Co. Ltd. cited above. I have submitted my reimbursement claims to your office.

A period of more than Ten Months has passed but no amount has been reimbursed to me from my above Claim IDs. It has become very difficult for me to spend on further treatment. I have made many telephonic requests to TPA Safeway for reimbursement of the amount but of no avail.

I was admitted in Sir Ganga Ram Hospital on 25th May, 2010 where my kidney transplant was done. I was discharged on 7th June, 2010. At the time of discharge I was advised by Doctors that for about six months I should take complete rest and not to go out side thatswhy I could not contact them after little recovered I started contact them but no avail copy of discharge summary enclosed for your ready reference.

I am a poor person was working as a clerk in a private company. However, on my falling ill and since admission I am almost out of the job and living on the help of my sister and other relatives. I had taken loan for my treatment. The people from whom I had taken loan in distress are asking for repayment. I am now in very embarrassing situation and looking for your help only.

I am under the cover of Mediclaim policy of your company since 2002. Please pay me with 12% interest.




I shall always be thankful to you for your this kindness.

I have submitted my reimbursement claims to your office as under:

1. Letter dated 11.03.2010 Claim for Rs. 10, 630.00
2. Letter dated 20.03.2010 Claim for Rs. 32, 100.00
3. Letter dated 15.05.2010 Claim for Rs. 3, 040.00
[protected]
Total Rs. 45, 707.00
========

Thanking you,

Yours faithfully,





KISHAN KANT
Dear sirs,
my Joint mediclaim policy no.330502/34/09/11/00000101 on account of Satish Solanki.Iam not received my mrs Smt.Shobha Solanki operation claim dated 05.10.2010.all document submitted on 05.10.2010 in company.
Do needful.
Satish Solanki
The Chairman,
The New India Assurance Co. Ltd.
87, Mahatma Gandhi Road, Fort,
Mumbai 400001.

ARREST CORRUPTION .

Sub :-- Intentional Delay in settling Motor claim.
Policy No. :-[protected].
Claim No. :- 2484.

Dear Sir,
A claim against above policy was lodged with RO-I New Delhi on 17/08/2011 for a sum of Rs. 12000/-. The claim No. is 2484 .

The dealing assistant Mr. HARBINDER SINGH is sitting on the claim and inspite of repeated requests refuses to settle the claim unless he is gratified with money. Complaint to his officer has also proved to be of no avail .

Your intervention is requested to take action against the erring official .

Thanking you,

Yours Sincerely,

R N Kapil,

M No.[protected].[protected].
Mediclaim - Claim free health checkup

submitted claim in september 2011

Bilmar T Dourado
Policy[protected]
Mob [protected]
I had submitted my claim for the hospital expenses for my son in May 2012. On persistent follow up with your Chennai office, I was informed that the claim has been processed and cheque has been despatched to my residential address on 24the November 2012. The computation sheet has been sent on my e-mail id. However, even after nearly a month, I have not received the said cheque. Why is the re so much delay in receiving the cheque. Besides, to get someone to talk to on telephone is so difficult, because theere is no prompt receiving of the call and the call just gets transeferred to one person or the other, or they ask me to contact the Bangalore office or the Mumbai office. There is no such problem from us when we make the payment. The payment is promptly paid and the insurance company does not have to go through so much ordeal to get the premium. Then why do we face so much trouble when it comes to getting our claim amount.

Janata Mediclaim Policy — Eye Operation

Card No [protected]A policy no[protected] Name Mrs Tara Devi Agarwal . Policy under The New India Assurance Co Ltd. Doom Dooma Branch. Valid up to 30.03.2013 We Submit the document in the company on 22.12.2012. we are not received claim amount till today.

The New India Assurance Co. Ltd. — Regardind Reject claim.

Dear Sir, P. No.[protected]. I am holding mediclaim policy since 11 years of The New India Assurance Co. Ltd. I had been hospitalization claim after 11 years for Hypertension. M D India rejected claim. Please check this matter. Thanks and regards, Pramod Koramkar Nagpur [protected]

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    The New India Assurance Co. Ltd. - Late payment of mediclaim & unwarranted deduction from claim amount.More over award of ombudsman not implemented.