Family Health Plan [FHPL] Complaints & Reviews

Sir, we have done investigation before admitting only but simply by telling only admitted for investigations the claim has been rejected pls do needful

Hi,

I have submitted Medical Claim ID: 3460565 for my dependent . But the Claim got rejected stating the reason as "Rejected due to not submitting the mandatory document. Even after multiple follow up (more than 2 months) still I could not find out what is the mandatory document which they are expecting.

Kindly help me to sort this issue.

Fhpl taking 10 to 15 days to update in custmer portal. Why it's happening idont know. Fhpl taking toomuch time.If want good relation all brokers don't business to fhpl

Hi,
My documents received on 23/10/2021
Still not received credit it takes how much time for credit process. Please clarify...
Employee id-S34521
Claim ref.no-3529453

I have requested for maternity coverage for my delivery. But the claim was rejected considering as it's 3rd pregnancy. 1st - miscarriage happened during 1st trimister on 2014 and this was considered as baby born and claim has rejected and 2nd delivery happened on 2016 and 3rd delivery 2021.

I wasn't not utilized maternity insurance and but claim was rejected considering 3rd kids but given baby birth only 2. I'm applying only...

We are trying to raise a claim and calling the mobile numbers provided on the ID cards, both the numbers are not responding. Called Toll free, they said they can't respond by phone to my question and asked me to send out an email. I have sent an email and then follow ups but no one answered yet.

This type of service in Insurance sector is not at all expected. I definitely will not go with any insurer whose TPA is FHPL.

I had submitted all the required bills to process the disallowed amounts against my claim # 3350581 on 04-Aug-2021. Till today i have not got any response from any one. The Grievance team is not helpful even after writing to them 2 times. They just copy paste a generic template as reply.

With your reference of grievance stated its has claim id 3429501 was under process and did not respond properly by concern FHPL TPA at the early stage.

At present the concern authority from FHPL TPA had contacted me and discuss the settlement details and then he had shared the Claim settlement voucher through via Email and assured be send the payment details after issued by SBI insurer

We request to disposal...

BA NO 11203392 UB AROGYADAN. I hadsent a claim to sardar patel road address of good health tpa. Before sendinfg, I contacted Family Health TPA and as they me to send the clain to Good Health as my ADMISSION TO HOSPITAL WAS 06/06/21. Now THEY HAVE SENT ME A MAIL TO ME STATING THAT I BELONG TO FAMILY HEALTH, BUT THEY HAVE NOT RETURNED THE ORIGINAL DOCUMENTS.

PLEASE ADVISE ME WHAT I SHOULD DO
REGARDS
RAJENDRAN

I have requested for claim process and it's been more than 20days and I have still not got the amount credited to my account

uhid no .13762341
Ubid no.14643091
Uhid no.3404923

CLAIM ID. - 1546846
Policy no - [protected]-01
Member id - SBIG.[protected]
PF ID -1260197

This is to inform you that my father Mr. Hemanta Kumar Chattopadhyay applied for cashless facility as we were not prepared for DSA. ( ANGIOGRAM) which is not an investigation, it's a mandatory requirement for him as per MRI report.
He was supposed to get admitted at FORTIS HOSPITAL, BANNERGHATTA by today...

My claim was submitted in 13th july 2021 they told 15 working days will settle till date i am contacted call center more than 20 mints not connecting get disconnect also sending mails but getting reply standard format within 2 working days will revert and sending ticket number but after that no response very worst claims processing by fhpl team
uhid nic 19812190
intimation id 1070493...

My wife was diagnosed with UTI infection in her 6th week of pregnancy, so was admitted for antibiotics and blood transfusion. Total bill came was around 1 lakh 30 thousand. But they only cleared 50k saying that's maternity limit.

But as per policy benefits of Insurer, it’s clearly mentioned “INR 50, 000 for Normal Delivery and INR 60, 000 for C-Section” under maternity limit, there is nothing mentioned like "illness diagnosed during pregnancy will be treated under this cap".

I raised this claim in March 2021, but after regular followup they didnt provide me with correct information where it's mentioned that cap limit for illness is covered under maternity.
They just responded UTI is "very common in pregnancy",
but these guys dont't know i guess that UTI do happens to non pregnant women as well.

Now because of some complications, we went for abortion which costed us nearly 40k. Again they rejected my claim saying maternity limit has been exhausted.

They disallowed my total amount of 1 Lakh giving this ### excuse.

I never thought FHPL will turn out to be such a big fraud, they just want to irritate there CUSTOMERs for months and later find a reason how they can skip from paying claimed amount.

Claim ID: 3252617

Claim Id is not generated
Hi Sir,

Please note i have submitted the claim documents for Akhila S ( UHID - Q[protected], Newborn Baby Male B/o Akhila T I(UHID - Q[protected], Newborn Baby Male B/o Akhila T II (UHID - Q[protected] .

I have submitted the respective documents for Newborn Baby Male B/o Akhila T I(UHID - Q[protected], Newborn Baby Male B/o Akhila T II (UHID - Q[protected] for PARTIAL...

I have submitted for mediclaim reimburesemnet on 12thjuly and send all original documents to FHPL Kolkata office it was reached on 15.07.21 and its show in tracking its reach on 15.07.21 . But when i cll to fhpl office to find out my application status to they respond very irresponsibly and said first it was not reached and when i confirm with the courier agent and same as the tracking report its shows it was deliververd on 15.07.21 and when i cll back to intimate them they said jab hoga tab karenge na this was the response from fhpl staff his name is mr.Arnab ray (sr.manager) in fhpl kolkata branch very irresponsible and .request to kindly take againsgt him and clear my cliam

Did not receive insurance coverage for post covid diseases citing random reasons. I need justice. We have been cheated by saying we would be given cashless facility but none given.

Hi Team,
My mother was admitted in hospital during - 08/03/2021 to 17/03/2021 for treatment of Breathlessness and Cough - pneumonia.

We have requested for reimbursement as part of corporate insurance, but the insurance company is requesting for Indoor Case Papers which the hospital is not ready to provide.
Instead they are willing to co-operate if any representative from insurance company approaches them.
Since we couldn't provide the documents, the claim has been closed.
It's painful to have an insurance and not be able to reimburse the money. Requesting you to kindly look into this.

Worst customer service i have ever seen.

They asked me for missing documents. i uploaded it in FHPL portal and also sent email to [protected]@fhpl.net, but no response yet. its going on since 22nd June 2021 and today is 22 July 2021.

Even today I spoke to the FHPL customer care representative (Shyam singh). Even he is not providing any information. Anything I ask, he is just saying, “I have escalated sir and they will get back to you in 2 days”. I asked him for escalation channel, which he don’t have. I asked for SPOC assigned to Dell EMC, he don’t have information about it. I asked him to transfer call to him manager, he says he cant do that. I don’t know for what we are calling to FHPL customer care. Another amazing thing is that the call wont get connected before 15 to 25 min, after waiting for so long these are the responses I get from them.

This is not just once, every time I call them its the same.

There is only one email ID for any issues, that is [protected]@fhpl.net. apart from sending automated emails, which never responds to your email.

I don’t know for what they have SLA of 2 days, but till today no one from FHPL has called and solved my issue.

Member ID : 21451460
Claim no.: [protected]

I have have already submitted the document “[protected]@fhpl.net”
Why he was disallowed2077 amount. mail Of 6 june 2021 at 7:03AM .for your reference again it was attached.
But again mail to the fhpl but there is no responce
Claim ID: [protected]/1
Patient Name Sanjay Martandrao Mahajan Main Member Name Sanjay Martandrao Mahajan
Uhid No OIC41218853 Main Member Uhid No OIC41218853
Age 34
Diagnosis COVID 19, Billed Amount 13990, Settled Amount 11763

Disallowence Reason 2077.00 No Details for receipt date 24/04/21,

Dear sir, Please settle my disallowed amount in to account
Regards,
Sanjay Mahajan

FHPL Customer service is the worst thing..plz do not opt for FHPL..You life will become miserable.
Had a tuff time get the claims..Still suffering.and yet to get the claim.

They have not picked the call even once..It will keep giving waiting numbers and when turm will come they will disconnect.
[protected]