Family Health Plan [FHPL] Complaints & Reviews

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

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, itâs clearly mentioned âINR 50, 000 for Normal Delivery and INR 60, 000 for C-Sectionâ 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

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]

P.A. No.- 1519269

The team working on my cashless claim was not proactive in processing the claim and highly inefficient. They stated reasons such as resource constraint and the obvious fact that my claim isn't the only one they were working on. Highly unprofessional behaviour which could lead to stress and anxiety for my patient who waited patiently for 9 hrs to get discharged! Will the TPA company compensate for any further hospitalization due to unnecessary exposure of patient in the hospital beyond the required time??

My mother affected covid 19 +ve so I called customer care and informed there is no bed is available in the hospital, they told me start the treatment in the day-care later u can reimbursement ur bills so I did accordingly. Now applied for reimbursement and it is rejected reason provide me is outpatient treatment wont covered for reimbursement.
Initially they told reimbursement is applicable for day care once treatment completed I was applied reimbursement they are replied outpatient is not covered in my policy.
Why they are playing like this.kindly provide me solutions.

Dear Sir/ Madam,

This is to bring you notice that in savings account got debited Rs.3593/- on Date:[protected]. From the day till now I am coordinating with home branch I am not getting any support.. hence request you your support / advice resolve this grievance.please credited to my account back that money.

I don't get any proper response from the FHPL. Even after submitting hard/original documents in March 2020 yet my claim is not settled. On multiple occasion FHPL asked me soft copies and even after giving those they don't respond. Imagine the work they are doing...
Fileno/Claim No
[protected]/1

Actually fhpl done a fraud policy of person as i suffering from same kind of situation where nobody help us only give a time to us that they clear issue within 10 min 30 min 1 hour etc. Story is this that patient was admit at hospital on 1 may due to covid
And doct plan a Discharge to her on 3 may and the staff of tpa sent all bill to fhpl but till now they didn't approve i don't know why but i knows only one thing that i will spread only one to nation that don't take policy from fhpl Because they all are fraud and one more thing patient is crying and says that pls release her as she is fit and fine but the hospital staff didn't discharge her till the bill approval .

Third class company, don't take any insurance through this company, i[censored]r company have insurance through this don't use it.
From last two months I am waiting for claim settlement.
no one from fhpl is even response.

I am a employee of hdfc bank and i am admitted on 16 04 2021 on gaba hospital yamunagar .On that time portel not wroking
and approval not received from last five days .Hospital provide the details on mails that one patient is admitted and due to technical issue patient details nit updated in portel so that please provide the apprval on mail but after five days not a single response received from company side.I have call to care center but they also missguided me.Very worst service.

I am working on hdfc bank and I am admmited in gaba hospital yamuna NAGAR HARYANA since 16/04/2021
Now doctor discharge me.but on due to portel issue request not raised by hospital on 16/04/2021
And hospital provide the mail on [protected]@fhpl.net I'd but after two days approval not received .I am fed up because I am regulary call to call center and they not give any solution only said wait approval received on 2 hours .now hospital said if company not provide the approval you can pay the whole treatment amount in cash .

Hi team,

FHPL took almost 5 hours to approve the bills on discharge day.If we have to follow-up these many times with you, I would suggest My company to change our Insurance team.

It took whole day for us to get approval.Hospital has submitted claims at 2:30 and its 6 PM, amount is not approved.If you cant take the request on time and keep the patient waiting like this, its really hurtful.

On top of that, helplie is always busy, just waste of time.

Dear Team
The required document i.e correct medical report was produced at your end on[protected] It has been observed that no body is showing their interest regarding the same claim which I am following up from more than two month. Which is very harassment to me. Please look into the matter as soon as possible.

Thanks
Bharat daraji
[protected]

All phone numbers are just for display or do you people even respond anytime to the calls. Seriously you'll have to really think in what nature of business you are in. It's matter of life and death.

Hi .
I am repeated called for my claim status but not getting information from any one .
E code 29525
Dr reddys Hyderabad
[protected]