Jain International Organisation [JIO] Complaints & Reviews

Hi,

I am trying to fill in the details for payment but the website is showing server down. After 2 days you people will say that we have to take fresh policy, why we have to suffer due to your incapabilities. If you want any more details I have screenshot of the same for your reference. We also called claim department ( since no one is receiving the calls on customer care number) regarding other query the lady on the call said we cannot answer you now. What kind of service behaviour is this.
It’s a request don’t cheat is by using the name jain in your organisation.

I the Policy Holder Mittal Shashikant shah have Health Insurance Policy from JIO through Universal Sampo and TPA Ericson Insurance TPA Ltd via Policy no. - 2839/62191478 / 00/000 with certificate no. 62191478 / 00283 dated 31st Oct 2020 got expired on 30th Oct 2021 which i couldnot able to renew and was under impression that will get 1month grace period to renew the policy which other Insurance across industry does.
Being your existing policy holder request to please renew my this policy will make the online payment immediately. I have other 4 family members also covered under this policy.
Please do the needful and appreciate your positive revert on this

Thanks & Regards
Mittal Shah

Claim No - 181249

The claim is not getting passed as Ericson team is saying there is no proof of intimation.
My question to JITO -JIO & Ericson is how the claim number was generated? If you need proof then?
The fact is intimation was done by hospital on very first day however it got denied as cashless was not fitting in our policy. Ericson told to submit physical documents to their Bangalore office via courier. We did immediately.

Now, second claim ID was created. And now the team is asking for 2nd intimation claim, which I don't have as we had physically couriered the documents. All senior management from Ericson were on mail plus all the details were submitted. Ericson employee reached out over phone for accumulating all details. However, multiple mails are received for not providing claim intimation for 2nd claim ID? Ericson team & JITO jio team are not helping me out & are replying you have summitted documents delayed.

Is it consumer fault for creating 2 claim IDs for 1 patient?? Out of 2, 1st got denied & now the team is asking intimation proof for 2nd??

Dear sir/madam
My name is Bhaumik Bhupendrabhai Teli. My claim # 164064 claim reimbursement and claim is 4 months old. We are 5 time renew our policy but this time claim my mother admitted in hospital. And till date not received my claim refund.
Pl. Reply

Image.gifDear JIO team,

Just a month back ago Jio fiber supporting person came and request me for taking the jio fiber and also promised me two months of free services,
But I have received only one month of free service and when I reach out to that employee where is month another free trial he told me that SORRY we can't, then no response. The number of that person is-[protected] (Name-Masud branch-Dunlop Kolkata, Mail ID-masud.[protected]@ril.com)

Request to jio marketing doesn't give fake promises to the customer.

Claim ID 160296

Name Laukik Shah

Folowing for last 3 months but unfortunate reply ask about basic details only. Please look into matter

Dear sir,
Claim ID 137827 & 137826
My parents resides from Raipur whereas I am settled in Jagdalpur. My parents were severely affected by covid in addition to that my entire family including children who were 9 & 4 years old were also affected by covid. During that time Jagdalpur was under lockdown and Raipur was worsely affected by covid. Forced by the situation, I had to urgently go to Raipur to get my parents admmited. After a lot of hustle we finally managed to get 2 beds at Shree Narayana Hospital. After two days when situation was little bit under control we intimated hospitalization of my parents on your toll free number in 17/4/2021.
My claim was rejected just because i was'nt able to apply for claim under 48 hours which is a very short span of time. It was rejected just because I was a day late, you can't even imagine the pressure I was going through at the time this is not a reason enough to reject the claim.
Medical insurance is done so that it helps in case of medical emergency. Being a jain we chose JIO but we are not getting proper response and also company had sufficient time to investigate the matter.Many times we tried to reach to JIO to resolve the issue over countless mails but there was no proper response from your side.
Please raise the issue as we were depended on the claim to settle for our needs.
Please do the needful

My Claim Id-140030, My Dad had been admitted to hospital for covid-19 treatment.
i had submitted my documents on e-mail within the time frame of 30days.
Ericsson TPA didn't even notify that the claim was on hold. After enquiry and lots of email i came to know it was on hold and they require Hard copy.
On submission of Hard copy i had to take the follow up for the same where i came to know the claim was rejected due to late submission.
Please raise the issue as we were depended on the claim to settle for our needs.
Please do the needfull

Dear sir,
i am sorry to inform you that
we have not submitted claim document time limit 30 days. Due to covid-19 pandemic. My douther is effective in covid -19
also lock-down is our area
so request approved my claim no.150074 card id 1050215 name of jayantilal k morabia rs.11772.

Ericsson insurance tpa pvt ltd. Status report rejected and also shawn approved amount rs.11772. What is different rejected & approved amount rs.11772. Please release my claim amount rs.11772

With a very heavy hearth I am putting it across that despite being a Jain I am compelled to force to put complete negative feedback with this pathetic organisation.
These people are extremely least bothered to reply to their claimants and their seniors are just enojoying their salaries.
They have nothing to do with their claimants' claims, their prolonged statuses, etc etc.
They are simply behind collecting their renewal premiums and busy in flashing up fake posters or ads to implicate the new ones.

This is in reference to my mediclaim no. 152239 availing a cashless facility for the procedure of Angio Brain. Before the admission i would have atleast called 4-5 times to confirm whether the procedure is covered under my policy or not, which was confirmed that its covered by the ERICSON TPA Call center executives. Later on I did mail them for getting the confirmation to my surprise till date there has been no revert on the same. On the day of admission in the hospital I had availed for cashless facility as the hospital was under the list. After availing the cashless faciltiy i had been waiting from morning till evening for the confirmation of aproval and had been calling the Ericson TPA repeatedly. But till 5pm there was no aproval rather the TPA raised about 6 queries to the hospital which was replied to them by the hospital. Till 8pm i had been waiting for the approval and was lingering to choose what category of treatment shall be availed. Moreover with the ongoing situation of COVID19 we did not wanted to risk ourselves by staying in the hospital for the next day. So I wish to avail the reimburse facility which i did inform the TPA. the next day i get a rejection note from the TPA towards my claim. Moreover the feedback from the hospital regarding JIO Insurance was also not so great and they had very well informed that the company will surely not settle your claim which did actually happen. The policy document also shows that Angiogram is covered than why such rejection. Moreover I have been repeated mailing the greivance cell but they have yet not even bothered to reply or acknowledge my complaint. I think its the most hopeless insurance and fooling customers.

I id is [protected].my mobile no is [protected].claime no is 133362.m praful prakash sancheti. My jiojac patients name is chidambara praful sancheti. Claime not settle still date.giving reason to submission for late documents. In covid situation some dalay from submissions of documents. Plz help me for settle my claime.

. 140414 कमला देवी पाली (राज.)
मैंने 4-5- 2021 को आपको हॉस्पिटल के बिल रिपोर्ट एवं सारे डॉक्यूमेंट मेल द्वारा भेज दिए थे। मेरे परिवार में मै पॉजिटिव था। इस कारण से ओरिजिनल डॉक्यूमेंट आपको कुरियर करवाने में सक्षम नहीं थे।
हम सब कोरंटाईन होने के कारण आपके पेपर नहीं भेज पाऐ थे अभी मै और परिवार स्वस्थ होने पर आज तारीख[protected] को सारे डाक्यूमेंट्स DINLAND कोरिअर सर्विस पाली से ERICSON TPA चेंबूर मुंबई में कोरियर कर दिए हैं। कृपया करके मेरे क्लेम को ओपन कर मुझे क्लेम का भुगतान शीघ्र किया जाए।
मेरी कोरोना रिपोर्ट मेल के साथ अटैचमेंट है और कोरियर की रसिद भी आपको पीडीएफ फाइल भेज रहे हैं अतः हमारा क्लेम शीघ्र ही निस्तारण करें। मुझे पुरा विश्वास है कि आप मेरा क्लेम का शीघ्र भुगतान करेंगे
धन्यवाद सुरेश कुमार लुकड़ [protected]

यह मेल मैंने इरिक्सन टीपीए कंपनी को[protected] को किया था। उस समय पूरा भारत बंद था बाहर आना-जाना बिल्कुल बंद था यहां तक की सारे कोरियर वाले भी बंद थे। और मैं पॉजिटिव भी था इसलिए मैंने सारे डॉक्यूमेंट 4-5-2021मेल द्वारा भेज दिए थे और बाद में सारे पेपर मैंने कोरियर से भेज दिए थे फिर भी कंपनी मेरे क्लेम को रिजेक्शन के लिए आगे भेजा है अतः आपसे निवेदन है कि मेरे क्लेम को रिओपन कर उसका शीघ्र ही निस्तारण करवावे

और कंपनी द्वारा क्लेम सेटेलमेंट 8-10 महीने लगाती हैं यह भी उचित नहीं है अतः आप कंपनी वालों को कहे कि 1 महीने के अंदर ही क्लेम सेटेलमेंट करें जिसे किसी भाई को परेशानी ना हो

My JIO JAC ID is[protected]. Please send me the health insurance policy. As I am going to raise complaint against Ericsson TPA in Consumer forum for not setting the claim after 2 months and more than 50% deduction.

Sanjay Jain...

I have taken family flotter group health insurance policy for this year. My mother (Pushpa Jain) was hospitalized from 18/04/2021 to 21/04/2021 at Bombay hospital Indore. I have submitted all relevant documents on 27/04/2021. Claim ID was 140016. My claim amount was RS 38721/- . Claim was passed on 29/05/2021 for Rs. 18989/-. Yet refund is not received till today i.e. 15/06/2021.
More than 50% deducted with no justified reason.
I saw such huge deduction first time in last 20 years with other insurance companies.
Please resolve my issue or refund my money as I do not want to continue with such hopeless policy.
Sanjay Jain
[protected]

Http://www.jiojac.com/HELP

Respected,

With reference to above subject writing this email on behalf of Senior citizen Mrs. Rekha Shevantilal Shah (Age 73) for availing justice. Following are facts for your consideration and necessary action :

Mrs. Rekha Shevantilal Shah is group policy holder under Master policy holder Jain International Organisation since October 2016.Mrs. Rekha Shevantilal Shah (She) is renewing this group insurance policy regularly for all family members.She has taken Super Top Policy since 2018 of 10 lac with 5 lac deductible.Her[protected] renewed master policy number is 839/61175480/00/000 (Policy Document is attached for your reference)Her[protected] renewed Certificate number is 61175480/13715 Risk Commencement date 01/04/2020 Risk End Date : 31/03/2021.Her[protected] renewed master policy number is 2816/59774327/00/000 (Policy Document is attached for your reference)Her[protected] renewed policy Certificate number is [protected]/04578Risk Commencement date :01/04/2019Risk End date : 31/03/2019.

Claim Status about Cataract Operation for Mrs. Rekha Shevantilal Shah :

First correspondence done on 08 March, 2021 from email [protected]@gmail.com to [protected]@ericsontpa.com with cc to [protected]@ericsontpa.com for understanding eligibility of Cataract operation.Reply came only from 6 [protected]@ericsontpa.com on March 09, 2021 at 11.07 AM which was confirming eligibility of Rs.25000. (Actually mail was written to [protected]@ericson.comThere was no reply from [protected]@ericsontpa.com and this is the place where they created a miss direction to client Mrs. Rekha Shah.Client sent Thank you for confirmation mail on 11 March at 08.06 PM to [protected]@ericsontpa.com even though [protected]@ericsontpa.com was in cc and this is how Ericson TPA miss lead client Mrs. Rekha Shah.On March 17 at 10.55 AM one more mail was sent to 6saal mail id for knowing documentation process for cataract operation claim.6saal replied to this mail with list of required documents for processing claim and this reply came on March 17, 2021 at 11.45 AMOne more query done by client Mrs. Rekha Shah on March 22, 2021 to [protected]@ericsontpa.com about one more policy of 10 Lac which she is having. This time mail was sent only to 6saal mail id as she was receiving reply only from this mail id.She again got reply from 6saal mail id confirming eligibility of Rs.25000 for cataract operation on March 22, 2021.On March 24, 2021 at 1220 PM intimation email was sent to [protected]@ericson.com with subject line "Claim intimation of JioJac i'd [protected] with 2 attachment of documents.Operation was scheduled on March 25, 2021.On March 24, 2021 at 12.25 PM same claim intimation was sent to jio.[protected]@edelweissfin.comOn March 24, 2021 at 12.26 PM reply came from jio.[protected]@edelweissfin.com with confirmation of intimation and ticket number 1435337On March 25, 2021 at 1007 AM one mare email sent to [protected]@ericsontpa.com for getting claim intimation number.On 26 March, 2021 at 0157 PM mail sent to [protected]@ericsontpa.com about claim documents sent to their address through courier as per requirement.On April 01, 2021 at 0115 PM followup mail was sent on [protected]@ericsontpa.com to check claim paper status sent through courier. There was no reply from Ericson TPA.On April 02, 2021 at 0223 PM one more followup sent to check receipt of the courier which was carrying claim documents but there was no revert on this from Ericson TPA.On April 07, 2021 at 1230 Edelweissfin.com team members came into picture and received mail which was marked to [protected]@ericsontpa.com with cc to Mrs. Rekha Shah.On April 07, 2021 at 0251 PM there was reply from [protected]@ericsontpa.com (Which was not in picture at all) to jio.[protected]@edeweissfin.com with Cc to Client Mrs. Rekha Shah stating Claim intimation number 132506.On April 07, 2021 at 11.16 PM mail sent by Client Mrs. Rekha Shah asking confirmation of receipt of claim documents by reply to all mail to 6saal and edelweissfin.On April 07, 2021 at 11.20 PM there was automated acknowledgement mail from edelweissfin.comOn April 08, 2021 at 12.02 PM mail came from 6saal asking courier details to confirm receipt of claim documents.On April 08, 2021 at 02.10 PM mail sent by client Mrs. Rekha Shah stating that she spoke to customer care and they confirm receipt of documents. (It is surprising to note inhouse people are not aware)On April 08, 2021 at 02.15 PM received automated acknowledgement mail from edelweissfin.comOn April 08, 2021 at 05.16 PM mail came from 6saal to client as well as edelweissfin asking once again about courier details which is surprising as there was mail sent by client at 02.10 PM stating confirmation from customer care about courier. (Once again showing lithaginess of 6saal team)On April 08, 2021 at 10.17 PM Client sent reply to mail with courier receipt to avoid further arguments.On April 09, 2021 at 1246 PM mail received from 6saal stating attachment is not opening.On April 09, 2021 at 03.42 PM again mail sent by client to 6saal with attachment of courier receipt with cc to edelweissfinOn April 09, 2021 at 0540 PM mail came from 6saal with the same remark that attachment is not opening.On April 09, 2021 at 0718 PM replied by client with attachment in JPG format which was receipt of courier.On April 10, 2021 at 1136 AM mail received from 6saal stating that claim documents not received.(Surprising is Customer care is saying courier received)On April 10, 2021 at 01.29 PM client sent an email with attachment of courier acknowledgement which was showing courier reached on 27 April, 2021. (Total mismanagement by EricsonTPA. Very irresponsible behaviour).On April 10, 2021 at 0404 PM mail came from 6saal confirming receipt of claim documents as there was no scope to lie now because proof was sent by client.On April 14, 2021 at 0352 PM once again client sent Pan card, Aadhar card and 2021 policy documents as per demand by claim department.On April 14, 2021 at 0540 PM email from 6saal demanding documents in PDF. Last time they demanded JPG.On April 14, 2021 at 0836 PM client sent email of all documents once again in PDF file.On April 15, 2021 at 1137 AM mail from 6 saal gave confirmation of all documents and forwarded to concern people.On April 16, 2021 at 0544 PM again mail came demanding different policy details than what we claimed as well as same documents demanded which was sent to them on mail one day before.On April 16 at 0937 PM client sent all documents once again with all Health Card of current as well as past policies.On April 19 at 1231 PM email received from 6saal stating claim is under process.On April 20 at 0520 PM email came from 6saal demanding to share all documents in single PDF format. Client is a senior citizen and not tech savvy but took help and sent all documents again.On April 20 at 0724 PM client sent mail to 6saal where she mentioned about repeated demand of same or different documents but not settling claim even after one month. in this case she will approach IRDA for justice.April 21 at 1130 AM once again email from 6saal demanding one PDF of all documents which was really very disappointing.April 21 at 1143 AM client again sent all documents in PDF.April 23 at 0123 PM followup mail sent to 6saal to know status of claim by Client.April 26 at 0139 PM one more followup mail sent to 6saal for claim settlement April 29 at 1016 AM client sent mail to 6saal for checking claim status. All the time edelweissfin was in cc.April 29 at 1035 email of claim rejection sent by 6saal with reason that Cataract operation is not covered in first year of policy. (Actually policy has continued for the last 5 years)April 30 at 1010 PM email sent by client to 6saal that this claim is registered under base policy which has been running for the last 5 years and not super top policy.Again and again correspondence is done to 6saal, edelweissfin but they are not processing the claim so finally we are writing all the above facts to get justice.

Some of our observations :

Claim process is given by edelweissfin and we followed the same by client but they tried to create confusion by sending email through different mail id like [protected]@erisontpa.com ; jio.[protected]@edelweissfin.com and [protected]@ericsontpa.comClaim was registered under base policy but they are trying to show under Super Top Policy.It seems to be intent of rejecting genine claim by misleading client as well as JIO JAC organisation.This looks like a case of fraud by Broker as well as company.

Sincere Request :

Strict action and punishment need to be done for all involved with life time lessons so that customers should not suffer.Our claim with penalty of mental harassment of senior citizens to be charged to all responsible parties.

Claim ID: 116163
operation happened in jan 1st week. After that I applied for claim and since then it is in pending state. I have called them 1000 times and I have sent 100 mails but still there is no reply from there side.

I like jio SIM and I recharged of 599 rupees but it is showing renewal in 17 hours from last 3 days plz fix it.

I have taken group insurance of 6saal for my family in year of 2018.

My mother and father hospitalized on 23rd due to COVID19 infection and I have informed [protected]@ericsonTPA team and Jio.[protected]@edelweissfin.com, but when I called Jio Erision TPA team on 27th March as I am not getting any response from them they said forward email to [protected]@erictionTPA.com and I got intimation numbers for my parents.

I submitted all the required documents with claim form, they generated claim Ids.

Mother hopitalization claim id - 133145 and father 133156

They have asked me to submit doctore's prescription for investigation reports then I uploaded the same in Ericson TPA portal, emailed a soft copy as well as hard copy sent to them via post.

After few days they rejected my claim said, intimation not done within 48hrs, then I emailed and called then mutiple times they just saying waiting from Insurance approval and today they rejected my both claims.

It looks like a big scam and I am finding my self so helpless and do not know what to do further.
| hope you will investigate into this so that many persons like me can get some remedy.
If you need any details or information I can forward it to you

below are the policy and hospital detail.

Hospital Name: Mahavir hospital Dahod Gujarat.

Name - Santosh Saklecha

Policy No. - 2839/62271303/00/000

RMN-[protected]

UHID-USER 1667466

Age - 56

Name - Shantilal Saklecha

Policy No. - 2839/62271303/00/000

RMN-[protected]

UHID-USER 1667467

Age - 66

My jac id [protected]

i am pay the 1000 rs. for jac & 33100 rs. for insurance renewal premium on[protected] at 12.02

a.m. but till today i have not received a confirmation for premium or jac id.

so please check my details & give reply as soon as possible

thanks,

hemal mahendrabhai jariwal