Jain International Organisation [JIO] — can I raise this complaint in consumer court against jain international organisation.

Address:	400092
Website:	jiojac.com

Dear sir,

My name is sachin pravin kamdar and i am associated with jain international organization (Jio) since 2014 when they introduced their group mediclaim policies for jain shravaks. I have continuously paid my premiums for jio mediclaim phase -1 and never defaulted on any renewals.

At the time when i had taken jio mediclaim phase -1 in 2014 i also had oriental insurance of my parents going on simultaneously. I had continued both the mediclaim policies that are jio mediclaim and oriental insurance company mediclaim for 2 years.

Then i discontinued my oriental insurance company and went along with jio mediclaim policy phase -1 as it was difficult for me to continue both policies as premiums were increasing year by year.

Jio mediclaim policy was doing well and i had submitted some claims and it got passed after some standard deductions.in a way i was satisfied with the jio mediclaim service.

Then on 16/10/2016, there was renewal of my mediclaim policy and i paid the premium through the credit card for which i have the acknowledgement.
Then on 20/12/2016 my wife delivered a baby boy. As my wife was under maternity cover in the mediclaim policy, i had send the jio team mail intimating them about the delivery, but to my surprise they told me that still the tpa (Third party administrator) had still not been finalized by the jio group team in spite of me paying the renewal premium on time.

They gave me assurance on the mail and on telephone that the tpa would be finalized soon and my claim would be taken care of and so i waited for a positive reply from the jio management.

I used to get the same reply from them whenever i use to enquire about the mediclaim policy status and that soon the tpa would be finalized and my claim would be passed.

Then again on 03/03/2017 my mother was hospitalized and she had been in icu (Intensive care unit) for many days as her health was critical. I again approached the jio team intimating about the admission of my mother in hospital. They again told me that the tpa had still not been finalized and they cannot help me out in this matter.

I was really shocked and surprised to receive such reply from a reputed organization such as jio whom we trusted so much and they did not help us when it was needed the most. They told us that they would refund the amount if i want, but i told them that i am associated with jio since phase -1 and how come they cannot finalize a tpa for so long. They must have come to a deal with the tpa first then only they should have requested us to pay the renewal premium. Now all of a sudden they are saying that they cannot help us. I questioned them that how come you take such an important issue of mediclaim so lightly and do not finalise a tpa for so many months and even did not bother to inform us that the tpa has still not been finalized. It was then when i came to know about it when i had called them about intimating them about my wife’s hospitalization. Then too the jio team gave assurances that the tpa would be finalized soon and my claim would be passed. We pay our premiums to the jio shravak arogyam and so it was their duty and liability to get the mediclaim for the associated person. I am not able to understand how come they were not able to finalize another tpa at that time and it took them six months to find another tpa. I am sure that there would be many people like me who would have taken mediclaim policy and would have been left stranded and helpless for six months just because they could not find another tpa and neither did they inform us about it. Why did they did not think of a back-up plan if such an adverse situation had arised? I think they are solely responsible for our pain and agony.
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I closed all my previous mediclaim policies and only relied on jio because i felt it has been done for the purpose of betterment of all jains but to my shock and surprise it was not the case and i was left stranded to helpless to fight the situation.

I had sent repeated mails and even call them many times and i received the reply saying that they had filed a case against the tpa which was finalized at that time and they are waiting for their judgment.

In july 2017 also they had taken a meeting to resolve the issues of jain members like us who had a jio policy and their claims could not be paid off. They took the details of all the things i have mentioned in the letter and also assured me that they would look into the matter on urgent basis. I insisted them to give me acknowledgement of the matter i had discussed with them and that i had met them but they just took my phone number and email id and said they would call me once my case is under process.

So again time passed by and no proper answer was been received from them. Now after waiting for so long and suffering so much pain and agony i am left with no option but to file a case in consumer court.

My mother is no more and i had paid the hospital bills through credit card loan. I had to go though lot of tension and agony at that time. At the time when my mom was last hospitalized i had asked some financial help from our community as we had paid a lot of bills through credit cards and asking help from relatives, we were really going through bad times as financially we were weak as my mom was on dialysis and we had already paid a lot in hospitalization `they did provide us with financial help of rs 50, 000/- for only dialysis procedure. But before we could use them my mom passed away.in this case one could realize how we were managing financially and how badly we needed the claims to be passed.

The total money that i paid for bills of my wife and mother are as follows.

Hospital name bill date bill amount patient’s name

1. Nalini maternity and surgical home 22/12/[protected]. 00 priti sachin kamdar
2. Shreeji kripa surgical centre 03/03/[protected]. 00 meena. P. Kamdar
3. Sterling hospital 14/03/[protected]. 00 meena. P. Kamdar
4. Sterliing hospital 27/03/[protected]. 00 meena. P. Kamdar
5. Medical bills/other check-up cost 80000. 00 meena. P. Kamdar

Total amount 486163. 00

For medicines and other check up costs the amount spend was about another 80000 rs i have the bills for that. I want to claim the total money amount of rs 486163. 00 (Four lakhs eighty six thousand one hundred sixty three only)
I will provide all the relevant documents required for the case to be filed in consumer court.

I have already lodged an online consumer complaint against jio shravak arogyam as i did not received a reply from you for my e-mails. The docket number for my online complaint is 990946.

I would request you to help me with this matter and help me pass my claims, i am left with no other option but to go one step ahead and file a proper written complaint with you against this organization. I can provide you with all relevant documents.

They have troubled innocent and hard working people like us in the name of jain gurudev shri naypadmasagarji maharajsaab

I have waited too long for help and justice from their side but now i cannot wait any more. So i am looking to get proper justice from you.

Regards


Sachin kamdar – [protected]