Oriental Insurance Company Complaints & Reviews

[protected]

Above is the claim number and already submitted all details. Rohtak insurance ppl saying clain stuck at delhi and delhi insurance saying we have already forwarded all data to rohtak long time back

I am following these ppl, nobody picks up the call and its difficult to coordinate at 2 places. Its should be their responsibilty to get it done

Sir

This is to inform you that I had taken a cashless policy from your company for my Maruti Swift Dzire Car No. HR51BB1318 vide Policy No. 211200/31/2018/73483- insured code 81538341 on 19/09/2017. I met with an accident on 16/2/2018 and the car was got repaired from Vipul Motors Pvt. Ltd. Faridabad after inspection of the car by your surveyor. The car was delivered to me by Vipul Motors on 28/02/2018 against cash payment. As asked by the surveyor I had sent a copy of cancelled cheque to him.

It is a matter of great regret that despite my cashless policy I had to make cash payment of repairs to the tune of Rs.36295/- to Vipul Motors. Despite having telephonic conversation with Mr Luthra, Surveyor many times I am still waiting for the payment from your company, although a period of more than 21 days has since expired after delivery of the car to me and making cash payment to the repairing company.

This is altogether contrary to the claims made by the representative of your company while doing policy of my car on 19/09/2017.

I woud request you to look into the matter and get my payment released without further loss of time.

Thanks

Ishwar Singh Sharma

DEAR, ORIENTAL insurance company, Sunane ke liy dhanyawad... RJ14-HX-0410 Ka bill abhi tak clear nahi karwaya gaya aap logo ne... Insurance ka paisa toh aap logo ko time pr chahiye hota hai.. Fir bill pass me itna delay kyu..8 ko scooty received ki thi aaj...21 ho gay... Tum logo ki sb policy fraud hai ...chor ho tum.. Sb, looto garibo ka paisa insurance ke Nam pr... Had hai tum logo par... Ek toh company ki bill ki bhari marr Upr se tumari maar... Sb ke sb fraud ho...tum log... Or kam se kam apne phone call toh attend kiya karo...5 number try Kar chuka Hu.. Chor

I have paid rs.1, 301 on march 6th via tez but the policy has not been renewed, when wrote to customer care i have got an revert from one of the executives ([protected]@orientalinsurance.co.in) that the amount will be refunded but failed to respond to my question as when. The concerned person has then included two more executives to revert on the refund status (Abhishek. [protected]@orientalinsurance.co.in & [protected]@orientalinsurance.co.in) and that is the last communication from the team. I have wrote multiple emails to above mentioned contact and no revert yet, tried calling to the customer care but its not connecting. Its been two weeks now and this is one of the worst experience i have faced with any customer care. If oriental team is not cared to revert for such simple issues, its alarming that that there will be no response for issues related to claiming.

I am struggling for last 1 year regarding my claim which i hadnot recieved yet and my file has been lost by the insurance company and the claim company i. E. Raksha tpa in chandigarh and faridabad they are giving me the proper way to deal with and always running from their duty.
Orintal insurance company
Karnal-132001 (H. R.)
Please help me out and solve my case.

Sir, my case pending on 30-01-18, i am calling on customer care and talling about my case but there are no responce.
My name is saiyad hifzul hashmi from balaghat (Madhya pradesh)

Policy nom - 18101/31/2018/7036,
My con no.[protected]
Policy purchasing on gondiya (Maharashtra)
I am regularly try to contact on my policy office (Gondiya)
But there are nao responce, i m facing on vary dificultees on may life with you,

Next time i m not intresting with you

Dear sir/mam.
I have taken claim for my car repairing as it met with an accident.. Papers have been submitted by surveyer on 20th january to mall road kanpur branch of oriental insurance... I was supposed to received the payment before 5th of february but not got.. When i contacted kanpur branch they had shown me papers that they have couriered to karol bagh branch on 29th jan 2018... When i contacted karol bagh branch delhi they told to contact barakhamba road claim cell delhi.. When i contacted barakhamba branch i have not got any positive response.. They had misguided me and not solved my query from last 8 days... Need your help to kindly get it resolve as its paining now...
Policy number is..211200/31/2018/100654
Car number up78dq 7273.

On 11.03.2017, i paid mediclaim premium through online rs.27061/- and the same was debited from my bank a/c with sbi of bauria branch vide transaction no. Sbipg iu[protected]oicl neither the policy certificate issued nor the money refunded. Perhapes, it is kept in the suspense a/c. I could find the policy of 2014-15 bearing no. 31140/48/2014/7276 and my insured code is 41243845
Of 2014-15. I will be very much grateful if the certificate is issued or money is refunded. Thanks and regards.
Kalpana satpaty (Patra)

Dear Sir / Madam,

I would like to inform you that I am having a Oriental Insurance Mediclaim Health Insurance policy - (Vipul MedCorp Insurance TPA Private Limited) for the last more than 7/8 years and for the first time I had to visit hospital for my son's knee surgery (ACL Reconstruction).

The mediclaim department of Medicare Hospital, Indore sought an approval as per my mediclaim facility and Vipul MedCorp Insurance TPA Private Limited sanctioned approval mentioning that I am eligilble for a private room. Accordingly, the package was given by the hospital as approved by Vipul MedCorp Insurance TPA Private Limited. Unfortunately, at the time of discharge, when final bill was submitted for approval, to my surprise, Vipul MedCorp Insurance TPA Private Limited raised a query and said that I was eligible for a semi-private room package and not for a private room package. When contacted their executives and informed them about their sanction letter wherein it was clearly mentioned 'Private Room', they told that it was mentioned by mistake and they would approve amount as per semi-private room only. I told them that if they had informed me in the beginning at the time of booking room / package in the hospital, I would have booked semi-private room only. On this they could not give any satisfactory reply. Finally, I had to end up paying a hefty amount being the difference of both the packages for no fault of mine. Moreover, Vipul MedCorp Insurance TPA Private Limited took more than 6 hours to settle the claim which created unnecessary anguish and inconvenience.

I would request you to kindly appropriate action against Vipul MedCorp Insurance TPA Private Limited for this negligence on their part and advise them to reimburse me the difference amount of Rs.19, 881/- immediately along with penalty for causing unnessary mental agony.

The scanned copies of the initial sanction letter and final settlement letter are attached herewith, which are self-explanatory.

Thanking you and soliciting your kind cooperation.

Vishvajeet Chatterjee
[protected]

I had my car maruti 800 insured by oriental insurance at shimla in 2017 my car met an accident in april 2017 i remained in bed for two month ihad reported to oriental office well in time. They had sent a surveyor who assesed the losses and asked me to get the car repaired at badog solan at himachal automobile. I had paid the whole amount myself as workshop owner said and also the surveyor said that claim will come to my acount. Ihad asked the office at shimla somany times but they says they have not recieved the case but surveyor says he had sent the case. My policy no is 263102/31/2017/814 code 62006365. Kindly guide me should i go to court now. Bali ram sharma. B. R. [protected]@gmail.com

I was operated for breast cancer in sep'2015 after which 6 rounds of chemotherapy (Under dr. Advani at sushrut hospital, mumbai) and radiation (At apollo hospital, bhilai) was done. All claims till then were reimbursed but two claims of rs. 10911 dt. 18/01/2017 and rs. 11347 dt. 08/08/2017 were refused without any soild grounds. They have said that it is not an active line of treatment. It is known worldwide that the treatment of cancer takes 7 years to complete and in my case its not even 3 years now.
I had written many times to the tpa, divisional manager but to no avail. Even personally i have met the authorities but they have refused the claims. I have been a regular policy holder for last more than 13 years in continuation and i wish to benefit from the same.
Its a request to kindly not to harass me any more as already it has caused a lot of mental tension for getting a genuine claim passed.
Even the prime minister is celebrating cancer week so what is the use of it.

Respected sir,
I am having policy of the oriental insurance company (Toll free no. Is[protected]. My policy no. Is 172299/48/2018/929. We are policy premium from last 10 years. My mother shri ganjawala nilaben was diagnosed with accute appendicities and she was operated on 29th november, 2017 in baps pramukh swami hospital, adajan, surat. We had claimed for rs. 58110/- against which we were paid only rs. 41721/-. All our bills are genuine. I have also submitted doctor’s certificate for undue deduction made in claim settlement voucher. I request to pls settle the remaining amount. My email id is [protected]@gmail.com and mobile no. Is (M) [protected]. All the documents are processed from raksha health insurance tpa pvt ltd. Phone no.[protected], email id is [protected]@rakshatpa.com

Dear sir

I am jacob from chennai and working in cpcl (Chennai petroleum corporation limited) at manali, chennai, tamilnadu - 600068. My bike (Pulzer 135) no is tn 18 b 9661 (Pulzer) missed on[protected] and immediately compliant with local police station and they told me that it will take time to take inquiry of theft of my bike so i was assaulted in inform to insurance company in local area and i have not good knowledge in statutory of procedure of claim and my bike details and my details are given below for your reference.

Name : jacob ambrose r

Address : no:12 third street, vimalapuram, manali, chennai-68

Phone no:[protected]

Email: [protected]@gmail.com

Policy no:411219/31/2018/7289

Period of policy: 02/12/2017 to 01/12/2018

Insured's code : 62887292

Issue office : do 2 chennai (Code:411219)

Compliant date:[protected]

Compliant place : manali police station

Working company : chennai petroleum corporation limited, manali chennai-68

Bike details

Bike registration :tn 18 b 9661


Engine no : 59006


Chassis no :58422


Make and model :bajaj auto bajaj pulsar 135 cc (Block colour


Year of manufacture :2010


Type of body : solo


Seating capacity : 1+1


Cubic capacity :135


Policy value of vehicle :15000 —

With regards

Jacob ambrose. R

Cpcl, chennai

[protected]
[protected]

Policy no.211200/31/2018/89322
Filed claim in november 2017 but not received the claim amount till 29th january.
Dispite various attempt... They are just saying it is under process but not telling exact claim status.
Please i request you to look into my matter... And help me in getting me my claim amount.
It is a worst insurance compney
Contact number [protected]

Sir/madam,
I have made a insurance of my car from 'oriental insurance company'purnea, bihar and approx. Two years ago my car damaged accidentally. But they haven't given any claims for this.
My car number is - br-43b 3482. Owner's name - ratnesh kumar singh.
Not resolves oriental insurance staff (Raj kumar sir) he has been more disturbing me.
I request you to solve my this problem and help me to claim my price of the insurance.

Thank you.

Oriental insurance is worst insurance provider and their claim procedure don't have any tat for customers... We all bought insurance to make ourself free from any unfortunate things but if we talk about insurance company like oriental insurance they never support in these things.

I took car insurance from oriental on a thought that this is semi govt orgnisation and i will be in safe hands but they are thief.

Unfortunately i met with an accident on 17 dec 2017 and sent my car in workshop which is in cashless list of insurance company but after 20days my car is still at workshop just because insurance company didn't release delivery order to workshop.

I am chasing many guys like mr. Yk rao, mandakini balodhi, anita kalra, v nagpal, sanna mohalla via mail but all are sitting ideal and don't have courtsy to reply on mail.

Guys its a learning for me and a suggestion for you that never buy anything atleast insurance from govt/ semi govt companies.

Finally i decided that i will pay from my pocket and will get my car tomorrow.

Third class service from oriental insurance.

After much to and fro, i had filed a complaint with ombudsman last may but i still haven't received any response from them. Kindly help

Reference: happy family floater – 2015 policy no.: 215300/48/2017/913 on[protected].

Dear sir,

With reference to the above, please find enclosed the reimbursement claim, along with the duly filled form and all relevant documents.

The claim was initially lodged with your appointed tpa - emeditek tpa services limited through max healthcare gurgaon and all the relevant documents were submitted to them. Subsequently, the tpa issued a pre approval on 10th february 2017 for rs. 50000/-, which was subsequently increased to rs. 70000/- on the same day and a fresh pre approval was issued by emeditek.

The undersigned – insured / patient archna singh, after receiving the pre approval got admitted to max healthcare gurgaon on the 11th of february 2017 and got her surgeries performed and got treated for her ailments.

On 12th february 2017, the undersigned was discharged from the hospital and the relevant discharge summary and the final bills were sent to emeditek by max healthcare for the final approval and for releasing the payment advice. Emeditek after several hours sent a query asking for past medical policies, which after great difficulty were located and sent to emeditek. Thereafter, the tpa took several hours yet again and sent a email rejecting the claim and directing the undersigned to make a reimbursement claim on the oriental insurance company limited directly. The flimsy grounds mentioned by the tpa was that, the surgeries need a minimum of three years of standing, before they can be considered for claims.

With no alternative left, the undersigned had to pay the entire bill of the hospital, amounting to rs, 1, 61, 216.00 using her credit card and got discharged to go home.

Now, there are very pertinent questions which arise,
(1) why did the tpa issue the pre approval without inspecting the previous policies;
(2) the tpa did not consider the clarifications issued by the renowned doctors of max healthcare, which clearly shows that the surgeries performed were well within the purview of consideration by the tpa;
(3) had the surgeries not been within the purview of consideration, the insured / patient would have waited for 4 months, got the third renewal done and then got the surgeries performed. The ailment was not life-threatening and the surgeries could well have been postponed by 4 months and could have been performed later, and the situation was not that one of any emergency.

Why was a pre-approval sanctioned and issued by the insurance company appointed tpa, without verification of all documents? Once a pre-approval is issued, it means that the insurance company is liable to pay the expenses.in case the policy conditions did not approve payment of the claim, the pre-approval should never have been issued and the claim rejected before the insured / patient archna singh got admitted and got the surgeries done. The tpa or the insurance company cannot issue a pre-approval and ask the insured / patient to get admitted and get the surgeries done, and when the final bills are submitted or the payments, reject the claim on the grounds that the policy conditions do not approve of this. It is the duty and responsibility of the tpa and the insurance company to verify all the documents upfront, when the claim forms are submitted and only after being convinced issue the pre-approval. The tpa and the insurance company in this case has done fraud with the insured / patient and cheated her.

The discharge summary and final bills were submitted on[protected] @9.07am to emeditek, and till 9.32pm on[protected], full 12 hours after the final bills were submitted to emeditek, there was no concrete reply from them. The behaviour and actions of the tpa and the insurance company were totally inhuman and the biggest mistake made by them was issuing the pre-approval without verifying all the documents. By keeping a patient in the hospital for 12 hours within 24 hours of her surgery, the tpa and the insurance company has done a dastardly act and this caused much agony, harassment, mental torture and indisposed the insured / patient post surgery, when she should have been resting at home and on the path of recovery.

In light of the absurd, fraudulent and act of cheating done by the insurance company appointed tpa and as per the advice of the tpa, we are forced to file this claim for reimbursement. All documents enclosed are photocopies, however the originals can be produced on demand, for inspection.

You are kindly requested to consider the claim, and have the entire amount reimbursed on top priority.


Thanking you in anticipation.

Sincerely,

Archna singh

Memberid : o[protected]
Policy no : 131500/48/2016/5815
Policy period : 07/02/2016 to 06/02/2017
Insured name : mr jadhav chandrashekar
Claim in respect of : smt malati jadhav
Relation : mother
Claim ref no : [protected]
Dev officer/agent code : na[protected]
Hospital name : holy cross hospital - kalyan (Only for m t n l)
Claim amount : 93292
Diagnosis : biameleolar fracture left ankle with hypertension diabities managed conservatively
Date of admission/date of discharge : 28-nov-2016/08-dec-2016

My claim was pending last 60 days with you.

As per oriental insurance reply the dub decision will be taken by tpa not insurance company but as per your statement was difference.

Kindly resolve the issue asap and clear my claim.

My claim amount was rs. 4037/- only but every the premium i was paid rs 15, 000/-.

Kindly consider customer view also for customer services.

Dont push us to piller to post for rs. 4037/- claim.

From,
Kirtibhai m shah
Residence-malad-e (Mumbai)
Policy no-131102/48/2018/1786
Dated: 1st december, 2017
To,
The oriental insurance co. Ltd.
No.8, vishva vinay bldg,
Behind johnso, bhagoji, keer marg,
Mahim-400016
Subject: declining your “denial letter” & reason of claim given by oriental insurance co. Ltd.

Details:
Claim no[protected]
Policy no: 131102/48/2018/1786
Patient name: kirtibhai mafatlal shah
Policy holder name: maltiben kirtibhai shah
Maid: 272577

Dear sir,
My self kirti m shah from mumbai received your denial letter of dated 13.11.2017.in above policy, given reason is not acceptable against claim.
1) as given hyper tension reason, was only the history which was occurred 20years before for which no further treatment is going on. Also, there is no link between hyper tension with current diagnose diseases i. E. Angiography & angioplasty as per doctor’s clarification.
2) if you have any evidence regarding current diagnoses is link with hyper tension, please provide the same. Although as per doctor’s concern there is no link between it.
3) if you require any clarification regarding this claim from the doctor please raise the clarification letter address to doctor with details. This we can provide you for your query.
4) as per doctor’s clarification with us there is nothing to do with current diseases. He is agreed to give clarification if you ask for the same.

We are waiting for your positive reply & if you want any further clarification we will like to provide the same.
Request you to resolve the issue as early as possible.in any case if we are not satisfied with your reason of deny the claim; the same will be escalating to higher authority.

Regards,
Kirti m shah

Note: please find enclosed documents,
1) policy document
2) denial letter
3) discharge summary