Oriental Insurance Company Complaints & Reviews

Mediclaim policy no: 442600/48/2018/1, claim no:14915526
Patient admitted at mosc medical college kolenchery on 17/7/2017 & submitted all documents for cash less treatment. But tpa medi assist rejected the cashless without explain any reason. Severe negligence from the tpa. I think cashless is not a bounty of tpa. I need cashless & justice urgently....

Subject:- our claim for loss at our processing unit in village –saidpur, derabassi with reference to insurance policy no. 231400/11/2014/25 dated 28.05.2014 (Standard fire & special perils) & policy no. 231400/48/2014/132 dated 28.05.2014 (Burglary standard policy)
Respectfully it is submitted as under:-
1. That the insurance policy issuing office was sco 20, 2nd floor, phase 1, mohali, chandigarh – 160055.

2. That the heavy rain had taken place at derabassi on the intervening night of 18/07/2014 and 19/07/2014, due to which we faced heavy loss in the shape of stock of fabric cloth and finished suiting, shirting material lying in the processing unit and also the plant and machinery got damaged. The unit was running and suddenly heavy rain water resulted in heavy flow of water inside the unit to almost 6 feet deep.

3. That we had already submitted the claim intimation vide letter dated 19/07/2014 to your office. Subsequently, the surveyors m/s vinod bhan & associates, s. C. O 179-180, top floor, sector-17-c, chandigarh visited the premises on same day i. E. 19/07/2014 and m/s vinod bhan & associates vide written communication asked us to submit certain document and all the document which were require from the company were submitted vide letter dated 14/05/2015.

4. The technical report of damage occurred at amartex industries limited at village saidpur due to flood, was also submitted along with all the relevant bill and document.

5. That in spite of our regular follow up and visit to the insurance company we have not received any reply till date from the insurance company regarding claim.

6. That we have not received any reply till date from the insurance company.

To

Head office: hyderabad
3rd floor, parisrama bhavan,
Basheer bagh,
Hyderabad - 500004,
Telangana, india.


Sub: application for reimbursement of mediclaim of e-meditek and policy no 215600/48/2017/4786

Sir,

My claim was still rejected & i was asked to apply to for re-reimbursement as physical verification would be done. I agreed, paid the bills and applied for re-reimbursement. I was told that a verification will be done by experts who will solve the issue

T makes very third class image in the mind of clients.
I have find the another good agent that's why i'm still with oriental otherwise there many good & reputed company in the market, specialy at this time, where compition is very high.
So, please make sure that such kind of activity get stop asap.

.
I got a rejection letter of reimbursement of mediclaim of max from mrs. Beena divisonal manager of oriental insurance, barakhamba road but i have filled two claims
One of max hospital
And second of fortis hospital but she had replied on max hospital claim

I want to file a legal action because at present i have spend more than double insured amount of my victim
I would appeal that please file my case in irda cell and i would be present on hearing

I also enclosed the attachment of letter which i got from mrs. Beena divisonal manger of oriental insruance ltd.

I will also file the complaint to irda for the same, as it is not acceptable at all.


For sure i am going to log serious complaint against the oriental insurance co more to that i will specially share my experience in all the social websites so that others should not get in to this the oriental insurance scam, this is really pathetic. Single claim in entire year, that to for emergency issue which is not related to pre-disease or not covered like issues and claim rejected. I will make sure this message should reflect on every available social websites, whats app, facebook and to in newspaper. This kind of cheat companies should not be legal in india and will make sure by going legally to remove this insurance from all the hospital panels in india.

My wife is hospitalised right now and i have applied for mediclaim in e - meditek insurance ltd but i am so much disappointed with the service of e - meditek insurance ltd

From


Sunny arora
Policy no 215600/48/2017/4786
2677 outram lane
Kinsway camp
New delhi 110009
(M) [protected]

C/c sent to
1. Hon. Cm delhi
2. Irda cell
3. Pmo of central public information officer

The complaint which is given below:
—

I am not getting that why you should give the liasons to that company who does not commit and do not provide the mediclaim cash less when it is required

Now i m facing the two problem first my wife who is sufering from critical disease and she is admitted in a fortis hospital, shalimarh bagh and another i have to face monetray problem becaue right now i have to borrow amount from my realtive

Really already i send my case to the office of meditek insurance ltd but i dont get a response from my previouse claim

I request you to kindly take the strict action against meditek insurance ltd (The oriental insruance co ltd.) because my wife claim is being rejected by the e-meditek insurance ltd

Kindly response me fast because i could not able to pay the amount and i have already paid the premium of meditek insurance ltd

Kinldy reimbursement my medicalim as early as possible


I am sending the details of my policy which is given below

From
Sunny arora
Policy no 215600/48/2017/4786
2677 outram lane
Kinsway camp
New delhi 110009
(M) [protected]

I am writing this email to bring to your notice about the unsatisfactory service been offered by your insurance organisation.

The policy and claim details are as below -

Policy number - 211200/31/2018/2246

I am parveen kumar owner of vehicle number dl4caw1748, policy number - 211200/31/2018/2246. My car got damaged and after long follow up, it was surveyed by mr. Gurjeet juneja on 4th may, 2017 and i repaired the car at ring road honda, peeragarhi, delhi. I submitted my all documents on 4th may, 2017 to ms mandakini balodhi on the same day. I paid the money to honda service centre and submitted my bills to oriental insurance on 16th may, 2017. Now, i am seeking reimbursement of my bills under policy no. 211200/31/2018/2246 from last 2 months but oriental people are not replying to my calls and emails. I have submit previous insurance policy and ncb certificate as well to ms. Deepika. This is giving me physical and mental harassment as nobody of yours company is caring about my hard earned money. I did 2 personal visit to orientals' regional head office barakhamba road office.

Regards

Parveen

Dear sir

My truck was stolen last year[protected] at odhav ahmedabad gujrat and i submitted all document to insurnce company oriaental insurance but still i dont get claime and insurance company not giving any answer

Truck numbar: gj1cx 5959
Name: patel chandrakant somabhai
Policy name :the oriental insurance company ltd
Police numbar:171591/31/2016/752
My mobil numbar; [protected]

I have all document for claim but insurance company are not intrested for pass this claim
So please do need full for that
Document are attached

I have been trying to cancel my insurance since 25th of june, before they have come into power, but receiving no action from the company what so ever. Only one person replied to me guiding me to a particular person who is failing to respond. I have contacted him via email and whatsapp. Please contact me at [protected]@gmail.com to get details of the policy.
Regards,
Yulia...

Respected sir,
Pl find attached copy of the complaint given to e meditek against ms. Mehta hospital, chetput chennai for collecting excess amount.
The attached mail is self explanatory.
My son mr. Rahul balaji was got operated for hernia from ms. Mehta hospital, chennai on 14th april.
At the time of discharge i have paid rs 97609.74 and the hospital has collected rs 35608.74 excess from my side.
When i asked the reason for collecting excess amount no one has given any reason and asked me to contact the insurence office.
When i resisted for paying excess amount, they threatened me to pay the amount and walk away.
Mehta hospital has not given any itemized bill which i demanded from them.
The hospital authorities is not ready to give any explanation what so ever and forced me to pay the excess amount.
Since my son need rest after the operation i paid the excess amount and got the discharge.

Now the issue is,

If it the cash less hospital, why the hospital must charge the excess amount?
Why the hospital is denying to give the itemized bill and all original vouchers?
Who will repay the excess amount paid by me to the hospital? Hospital or oriental.
Why the insurer must suffer by paying excess amount when the hospital and insurence have agreed for a fixed amount.
Surgeon is also charging excess amonut from the patient? Why?

I visited the chennai e meditek office and met mr,. Narasimha and mr stephen raj and explained the problem in detail.
Can you pl look in to and help me in getting back the excess amount paid for my son operation.
Looking forward for your early response.
Regards,
S/d
S balaji
[protected]

Dear sir

I have claimed a insurance of wife but oriental insurance are passing my claim without any reason i have submit all thee documents which they have needed but still not passing they had taken too much time abve 3 months this matter thats i have compled to complaint.

Sub claim no 14499984 in the name of sangeeta devi

Company name oriental insurance company

Regards
Shakti pal
M: [protected]

Policy no. 151200/48/2017/11514
Claim no. Hh[protected]
Insured : mr kalyan singh khalsa
Company repudiated claim under clause 4.1
Where it's written if patient have disease at the time of taking policy,
But if any disease occur after inception of policy is cover, but with a false reason they rejected the claim,
Please have a complete look on complete case

Hello Sir,

My name is Dipesh Shah.

I am writing this email to bring to your notice about the discremental and unsatisfactory service been offered by your Insurance Organisation.

The Policy and Claim Details are as below -

Policy number - 121200/48/2017/11020
Claim Reference Number - [protected]
Insured Code[protected]

This is in context to my sister's medical insurance claim which I claimed recently amounting to Rs. 27862.

She was suffering from Severe Migraine and was admitted to the hospital for the same. She underwent treatment for almost 3 days and she had a policy with Oriental Insurance from almost more than 10 years now. The Ploicy was of Rs. 50000 initially and since last 3 years, we have increased the Sum Insured to Rs. 3 Lakh.

After discharge, we submitted all the documents to RAKSHA TPA. It is been 2 months almost now that we have submitted the documents and when we are calling for an update, we are been told that THE DIAGNOSIS IS NOT CONSIDERED TO BE AN ACTIVE LINE OF TREATMENT. I really dont understand this issue.

WE HAVE BEEN PAYING THE PREMIUM FOR THIS POLICY SINCE 10 YEARS AND WHEN WE ARE CLAIMING FOR THE FIRST TIME THINKING THAT WE ARE SECURED WITH AN INSURANCE POLICY, IT IS PEOPLE LIKE YOU WHO BREAK OUR TRUST.

I really understand the delay behind this process. This is the reason why Private Companies are much preferrable when it comes to Service.

I have been sending email to RAKSHA TPA (Swati) and Oriental Insurance (Dharmendra and Smitha) since a long time but there is no response from their end. They are not even bothered about the customer who is facing severe issue and seems to be Super Careless.

I have been disappointed from Oriental Insurance after paying a premium for almost 10 years now and without any doubt would have to migrate to a Better Insurance Provider who has the capability of paying the claim without giving any valid reason.

I have not yet received any letter or email from Oriental Insurance about my UNPAID CLAIM and there is no where menioned under any clauses in my policy about the reason due to which the claim is UNPAID.

I am hereby lodging a complaint against this onto the Consumer Forum, PMO, IRDAI and will need to bring their involvement on this issue in order to settle my claim.

It is the hard earned money that we have paid you as a PREMIUM for the past 10 years and under any circumstances, it is your duty to meet upto the customer satisfaction.

I hereby need a prompt resolution on this without any more delay and look forward to hear from you.

Hi,
I have taken mediclaim insurance of oriental 3 years ago. Till the time i didn't face any problem but now, at the time renewal of my mediclaim my agent is asking that if you want to continue this policy, you have commit me that you pay rs.500 cash for each your claim during next year.
I have already proceed to change my agent. But complaint is that "why oriental hiring this kind of agent in system"
It makes very third class image in the mind of clients.
I have find the another good agent that's why i'm still with oriental otherwise there many good & reputed company in the market, specialy at this time, where compition is very high.
So, please make sure that such kind of activity get stop asap.
I also sure that my agent is getting this kind of bribe from many innocent client, who don't know anything about the system & regulation.
I will also file the complaint to irda for the same, as it is not acceptable at all.

Yakin vaghasiya
[protected]

I have sent my spouse eye operation bills th. Courier. The bills recd by mediassist with claim form on[protected]. I saw on that
All the papers are complete required document none. The claim is in progress since april17. My policy no. Is 253500/48/2017/1126.
You are requested to pl. Clear the claim and send the payment earliest.

Thanks
Umesh jaim

We are continuously doing follow ups from march 2017 regarding our insurance claim, it's now more than 4 months and we haven't received any proper response yet.

Whenever we called we either asked to call after a week so that they can check the status or we got the response that the concern person is not available due to which it is pending. No one ever told us about the ncb, seems that either no one was even bothered to entertain customer or they have lack of knowledge about the process.

We can see in the trail mail that the mail for ncb confirmation was sent on 23rd of may'2017 and that too on the wrong email id.

And then the same mail was forwarded again after 20 days when we called and again they sent it on wrong mail id.

This has become really painful for us to keep following up without any positive response.

As i have checked and found that the insurance renewal is only done based on the previous insurance claim and due to which ncb is no where required.

Percentage of ncb is also clearly mentioned in the insurance policy document provided by your company.

Could anyone please tell us in one go what we need to do to get this resolved?

Quick response from your side will be highly appreciated.

Thanks & regards,
Nidhi srivastava
D/o brajesh mohan srivastava (Owner of the vehicle)

+91-[protected]
Nidhi.[protected]@gmail.com

Dear sir/madam,
Need your help and support

Our vehicle no rj 41 ga 1291 (Shri ram raj borewell company) was accident in feb'17 for which we have apply for claim in insurance company but insurer not providing full amount of claim we have insured our vehicle with imp. We have claim for rupees 295000 but you are approving claim amount only rupees 130000 which is not fair.

We request you to please see the matter and do needful.
Policy no : 243308/31/2017/2278 (With all add-on coverages)

Period of insurance - from 00:00 on 27/06/2016 to midnight of 26/06/2017


Rj 41 ga 1291

Make and model - tata tipper 2518/38 hd bs ii

Shri ram raj borewell
Company
Cbo 2 jaipur
[protected]
R/o rigus road near dharma
Kanta teh - chomu jaipur

Branch office address:-

Kundan bhawan
Opp. Chaudhary hotel
M. I. Road, jaipur
Jaipur rajasthan 302001

Ba[protected] naresh kumar saini, [protected] [m]
Na[protected] h. K. Saxena
P. No-11, royal nagar, opp. Fci godown, tonk
Road, jaipur, jaipur, rajasthan, 302001
[protected] [m]//nareshraj. [protected]@gmail.com

Regards

Kamal chhipa
Shri ram raj borewell company
[protected], [protected], [protected]
[protected]@gmail.com

Subject: denial of medical health insurance after claiming 50% of annual insurance amount covered by oriental corporate group policy for the first time in 5 years, with no reason for rejection of renewal provided by insurance company; leading to loss of all medical coverages for the pre-existing ailments (Diabetes) and thereby betraying the customer and causing severe economic and mental issues for the insured

15-feb-17: insured emailed medimanage requesting for notification and steps for renewal of policy coverage for year 2017-18 (Policy start date: 21-1-17 and end date: 20-1-18)
Medimanage responded that the approval process of the policy with insurer is still pending and we estimate that this may take another 4-6 weeks for closure. We will get back with the new process and benefit plan by mid-march.
02-mar-17: after next followup, medimanage says - the policy is currently in inactive stage hence there will be no coverage / benefits until the policy is renewed. The policy renewal is delayed as this is an annual contract which needs approval yearly. Currently we are awaiting for the approval on terms and conditions and it is pending from the insurance side.
We expect this to be renewed in end of march and you will get the invite from us on the said time line.
After multiple followups on email and phone - medimanage responds with rejection for renewal response stating - we regret to inform you that the insurer (Oriental insurance company) has declined for the renewal of policy for the year 2017-18. There is no reason specified for rejection of renewal from oriental health insurance
6, 7, 8-may-17: insured follows up on email with medimanage along with multiple phone calls medimanage: the insurance cover is provided by the insurance company. Final decision is taken by the insurance company and the same is conveyed to you. There is no clear response reason of rejection nor is the guidance about contacting the insurance company, even after multiple phone calls and mail follow-ups by insured
—
This delay in communication from medimanage side has resulted in cumulative delay of 3.5 months already from the end of policy for 2016-17 (Which is[protected]
—
15-may-17:now medimanage says that this policy is declined by insurance company and the insured needs to take new policy. However, did not provide the reason for rejection or any contact details for oriental insurance

This is a delay of about 4 months from end date of policy (20-jan-17)

15-may-17 insured immediately contacts csd department of oriental insurance ([protected]@orientalinsurance.co.in & [protected]@orientalinsurance.co.in) explaining complete scenario about the delay in renewal of the policy and requesting for guidance to get the policy coverage asap – since the insured party is without any medical coverage as of now, due to delay in communication from medimanage side also, medimanage has made it clear that oriental has denied the renewal of policy without any options for extending coverage
18 to 29 may-17: after multiple follow ups with oriental, finally received a contact of sunita ingle in mumbai branch (Not bangalore). There is no response from sunitha for next 2 days even after the case is escalated, the response from oriental is sluggish (After multiple follow up emails and phone calls)
31-may-17: finally she responds that policy cannot be renewed since its been more than 30 days that the policy has expired it is observed that policy no.124500/48/2016/10051 is expired on jan'2017. Hence the renewal of the policy within a grace period of 30 days has also expired. Therefore, in the given situation it will not be possible for us to renew the policy with continuity. We may offer fresh policy as a special case depending upon the age of parents subject to pre-insurance medical check-up.

This means that after so much of follow-ups and even without any mistake from insured– the policy cannot be renewed due to time after policy expiration.

It is very clear that 3.5 months was delay due to medimanage and 20 days was delay due to slow response from oriental insurance

Also this means that it will be complete new policy – with no coverage for pre-existing ailments – even after insured having the same policy for last 5 years

31-5-17: thomas oomen denies the chances of coverage of pre-existing ailments in the new policy – even after the insured buys a new coverage; and just suggests to buy new policy with no assurance of coverages of pre-existing medical conditions – as expected – even after insurance holder is ready to continue with oriental – just to keep existing conditions coverage

This clearly shows that oriental denied the responsibility of providing the reason of rejection for renewal to the loyal customer of more than 5 years - on time, thereby resulting in loss of medical insurance and no guarantee to cover existing ailments in case customer wants to buy a new individual policy

Dear Sir,
This is to brought in your notice that i had applied for claim on dated May 8, 2017 from Dev bhoomi, Skoda dealer Mandi, but still i am not getting any reply about my claim file from Mandi oriental office and Jalandhar oriental offce.
Today i call at mandi office, Himachal Pradesh the officer Sukh Chand Thakur miss behave on phone no. [protected] instead of giving any Information .
My policy no.-233100/31/2017/12425, SOURAV SHARMA.
Request a strict action against the officer and Do the needful for detail of Claim otherwise i am not in any option to file a complaim with consumer court.

Dear sir,

Sub: insurance clearance status and claim amount payment
Policy no. : 215700/31/2017/86562
Issuing office: mibl

This is to inform you that we have log the insurance claim of rs, 16182.00 against above policy details on dated 17/03/2017 but still we have not recieved the status of claim.

We have request you to give us the statues and how much time still waiting.

Thanks,

Your faithfully
Mohd. Jamil
Rj10ca4860

Sir,
I take my car policy through policy bazar but two mistake in policy.
One my car seating capacity is 5 person but policy shaw 4 person. And second my car body type is saloon not hatch back. I mailed my new and old policy paper on below mail id - mandakini. [protected]@orientalinsurance.co.in, but no any reply come.
Regards
Umesh a patel
Mo[protected]
Car no-gj2bh3431.
Policy no-211200/31/2018/25786

Sir we are not receiving our claim amount till date (29/05/2017) after submitting all necessary documents of our policy no 192000/31/2017/5712. Document submitted in month of dec -2016. After documentation we already compliant telephonically and in local office also. But we are not receiving positive response. So please issue our claim amount as early as possible.

Ref. Burglary claim no.252100/48/2017/030002. I approching in gaziabad branch since april month but not resovle the issue. I am not satisfied this claim assessment report by taraani surveyar and approved claim not justify. Hence i requested for review of claim assessment report again. I will be obliged for company for rectify of issue in earlier. Regards ravinder singh deshwal. Mail id [protected]@rediffmail.com [protected]