Oriental Insurance Company Complaints & Reviews

Policy No 124500/48/2016/7568 insured name Geetanjali R. Gumaste, still my claim amount not released my claim has been passed in Sept'2016 for RS. 47000/- but still amount not deposited in my bank account I followed with Raksha TPA still not received any positive response. I have got operated in April 2016 almost 11 months passed and i already renew policy in Oct'2016 .

Kindly help me to reslove the same.

Details of claim is as under
· Name of Insurance Company The Orient Insurance Company Ltd.

· Policy No. 172301/48/16/06015

· Claim ID MDI2944773

· MDIndia ID MDI5-[protected]

· Insured Name Ashwinkumar Ramanlal Shah

· Patient Name Ritaben A Shah

· Relation Spouse

· Diagnosis Left eye cataract

· Date of surgery[protected]

· Date of prior intimation[protected] copy of mail attached)

· Date of Claim[protected]

· Reminded to the customer care on Feb 2 and Feb 14 ( copy of the mails attached)

Sir,

I submitted the claim personally to the Insurance Company at Vallabh Vidyanagar, Gujarat Branch. Since the cheque details was missing, sent the scanned copy of cheque on mail on the same date i.e.[protected] copy of the mail attached)

Still the settlement of the claim is not done. Today, on Inquiry through toll free number (MD India), I was told that some query relating to the holding of policy duration is pending with the Insurance Company.

My claim is pending with the Company for more than three months. I am least concern with MD India. I have a contract with the Insurance Company. Delay by the Insurance Company is unacceptable. I submit for the early settlement of the claim along with penal interest.

There was a demand of bank details from MD india, though the same was submitted to the insurance Company. As I was at Vipassana centre and out of any communication there, could not reply immediately. However, the same was sent to MD India on[protected] copy of the mail attached) . I believe the bank details are for the payment of the claim and not the sanction or settlement of the claim. The claim process could have been completed till the details come.

This issue is regarding client id 12603 and filed consumer court case (Docket id/ complaint no.: 178138) with detailed history of incidents mentioned below. As we spoke several times through your customer care regarding damage caused to our water purifier during servicing by your technician and not compliance to fix it since then. We have paid inr 2300/- on 10/07/2016 for annual service/ maintenance of my aqua guard (Classic) and company claimed as the authorized service network for aqua-guard.
In case no resolution and complete fixation of the issue by end of the day, we will go ahead and file case against ion exchange pvt. Limited / the oriental insurance company / aqua care insurance without further waiting period. These complaint will be filed against the above said company and persons mentioned below.
Here is the sequence of incidents:
1. 25th february 2017: i called your company on 25th february 2017 for general service of aqua guard (Periodical filter service/ cleaning). This water filter was working absolutely fine before that. The service request was to clean filter / general service which is the part of amc.
2. 28th february 2017: technician (Mobile no:[protected]) came on 28th february 2017 around 7 pm. While cleaning filter, he damaged the water purifier and not able to fix it.
3. 28th february 2017: around 8.15 pm, he wanted to leave without fixing the water purifier (He wanted to attend another service request). On being asked what happened, he said- this water purifier will automatically start vending water after 30 minutes. On further inquiry he contacted some person from your company named rajesh kumar (Mobile no:[protected]). Rajesh kumar tried to convince us with the same explanation and requested us to leave the technician and with his rajesh kumar’s personal guaranty.
4. 28th february 2017: 8.21 pm: then technician left to attend next service call. We have received an automated sms with text "dear customer, thank you for paying rs 0.00 to iepl. The following product has been installed. For any queries call us [protected]".
Upon enquiry why the sms received without fix, he explained- that is because he attended service, there will be one more sms when service is complete.
5. 1st march 2017: we called customer care ([protected]) multiple times to complain about the same issue happened and every time they simply committed "technician will come to attend service". The same thing repeated for minimum 50 times during the week.
6. 2nd march 2017: we received 2nd sms with text "dear customer, thank you for paying rs 0.00 to iepl. The following product has been installed. For any queries call us [protected]" ; but there was no service on that day.

7. 1st march till 4th march 2017: through help line number, we have spoken to many customer care persons named swati (Mobile :[protected]), subham (Mobile : [protected]), nagarjuna /uday kumar anand (Mobile :[protected]). There is no solution till today. However on 4th march 2017; they said, it is not responsibility of the company to fix it. We may go to file consumer court case or police case. Nobody (Including police/ consumer court/ ceo of the company) can do nothing to them.

Regards,
Biswajit mishra

On (23/08/2016), tuesday a fire occur in oswal autos (A-20, gtk road, delhi). At the time of fire my motorcycle yamaha (Fz-fi), (Registration no-dl10sr2729), (Chassis no-me1rg0719f0055624), (Engine no-g3c8e0207908) was standing outside the oswal autos. After few days when the conditions become normal i got to know the condition of my motorcycle and it was burnt completely and i lodged the request for claim to the oriental insurance company (Jhandevalan office delhi) on (16/09/2016). From then till now i didn't get my claim. I go to the insurance company almost daily and they did not give any response and just tell your work is in progress and so. They are mentally harassing me i am not able to concentrate on my study, work etc. So please help me regarding my case...

I manoj sabhnai is not getting claim due to dealership issues inspite of having cash less policy.
I spoke to suresh chandra on[protected] bank official i spoke to showroom gm kidwai on [protected] but not getting satisfactory answer.
I have been asked to pay first to gat my car from the showroom.
Pls someone do the needful.
My contract [protected]
Copy of incoice attached for reference

Dear Sir,

We have our JIO Mediclaim Phase -2 ( Gold Plan) policy SAH217621 w.e.f. 21.05.15 to 20.05.2016

We have send the Demand draft on dt 12.05.2016 for renewal and the same is
send to your office and received by your office on 17.05.2016 ( Receipt and Acknowledgement enclosed)

We have received the renewed policy w.e.f. 31.05.2016 to 30.05.2017 the gap between the policy continuation of 11 days from prior policy

Previous year Policy number[protected]/00000
JIO SA ID - SAH217621

PHS ID NO. USAHM2951023JIO3

CURRENT YEAR - VIPUL MEDCORP ID NUMBER

[protected] 26

Requested to kindly look into the matter and resolve immediately, my claim
for admission dt 30.05.2016 is denied by VIPUL medcorp due to above.

Waiting for claim settlement since last 3 months. No revert from the company.

Vehicle no: MH 12 KN 6718
Zero Depp insurance:
Policy No : 181300/31/2017/2597

[protected]@orientalinsurance.co.in
35, 969 5, 396 .5 41, 365
PCCV-4 wheelers - carrying passengers-capacity NOT 6
PACKAGE POLICY - ZONE A
CHQ [protected] - 25/10/2016
INDIA
MH 12 KN 6718 E[protected] + 1
MEEJSRBW4F900
0179
Pune - Pune
RENAULT Lodgy-85 PS RxL-1461

M/S ELITE DRIVE (PRO.ZEESHAAN
DILDAR PATHAN)

Feb 10 2017

Reference: Policy No. 153900/48/2017/3013
: Insured’s Code 58568875
: Issue Office Code 153900
previous policy no 153900/48/2016/3826

Subject: Issuance of Photo card

To
The General Manager
The Oriental Insurance Company Ltd.

Dear Sir,
I am sorry to say that I had got a PNB- ORIENTAL ROYAL MEDICLAIM Policy since last 4 year, which details as mentioned above, although I have got the receipt only, but I did not get the Photo Identity card and hospital list till now in spite of several conversation to branch office. I never expected the same from a well renounced organization.
Now I humble request to you, kindly issue me a cashless Photo Identity card and hospital list as soon as possible

Thank you

DR SANJAY KUMAR PARIHAR
238/1 KABIR MARG NAPIER TOWN
JABALPUR M.P.
Mob [protected]

On line renewal of mediclaim policy were done before due date vide lattest policy nos;- 1. 224600/48/2017/3736 of Narendra kumar Sinha n spouce, 2. 224600/48/2017/3889 of kunal priyadarshi n spouce. On enquiry, photos were submitted to sri Khan for item no 1. n for item no2. were given to sri H singh who handed over to sri Manjeet of Raksha tpa, of OICL/Bareilly.
Raksha tpa says neither policy is found updated nor photos have been received.

I made payment of Rs 30369/- for medical insurance policy on 2nd Feb. 2017 for renewal of policy no 212700/48/2016/3521 through Credit Card . The amount of Rs 30369/- is deducted but error shown on oriental insurance portal or Bill desk. I contacted insurance company, they told to deposit the premium in the office to continue the policy. The portal discount for making online payment is not allowed on payment made in the office.

What is the use of online payments when same is not through, though amount is deducted from account, it will take lot of time and efforts to get the amount reversed in the account.

Oriental Insurance Company Ltd.,
Customer Service Dept.,
Head Office,
“Oriental House”
A-25/27, Asaf Ali Road,
NEW DELHI-110002

Dear Sirs,

Re: Grievance against non-settlement of health insurance claims
JIO-HNI Policy No. 530000/48/2016/507 (Period:[protected] to[protected]
Insured person : Mrs. Jyotee D. Shah (Mother)

I invite reference to my e-mail dated[protected]copy attached) registering my complaint against non-settlement of claims lodged under the above referred policy in connection with hospitalization of my mother. I had also sent to you copies of “Pre-repudiation Letters” (3) of TPA, Health India TPA Services Pvt.Ltd. which were forwarded to me by Jain International Organisation (JIO) in response to my enquiries about the status of my claims. Though the said letters were found to be addressed to the Divisional Manager, Oriental Insurance Co.Ltd., CBRO Mumbai, Oriental House, Jamshedji Tata Road, Churchgate, Mumbai, they were giving sufficient indication that the decision conveyed thereby was purported to be the final decision of your policy issuing office. It is in that circumstance that I, taking cognizance of the contents of the said letters, sent the e-mail referred to above presenting the genuineness of my case and requesting you to issue necessary direction to the TPA to desist from maliciously misinterpreting the provisions of the policy of insurance and to settle the claims. Unfortunately, it seems, my letter failed to attract your attention. Since however you have neither disowned the decisions conveyed by TPA in their letters nor have you contradicted them, I construe that you are only inclined to concur with the unjust decision of the TPA to repudiate the claims. In this context, I consider it relevant to draw your attention to the fact that the reason for repudiation of my claims as shown in the letters of TPA is totally unfounded, biased and contrary to the provisions of the contract of insurance and hence your action or inaction in the matter of performance of the contract amounts to deficiency in your services.

In view of the foregoing, I again request you to examine the cases in question taking into account the fact mentioned in my letter under reference and with objectivity and fairness and arrange settlement of my claims immediately on receipt of this letter.

It may however be noted that if I do not receive any communication from you within 15 days of your receiving this letter, I will presume that you are not interested in resolving the issue and accordingly, I will proceed legally to recover the claim amount with interest and cost.

Thanking you,

Yours faithfully,

KUNAL D. SHAH

c.c.to: Divisional Manager,
Oriental Insurance Co.Ltd.,
CBRO Mumbai, Oriental House,
Jamshedji Tata Road, Churchgate, Mumbai.400020

c.c.to: Jain International Organisation.
103, Midas Tower,
Bhau Dati Road Extn., Sion-East, Mumbai – 400022.

Dear Sir,
I am a retired employee from Punjab Roadways, Amritsar=2.Due to pain in my knees I consulted in OPD at Fortis Escort, Amritsar on 9.11.2016. They recommended for my knee replacement. With my consent Hospital sent a proposal to sanction amount for my knee replacement to Oriental Insurance as I was eligible for health insurance upto three lacs from 1/1/2016 to 31/12/2016. After a period of 39 days on 17/12/2016 Oriental Insurance sanctioned an amount of Rs. 1, 65, 648.00 for the purpose. Hospital admitted me and operated me on 20.12.2016 for knee replacement. Before discharging me on 26/12/2016, hospital lodged a bill no. IPCR82203 on 26-12-16 amounting Rs.2, 59, 366.00 for payment of balance amount i.e. (Rs.2, 59, 366 – Rs.1, 65, 648) Rs.93, 718.00. Oriental Insurance gave no response for the balance payment on the day. As I was to be discharged by the hospital on the very day, I helplessly paid the balance amount i.e. Rs. 93, 718.00 to the hospital and got myself discharged from the hospital. Since I am entitled for health insurance upto 3 lacs, Oriental Insurance was liable to pay full amount of bill i.e. Rs. 2, 59, 366.00. Hence, it is appealed that Oriental Insurance may kindly be directed to pay the amount of Rs. 93, 718.00 which is helplessly paid by me to the hospital.
With thanks,
Sincerely,
Sadhu Singh
S/o S. Buta Singh, Vill. Jangla, P/o Naserke
Teh. Batala, Distt. Gurdaspur
Contact No. [protected]

My mother had health insurance through group – Association of Medical consultants for many years (Probably even before year 2000) as my mother, I Dr. Girish Dani being member of the said association. Policy no. 112500/48/2015/846148 premium paid of Rs. 27821 on 7/9/14 for period of 14-September 15.
FIR 2796677 TPA Paramount. Initially refused completely, then partly reimbursed still some not reimbursed

Respected Sir/ Madam,
I have taken an insurance policy in Medi Assist with the policy no.(233300/48/2017/620).I had dangue treatment in "SHOOR HOSPITAL" in Month of September.I want to know about the refund payment which is taken by Hospital during treatment (11500 Rs.)from us.We have visited a lot of times to the hospital to ask to refund our payment but Dr. Shoor has harassed us too much and told us that all the treatment payment has not been given to him (hospital)yet by the company.So, I request you to kindly look into this matter and ask the Hospital to refund the money as it is our ryt. Being a middle class family we people take this policy just to ensure our life safe form bad diseases and also from huge amount been paid for the treatment in the Hospital...Also i have mailed the company so many times..but they didnt respond..so, i request you to kindly look into the matter..The above written was same i written to mediassistindia but in vain.Now u are my last hope..
Thank You...
Shivna Mahajan

I had submitted my car insurance claim dated 28.12.2016 at its claim submission office 25 Brabourne Road Kolkata along with all papers of claim.

After that I had contacted claim department many times in telephones but I am not getting fruitful result of my claim.

My claim file no is 1383
Surveyor S K Roy

With regards

Sonam Tshering Sherpa
[protected]

In reference to subject I would like to bring to your notice that i had proposed for a oriental insurance medical policy through PNB khanpur, delhi & amount also debited from my account on 28th oct 2016.

Till date i had not received the policy nor any information in this regard from bank or the insurance company.

Kindly revert back for the same matter as waiting for medical insurance document from 28th oct 2016 or else give me the tentative date on which I will receive my oriental insurance documents.

My detail are as under PNB khanpur branch, Delhi

Saving a/c no. : [protected] proposed for Oriental insurance mediclaim policy for Raju Prasad Gupta, Payal gupta, Rishit gupta

Thanks & Regard,

Raju P. Gupta

I " shashank kumar " wasadmitted in Narayana Multispeciality Hospital, Jaipur rajasthan .on 26 july 2016 to 27 july 2016 . so hospital given me bill OF rupees eleven thoushand seven hundred twenty five . that time my parentsgiven amount rupees to hospital to discharge me . THEN I GIVEN ALL HOSPITAL INFORMATION AND COURIER MY HOSPITAL TO ADRESS :- PLOT NO -18/13, WEA, GROUND FLOOR, GANGA PLAZA, PUSA LANE KAROL BAGH-110005 NEW SELHI 110024 DELHI .AND FROM 27 JULY 2016 TIL YET 18 JANUARY 2017 .I DO NOT GET AMOUNT RS 11725 /- .SO HELP ME TO GET MY AMOUNT OTHERWISE IF I DO NOT GET AMOUNT I WILL NOT USE THIS HEALTH INSURANCE . non cashless policy number is 252405/48/16/03752

REGARDS
SHASHANK KUMAR
PHONE NUMBER IS [protected]

I applied for a medical insurence through PNB, Sector - 51, Noida, UP Branch on 16/12/2016. As I did not receive the policy, I contacted your toll free no which supplied me the soft copy of the policy. In this connection I have to state as under:-
1. Hard copy not received.
2 . My name has been spelt incorrectly as Sameer instead of Sumeer.
Branch not responding to calls. Could you please have a corrected hard copy sent to me.
Sumeer Sadhu
Policy No.272500/48/2017/6493

Dear Sir,

With respect to the bellow mail ( Query ) received fm. The Emeditek, regarding to the policy continution certificate fm. oriental insurance co. I have requeted more than 6-7 times to the concern person but getting no response. i.e. you are kindly requested to pl. help me to get clearance of the pending Medi claim.

Pl. find the attached all the policy documents requires for the bellow confirmation for your reference.

Your one confirmation will gives me a clearance of the Claim and I will be very much thankful to you for your kind support.

Claim no.[protected]

Kindly provide continuous coverage of mentioned details. Policy copy are also attached.

Policy no Policy period Remarks
141200/48/2016/9100 30.06.2015 to 29.06.2016 Current year policy.
141200/48/2015/8793 30.06.2014 to 29.06.2015
131100/48/2014/6988 04.07.2013 to 03.07.2014 As mentioned address column: Correct policy period is 30.06.2013 to 29.06.2014
121300/48/2013/4189 30.06.2012 to 29.06.2013

Your prompt reply for the above request mail will be highly appreciated.

Thanks & Regards

Bhavin Raval
Mob. No.: +91 [protected]

In refrence to above i would like to bring to your notice that i has propsed for a pnb royal mediclaim policy from pnb gandhi nagar branch kanpur on 30/12/2016.

Till dqte neither i have received the policy nor any information in this regard from bank or the insurance company.
My detail are as under pnb gandhi nagar branch knapur (Uttar prades)

S/v a/c no.[protected] propsed for royal mediclaim policy for

Vineeta pandey
Vinay pandey
Abhishek pandey
Ashish pandey

Your early reply will be highly appreciation.

Vineeta pandey
Mob [protected]