Oriental Insurance Company Complaints & Reviews

With reference to my policy no. I maid a claim for medical treatment of my spouse for femur neck fracture treated with dynamik hip screw fixation by renowned sr. Surgeon.

My claim is as per rules and regulation of oriental insurance for madi claim policy.

Still the company did not pay full charge of rs.77112/- given to surgeon for his service though all relevant documents and receipts is submitted along with my claim.

Further the insurance company did not pay ambulance charge of rs.3000/- which was very much essential for patient with seviour fracture of femur neck. Claim is submitted with original receipts and also confirmation letter from the surgeon for the ambulance service.

Kindly look into the matter and advice the company to settel my claim which is with in conpany's terms and condition.

We will approach consumer's court if my claim is not setteled and the oriental insurance company will be liable for all the incidental expenses.

With the above mention subject my old motor insurance policy no-322700/31/2016/9236 name biswajit biswas s/o- nani gopal biswas. I am trying online but not done in online. Amount is deducted in my saving account rs -1124/ with referance no-igocswlzg5 dated 20/09/2016. In 20/09/2016 i am also complain but till today it is not resolve. Please resolve early as early as possible.
Yours faithfull
biswajit biswas
[protected]

My car are accident car no. Mp15 ca6273 accident 5/5/16.in present situation my car insurance claim not clear. I submitted my documents on 10/06/2016 in sagar office and sagar office send document to satna office in 28/07/2016. My insurance iin oriental company in satna in 2015-16. I am very tired because my claim for car accident not clear. So please help me. Thanks mobile no. [protected]

Dear sir,

My self is dilip nathani and run automobiles business (aqua automobiles) since last 6 years in veraval. i have given all policy to oicl and given mini. 12-15 lac business/ annul to you. just now my show room toughen glass was broken in dec 2015 and i intimate also given 23/12/15 as per attach policy. at present, my show room, building, stock, house, other firm office with stock and our community policy (nagrik surakasha) is in your company. now our small bill is pending since a long time. your bo asked the surveyor not provide report thus your claim is pending. it is not our mistake. and i have already approved your surveyor (mr. panjwani) after many call. that time our supplier party was agree to work but mr. punjwani was approved very late and than i keep other party for same work. both suppliers quotation are same. i have submitted all document and bill in 10/05/2016. i have many call to your bo and meet personally many times he told always i will arrange within a week. i already discussed this matter mr. ak parmar in junagadh and mr. banga in ahemdabad. nobody is do process yet. second thing your veraval branch manager on leave 12-15 days in every month and other staff is not give proper response.
Now, pl. arrange and approve our pending claim and transfer amount in our (aqua automobiles - central bank) bank account.

I sure you will find this case on urgent basis and need full to us. i attach all necessary paper for your reference.
If you need any clarification pl. send reply on mail or call me.
Kindly co operate,
Regards,
Dilip nathani

I have submitted my file to Oriental insurance company on 11 Aug 2016, for accidental claim, but still today 22 Sep 2016, I didn't receive any update, every time i visit to the branch to check the status, branch people says, WE DONT HAVE ENOUGH STAFF AVAILABLE TO PROCESS THE FILE, THIS WILL TAKE SOME TIME, god knows how much longer this will take?, very bad service from oriental insurance company, I will never every go for oriental insurance again. @[protected]

This is to submit that the oriental insurance company, ro ambala utilized our services for investigation of five od claims as per the details hereunder:

Claim. no. u/w office allotment date date of submission fee bill

[protected] karnal 20.11.14 11.12.14 2460
[protected] panipat 20.11.14 11.12.14 3180
[protected] jagadhri 20.11.14 02.02.15 6204
[protected] y. nagar 16.12.14 11.02.15 6320
[protected] a/city 25.02.15 03.03.15 3662

Our e. mail dt 24.3.2015, registered letters dated 18.5.2015, 10.8.2015 and 28.1.2016 addressed to crm/dgm, ambala and also a letter dt. 8.9.2015 written to cmd did not yield any result and a total payment of rs. 21826/- has not been released till date, when a period of more than 1.6 year has already elapsed and i have been running from pillar to post to get my legitimate payment of rs. 21826/- for having investigated the five claims.

So it is requested for registration of the grievance and redressel of the same at the earliest please.

Vijay kr. datt
For bharat associates
Insurance investigators
Karnal-132001 (haryana)
Cell no.[protected]
E-mail: [protected]@gmail.com

I have done payment by yes bank ACC. [protected] for tha policy NO. 261200/31/2016/3846, but due to some have done payment by offline mode in oriental office, but that online canceled payment has payed by bank in orientel insurance online site .
so plz my 2nd time fee of rupee 1710 only .bank transfer ref.no -GYBK[protected] .and alredycomplaint many time but not responce
REGARDS
SATENDER KUMAR
M.NO- [protected]
POLICY NO:-261200/31/2016/3846

I am having HAPPY FAMILY FLOATER POLICY My renewed Policy.No.141600/48/2017/6024,
(1) Till Date not Received renewal Hard Copy or Pay recipe.
(2) no any person call receive below number. no signal mail reply Ahmedabad Branch.
SURESH CHANDRA
Direct No.[protected]
The Oriental Insurance Co. LTD
HEAD OFFICE,
(3) Old Policy Premium :- 14, 000
(4) Renewed Policy Premium :- 30, 151

Hi,

As per attached policy renewal notice, I am supposed to pay INR 17857 to renew my policy.

However, my agent informed me that Oriental Insurance is asking for INR 35387 to renew my policy.

As my policy renewal date is very near i.e. 12th sept 2016, without any further query I have given attached INR 35387 cheque for renewal of my policy.

My humble request to Oriental to refund me INR 17530.

I put a claim for rs.200459/- against hospitalisation expense but i was reimbursed for rs.155704/- only.

Insurance company deducted rs.37000/- against paid amount of rs.77112/- to sr. Orthopaedic surgeon against valid receipts.

I was also not paid ambulance charge for rs.3000/- (To & fro) though original receipts along with doctor's confirmation letter for necessity of ambulance was submitted.

(Claim settlement advice cnn hh[protected].

I put another request letter to reconsider my case, but received no reply.

Kindly look into the matters, and advice your department to settle my very much jenuine claim (With all proper receipts, report, e. T. C.) submitted.

Please confirm me at the earliest whether the policy no given by Yamaha manor motors berhampur odisha last year not showing in online while renewing for this year only two days left please suggest me what to do I hv to renew it by tmrw

Mail me at [protected]@gmail.com
Plz think it to be urgent orelse give me the no of Oriental insurance of berhampur so that I can do b4 the deadline
Thanking you
Raj
[protected]

My claim no. 142200/48/2017/000271 p no-142200/48/2016/17212,
My mediclaim policy sum assured for rs.1, 00, 000/-
After complain i received answer after 40 days. I have all serial mail to prove.
They are approved my claim as previous policy.

My claim for rs.51, 369/-/-
Company approved claim for rs.42, 542/-

Detail :
Operation dtd.21.05.2016

Claim submited dtd. : 07.06.2016

Approval voucher for rs.42, 542/- received on dtd.20.07.2016

I m not accept this voucher and return on dtd.21.07.2016

And after so many reminder i received replay by rajkot do1 mr. A. J. Trivedi. (No any changes in voucher)

As per my knowledge my current policy assured for rs.1, 00, 000/-

And company applied condition as previous year polcy i. E. Rs.50, 000/-

If my policy is assured for rs.1, 00, 000/- so i m alegiable hospital room rent rs.1000/- per day. So no any deduction in my hospital bill.

If company consider hospital room rent as previous policy i. E. Rs.500/- per day.

So company can pass my all bills.

I m submitting detail of my all bill here what i claimed.

1. Hospital bill rs.31, 900/-
2. Medical bill rs.13, 948/-
3. Anaesthesiology bill rs.4, 500/-
4. Krishna medical nursing home bill rs.500/-
5. R. B. Kothari laboratory bill rs.520/-
Total amount rs.51, 369/-

Please find herewith the answer i received after 41 days from rajkot do1 officer mr. A. J. Trivedi as here under.

A j trivedi
Aug 30

To me, c
Dear sir,

In reply to your letter dtd. 21st july, 2016 seeking full payment of rs.51, 367/-, we give here below details/break up of claim admissible amount rs. 42, 542/- :

* disease claim falls under exclusion for two years, hence sum insured of yr 14-15 of rs.50, 000/- is considered for admissible claim amount, but since claim lodged under current policy no-142200/48/2016/17212, terms and conditions will apply for this policy and as per this policy, room/nursing and hospitalisation charges excluding medicine charges are payable proportionate to sum insured payable on 50, 000/- (I. E. Sum insured of year 14-15)
* accordingly, break up of claim amount comes as under :

Total payable amount during hospitalisation is rs.28, 000/-

650 : 500 } 36400 = 36400 x 500/650 = rs.28, 000/-

(1) 28, 000/- eligible payable amount
(2) 520/- r b kothari 16/5/16
(3) 500/- krishna hospital 17/5/16
(4) 13, 500/- medicine 6 bills
(5) rs.42, 542/- total claim payable

We hope now matter is clear to you and we request you to kindly accept the voucher and return to us duly signed along with bank details to enable us to make payment.

Thanking you,

With warm regards,

A j trivedi,
Divisional manager d o 1,
Rajkot
Phone no[protected]
Cin-u66010dl1947goi007158
Disclaimer: the information contained in this electronic message and any attachments to this message are intended for the exclusive use of the addressee (S) and may contain proprietary, confidential or privileged information. If you are not the intended recipient, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately and destroy all copies of this message and any attachments. Warning: computer viruses can be transmitted via email. The recipient should check this email and any attachments for the presence of viruses. The company accepts no liability for any damage caused by any virus transmitted by this email. Thank you for your cooperation. www.orientalinsurance.org.in

You are requested please guide me how much more time i need to wait for my full payment of my claim rs.51, 369/-

Should i go for any court matter for my claim?

Thank you
Bharat chokshi
[protected]

Please do needful.

I am senior manager in pnb bank. I have a two wheeler insurance with your company with policy no. 261592/31/2016/702. My claim approximate rs.7500/- is pending in oic office of sirsa district state haryana since last two months. I bought insurance policy from oic because my bank has tie up with oic. But now i feel that i should not choose oic ever. I talked to your do mr. Makkar posted at ellenabad or but they are reacting like that they have no time to talk at least. If you will not settle the claim of pnb employee then how can you think that we will provide the leads to your company.

Insurance company: oriental insurance co'
Tpa: vipul medicorp

Subject: misleading information by tpa - vipul medcorp callcentre of oriental insurance co'

We had purchased a mediclaim policy which was effective from 1-may'16. (Vipul medcorp id no' [protected]). On 28-jun'16, my father-in-law needed to be hospitalised due to emergency hence i called their call centre[protected] at 9.04pm to check the list of network hospitals. The call centre said they do not have any network hospital in virar or nearby places & advised me to get admitted into non-network hospital & then claim for reimbursement. Following which we got his admissions in sanjeevani hospital (Near virar station).

The very next day @ 12 noon, i again called your mumbai office to confirm the given information - the lady (Ms. Sampada) over the phone gave the same information that we can get admitted into non-network hospital & claim for reimbursement. On 29-jun'16, 3.32pm i sent an email to them with regards to admissions intimation; also followed by a call to their call centre @ 4pm for which they shared the admission intimation number with me. Please note, during all these calls - i had given our vipul medcorp id no' for their staff to check the type of policy we hold.

Post discharge, on 11-july'16, we handed over all documents for reimbursement at your wadala office followed by a acknowledgement from them as a receipt.

After numerous follow ups (Emails & calls) we were given a understanding by mr. Swetaketu swain that company has refused to pay any reimbursement for jio phase-6 silver plans.

Their call-centre staff admits that its their error since they provided me misleading information at the time of admissions. Even if we say, it was one of the error, but then nobody bothered to come back to me even on my emails, even on my 2nd & 3rd call that silver plan doesn't support reimbursement. When their own staff is not aware about the policy t&c's then how do you expect client's to remember all these t&c's; that too even without receiving the policy copy. Yes, please note, till date - we haven't received any policy copy, all we received was the id number via email. The below details are extracted from online on www.taps.vipulmedcorp.com

Policy number: 111700/48/2017/204
Patient name: mr. Babulal nagjibhai fifadra
Vipul medcorp id no' [protected]
File number: 17rb03oie0248

My in-laws are very middle-class & this policy was taken to support their financial condition in case of medical emergency. Rejecting this policy on ground of your staff providing misleading information would be in-appropriate. We had doubts hence we called their call-centre - they never said that we couldn't get reimbursement if we get admitted in non-network hospital. Where is our fault? You can even check call recording at the call-centre.

If we were been given this understanding on day-1 or day-2 o[censored]s intimating them, then we would have taken discharge from that hospital & would have got admitted into a network hospital via ambulance on day-2 itself.

We have also approached the grievance cell at oriental insurance, however they are not responding & it is now being a mental harassment to us. It's been around a 50-60 days now, may i request you to please look into the same at your earliest.

Regards,
Sameer

OIC is rejecting my claim No. HI-OIC[protected] against my Policy No.171600/48/2016/830 by giving reason of Obesity claim is rejected. My wife was admitted in BAPS Pramukh Swami Hospital- Surat (Gujarat) on[protected] to[protected] for treatment of shortness of breath, Respiration. No treatment of Obesity was given is confirmed by CMO of Hospital.
My wife was admitted on[protected] to[protected] for the treatment of Shortness of breath & respiration. Claim was submitted in time & I have been given assurance that it is settled & amount within 2-3 days amount will be credited to your a/c. All of a sudden one doctor at TPA called me to meet him & behaved in very rude way & rejected the claim. i would like to send all the scanned documents for your ref. if you can provide me e mail id to send.

Of the total amount insured against med-claim OIC policy No:212203/48/2017/72 dtd:05/04/2016 covering Mr. D.P.Gupta and wife Mrs. INDIRA GUPTA for a sum of Rs.200, 000/=for each, against bill amount of (claim)) of Rs.67853.88 for Chikungunya hospitalisation in Max Saket, New Delhi, relating to Mrs. Indira Gupta, on 22/08/2016 Raksha agency of OIC has cleared (Cashless payment) to Max of only Rs. 15, 658/=only (Please note that the Room rent alone was Rs.28, 750/=), when I have paid Rs. 35, 329/= premium for the policy. I wonder whether it is worth going for a Med-claim policy?? Where has fairness gone??
DPGupta Ex-Project Director (NHVDC) a major R&D Mission of GOI. Phone: LL):46052895 OR Mo): [protected]. I shall wait for justice from your good offices.

Its been more than 2 months now that am following up for my claim of 4 wheeler accident. Every time i get to know some or the other reason or excuse and its just getting delayed and delayed. I don't understand if everything is completed from my side then why does it take more than 2 months for you to settle the claim. Very rude behaviour by your employees and unprofessional. Just unnecessarily getting delayed. Forcing me to move to private companies only, its ok even if we get less claim amount but atleast its quick and hassle free. Frustrating experience. I am old loyal customer of Oriental since more than 15 years for motor and medical policies but now this is really frustrating me a lot.

My mobile number is [protected].

Sincerely request you to settle this asap. Atleast consider the loyalty of a customer if not anything else.

Sir,
Ref: policy no. 441500/48/2016/801
Patient name : priya p r
Date of admission - 20/04/2016 to 22/04/2016
Policy holder : udayakumar p k

The mediclaim is rejected by divisional manager, aluva dtd. 05/08/2016 due to "current illness is incomplete abortion".
I contest the above claim, the point is :
Abortion is due to accidentally falling (Certificate enclosed) so the claim is admissible and may pass the same.

Udayakumar p k

I am writing to complaint regarding my worst ever customer service experience with a professional (Not sure if it is) company. Jyoti sharma was supposed to inspect but she never showed up for the same. She sent her junior yogesh for the purpose. He said that i needed to submit the estimate to the branch office but when i went to janakpuri branch for submission, they said that i needed to submit it in the cp head office. I spoke to jyoti and she said that she will be sending someone to collect the report from my home.

It has been more than 10 days now and both jyoti and yogesh have been making me fools everyday. They do not respond my calls. After so many attempts, if they pick up my calls they give me the same excuses over and over again; they are either ill or they have met with an accident. I would even call 30-40 times but they all go unanswered.

To my surprise, when i talked to jyoti and complained for the same, she became furious and said that it is not her business to submit the report to the headquarters but it is me who is supposed to do that. When i reminded her of what she said 10 days back, she started using abusive words that i cannot write here. I really cannot understand why you have these bunch o[censored]ncivilized and unprofessional staff.

1) Ref : HI-OIC[protected] Claim Extension - 2

Dear Sir/Madam,

This is in regards with the discussion with you that we have submitted a claim number HI-OIC[protected] Claim Extension - 2 for amount Rs . 60, 117/- and I have been authorised for the payment of Rs.1162/- only with a non-justified reason - not relating to current ailment.We have also submitted the justification of the concerned Dr. Shishir Mehta as instructed by Surat TPA (Dr.Sanjay Parmar) showing relation to the current ailment i.e the pain was related to current ailment and also the medication was given accordingly not to harm other organs due to current ailment.We have not received any favourable response despite of calling and meeting since long.

Kindly do the needful and authorise the balance amount of Rs.58, 955/-

2) Ref : HI-OIC[protected] Claim Extension - 0

In the above claim also deduction for amount Rs.24, 707/- is not justified as the treatment was given for UTI and cirrhosis of liver.The patient was suffering from swelling and pain in leg due to issue with the liver and had urine infection due to it.Kindly authorise the same deducted amount at the earliest.

We need to complete the above captioned issue.Hope you do the needful.
Any clarifications required from our end please call or mail.

Rathwa Sir : Please do the nnedful.It is related to the treatment and Dr.has not mentioned it.I request you to help and give a remedy.

PS: The file and supporting as asked for the same in original is submitted to Surat TPA already.