Oriental Insurance Company Complaints & Reviews

Meri Suzuki access 125 gadi choir ho gai uska full insurance tha oriantal insurance co ka. Sare documents dene ke bada Bhi Mera claim sanction nahi hua reason don't know... What we can do...

My address is b19, 3rd floor, sadashubh complex soc, near old toll, Bombay banglore highway, narhe Pune 41
My cell no is [protected]

Medical Insurance Reimbursement Claim in r/o Claim no: 2188925 amounting to Rs. 1,22,334/- (against PNB Oriental Royal Insurance Policy No. 263100/48/2012/264 ; MA-ID[protected] in r/o Mr. Anil Kumar Sharma having Saving Account no. [protected] at PNB, Argyle House Branch, The Mall, Shimla - 171001

Mr. Anil Sharma, the claimant/insured had suffered Brain Stroke and immediately admitted at the Artemis Hospital, Gurgaon (Haryana) on 4.1.2012 from where he was discharged on 12.1.2012. TPA had denied cashless facility on the plea that the claimant was having history of Diabetes. When the treating doctor certified that the Brain Stroke was neither due to Diabetes nor he was being treated for Diabetes, TPA requested the claimant to submit claim papers only for reimbursement after discharge. When claim papers were submitted, TPA rejected the claim now on the plea that the claimant had a history of Hypertension which was wrong. The patient has never suffered from Hypertension till date and as such there was no question of such treatment. Despite the fact that the treating doctor repeatedly certified that the patient did not have any history of Hypertension and he was not suffering from Hypertension and an occasional BP reading of 150/80 mmHg during hospitalisation of a 67 yrs old patient does not make him a patient of hypertension and even in non hypertensive patient, blood pressure can rise after Brain Stroke, still the TPA rejected the claim. Detailed registered post representations with all related papers (61 in no.) had been submitted to the Oriental Insurance Co. on 30.4.2012 with two subsequent reminders to all concerned by emails including customer Service Deptt. but the claimed amount has not been reimbursed till date. Please intervene in the matter as the claimant (67 yrs) recovering from Brain Stroke is unfortunately under lot of mental stress due to callous attitude and injustice by the Insurance Co & TPA by wrongfully rejecting the claim without any logic, ryme & reason but by an imaginary & incorrect plea despite repeatedly certifying on the contrary by the treating doctor. Choosing the course of litigation in Consumer Court may not be medically advisable for a patient recovering from Acute Brain Stroke but in case the Insurance Co. is not considerate, there is no option but to seek remedy fighting for justice and in that case the Insurance Co. will be liable for all the consequences. An early action is requested in the interest of justice.

Thanks & Regards
Parveen Kohli (On behalf of Mr. Anil Sharma)
5187 Modern Complex, Manimajra, Chandigarh-160101
(M) [protected]

I GOT A THIRD PARTY INSURANCE FOR MY ZEN ESTILO CAR PB 11 AP 8323 IN JUNE 2012 FRO QUEENS ROAD AMRITSAR.THE INSURANCE AGENT OF THIS COMPANY RUNS A BIG TYRE AND ALLOYS SHOWROOM AT QUEENS ROAD AMRITSAR.HE JUST GAVE ME A SINGLE PAGE COVER NOTE AND TOLD ME THAT THE POLICY WILL REACH YOU IN A WEEK BY POST.BUT I HAVE NOT GOT MY POLICY SINCE JUNE DESPITE SEVERAL COMMUNICATIONS WITH THIS PERSON. ASK THE INSURANCE COMPANY ON YOUR BEHALF HOW COME THEY ALLOW SUCH IRRESPONSIBLE AND DISHONEST PERSONS TO OPERATE AS THEIR AGENTS................

Dear Sir,
I have to inform you with great pain that I have one PNB-Oriental Royal Mediclaim Policy having Policy no. 331400/48/2012/1320 dated - 27/ 02 / 2012 in the name of Dr. Arbind Kumar Sinha with your esteemed insurance company but till date & time I have not received my corrected Policy Card as well as correction in our names, after a long pursuance with your issue office - DO / 3 Patna.
Really it was so tiresome & painful experience in my life that changed my good views in nightmare about your company's performance as well as about your employee, who has no vision or proper manner to do needful towards customer's problems / Grievances / Complaints.
Hope you'll enquire with your officers about my problems / Grievances / Complaints & will take proper step to do needful.
Thanking you in anticipation !

Dr. Arbind Kumar Sinha

Have already lodged a complaint of being not received Mediclaim Policy papers though the payment has been made on 24/03/2012 vide ch.No. 757830 of SBH, Sion Branch, Office Code & Name 121500 -MCDO 6 Collection No.51-01/[protected] Dept Code 48 Policy No.2012/2551 Dev. Off.Code NZ[protected]. Request arrange couriering of Mediclaim policy papers immediately on this receipt ofd this message. Thanks.

To,

Oriental Insurance Company's MD / India (TPA)

Sub: - Oriental insurance company and MD India TPA are not being taken any action regarding my claim.

Sir,

My name is Praful Mewada my policy number is: 131200/48/12/06854 and my claim id is: mdi127885

My contact no: [protected] Doctor Mr. Manish Kothiya Contact No : [protected]

में ने ओरींटल कंपनी में अपना बिमा करवाया है, जब मेंरी पत्नी को अस्पताल में दाखिल करवाना पड़ा और उसका बिल ओरींटल कंपनी में और एम .डी. इंडिया जो (टी पी ऐ) है बिमा कंपनी में जमा करवाया जोकि १८८६० की रकम का था

कुछ दिनों बाद एम .डी. इंडिया जो (टी पी ऐ) के तरफ से मुझे पत्र मिला की आपने जो उपचार किया है और जिस डॉक्टर से करवाया है वो हमारे नियमो के अनुसार नहीं है और डॉक्टर के पास उस उपचार करने की योग्यता नहीं है, इस नतीजे पे हम आपकी रकम का भुगतान नहीं कर सकते...

मेने यह पत्र डॉक्टर को दिखाया डॉक्टर ने कहा हमारे अस्पताल में हमने इस रोग और कई रोगी का इलाज हमने किया है और केई बिमा कंपनी ने बिमा रकम का भुगतान भी किया है. डॉक्टर साब ने मेरी मदद की और अपनी सारी डिग्रीया अस्पताल के कागजात मुझे बिमा कंपनी में जमा करवाने के लिए दिए, मेने सारे कागजात फिरसे जमा करवाए मगर अबतक कोई कारवाई नहीं हुई, एम .डी. इंडिया (टी पी ऐ) अब कहता है की आपका उपचार अयुर्वदिक तरीकेसे हुआ है हम आपकी रकम का भुगतान नहीं कर सकते ...मगर डॉक्टर के पास उसकी सारी डिग्रीय है



अब आपसे ही न्याय की उमीद है



Please open attached Documents Please contact doctor for this claims
Thanks & Regard's
Praful Mewada
[protected]

i have go through for treatment of my wife mrs shakuntala saraf in kol in columbia asia hospital and submitted my all bills to mr ajay biswas agent of oriental insurance co ltd whose code no ba[protected] on june 2011 but regret to say after a long period passed no response from co. i have contacted on march 2012 with branch head mr s p singh who informed that no claim had been lodged after that i approached to mr ajay biswas he informed that claim had lodged and you will recd reply from our branch very soon but sice 3 months expired no such reply recd since now

my policy detail policy no 332600/48/2012/8
insured code 35348683
issue office code 332600
issue office name do purnea
address 1st floor
govind dham kalibari road
bhatta bazar
purnea
854301
ph[protected]

My name is RAVINDER KUMAR, working with Keane India, an NTT Data, company for the last 7 Year, I have corporate policy no. TTK CARD NO. BLR-OI-K[protected]A of ORIENTAL INSURANCE COMPANY TTK Healthcare. TTK Healthcare branch is in Bangalore.
Address of the company
Unitech trade center
Keane India
6th floor
Sector -43
Sushant lok phase -1
Gurgaon

Compalaint against Policy No.. BLR-OI-K[protected]D

B/O MINI Policy no. BLR-OI-K[protected]D
BABY OF MINI admitted in hospital St. Stephen Hospital, Tis Hazari, Delhi twice in the month of December 2011.
BABY OF Mini born on 23rd December 2011 and discharge on 26 December 2011, Baby was stayed in Routine Nursery, I talked many times with ER spoc of our company & TTK to pay is cashless but they ignored it always. After many chats I pay all the bills by my own pocket. When I filed the bill for Baby for medical reimbursement, it was rejected always, everyone says Baby was not enrolled so we cannot approve the amount. Some of the executives of TTK said “You can enroll the Baby with yourself” and some of the executives says “you contact to HR ER spoc, HR will enroll the baby” but they unable to enroll the Baby because its in process we were working on it. Finally I contacted to the ER spoc of our company who is authorized for TTk named “Rashi Chawla” on 26th December 2011 , I sent the details of baby to enroll in the corporate policy. Same “Rashi” forwarded the details of baby to the TTK healthcare concern person named “LEENA”. Baby girl again admitted on 28th of December 2011 for Joendis that time baby was not enrolled so I pay the whole amount again.
At least 5-6 times I sent the details of baby to the Hr spokes “Rashi Chawla” and she also forwarded the mail to 5-6 times to the concern person “Leena” of TTK healthcare, But baby girl not enrolled.
Finally I filed the two claims of baby girl for different dates the medical reimbursement with “ORGINAL DOCUMENTS” in the month of January , but both claims were rejected because baby id was not enrolled. Again we sent the information of baby to enroll in the Policy, but nothing happened. Although I had called so many times to the CCE executive # [protected] (Chandana) but nothing happened I waited 3 months to enroll the baby in the policy
After three months in the month of march on 23rd day nearby, Baby of Mini Id (TTK CARD NO. BLR-OI-K[protected]D) was created and enroll in the policy but there was a shortfall saying “Need document”
Again I have re-submitted the Xerox copies again because “Original Document already sent on January.
After that new claim was generated which was BLR-0412-CL-0000067
In that claim no. BLR-0412-CL-0000067 there is shortfall again saying “NEED ORGINIAL DOCUMENT”

I do not simply understand, why they are asking for the original documents (see last attachment), when the same is submitted earlier. The required ORIGINAL DOCUMENT are already been submitted on dated 10th January 2012. POD details for the ORIGINAL DOCUMENT sent are: [protected] or [protected]. The required document could be found out in the records of the claim number BLR-0112-CL-0003862 OR BLR-0112-CL-0003884. Now you can see the New Shortfall which is made on 23/5/2012,In shortfall still they are asking for“ORIGINAL DOCUMENT” . PlZ fine the attached file of every details with screen shot in ms-format

2.
Compalaint against Policy BLR-OI-K[protected]B

FOR MINI CLAIM ID TTK CARD NO. BLR-OI-K[protected]B

Claim settlement no: BLR-0112-CR-0003106
I Filed claim for my spouse name “MINI” who was admitted twice in the month of November and December in St. Stephen Hospital, Tis Hazari, Delhi. Which is of In-Network Hospital. I filed a claim with ORGINAL DOCUMENT for medical reimbursement, they approved only Rs 370, rest of all the charges were rejected because of Pre-Post Maternity and it was showing only for 26/12/11 but dates are different, Claim was not of Prepost Maternity, rather it was for some other trouble during pregnancy. For this, I sent mail also. They have amalgamated all charges to Rs. 9103.00 and named as ‘prepost Maternity’ is incorrect. Charges were of Medicines, Lab, X-ray during Inpatient admission, which was medically necessary and was prescribed by the doctor. Details with the discharge summary has already been provided in original. All the bills are of St. Stephen Hospital.
Also, per Discussion with CCE of TTK Healthcare I again, re-submitted a separate claim for my wife (Mini) on 9th. March, 2012 amounting to Rs. 13,800.00 (approx), but it is not reflecting to the site.
At last I am totally frustrated to filed the claims again & again copy the bills sending them many times and always got response of rejected. I come to you for help Please help me to resolve this matter, when one of my friend told me. Please make the possible. I m really helpful & need your full support. In case any query please contact me feel free. I am still waiting your reply. PlZ fine the attached file of every details with screen shot in ms-format



Thanks

Ravinder kumar
Mobile # [protected]

I have submitted all the documents before 6 month but still there is no action has been taken by oriental insurance co., So what should I do for getting amount of claim.


SANDEEP MALVIYA
MO. [protected]

Dear Sir/Madam,
Mrs Uma Uppal is having mediclaim insurance of Oriental Insurance Company and she got this Insurance by Trisure Health Care Trust.
Mrs. Uppal had some health related problem and she got admitted in Hospital and paid all bills herself, she did not get cashless benefit. We submitted file for claim on 16th March and we were told that the payment will be released shortly. We mailed to check status after some times but it was pending and since then we have been emailing and calling up to release payment but not done. We also complained on customer care at trisure Health Care/MD India Health Care who work together for Oriental Insurance vide complained number 33238.

We have been getting assurance for last one month that the payment will release shortly. Finally we given one week time to resolve otherwise we will complain to consumer department however it is still pending.

May we kindly request you to take action and do the needful.

Thank you,

Yours sincerely,
Mrs Uma Uppal

MeRe pass 1 Suzuki access 125 scooter tha jiska insurance oriantal co se nikala tha gadi 6 months me choir hp gai jiska mene report Bhi kiya insurance office me air sare documents like keys, fir, leak hi Javab, rot documents, loan clearance papers , final report by court every thing I given them leaking wo log muse Arab 6 machine bad bolte he ki aapko claim nahi mileage kyu ki police complaint register ki xerox lag ati he wo sapana nahi di he. Aur insurance co ke norms me wo xerox kahi hi likha nahi he... Me bahot pareshan hu

my individual mediclaim policy no-41200/48/2011/494-my mother in law was hospotalaised, i informed the concern authorities, and submitted all the reqd. documents, still under processing,hospitaliasation taken place in may/june.

NAME OF COMPLAINANT: DILIP KUMAR YADAV
NAME OF THE PATIENT: SEEMA YADAV
COMMUNICATION DETAILS: VIVEK ENTERPRISE,
75, N.S. ROAD,
P.O. ASANSOL 713301
MOBILE NO: [protected]
INSURANCE TYPE: MEDI-CLAIM POLICY
INSURANCE COMPANY NAME: THE ORIENTAL INSURANCE COMPANY LIMITED
POLICY NO: 313100/48/2011/396
DETAILS OF COMPLAINT: I HAD SUBMITTED A CLAIM UNDER CLAIM NO. HH[protected]. I HAD REPLIED TO THE QUERY OF THE TPA ON 6/09/2011 AND AGAIN ON 29/11/2011 THROUGH COURIER BUT SINCE THEN I HAVE NOT RECEIVED A REPLY FROM THEM NOR ANY SETTLEMENT AMOUNT AGAINST MY CLAIM. A SERIES OF REMINDERS WERE GIVEN TO THE TPA AND THE INSURANCE PROVIDER BUT ALL IN VAIN. PLEASE HELP ME OUT TO GET ME MY CLAIM. THANKING YOU.

Our policy No : 151100/48/2011/6874
Claim No : 151100/48/2011/000214

Dear Honorable members, I would like to be guided by you, Because from last 1 Year I have been undergoing Mental Torture due to Negligence of Oriental Insurance Company's Employees, and due to which, claim of Burglary at our company's warehouse is kept pending since April 2011 by Oriental Insurance Company.

There had been a burglary of computers & peripherals at our warehouse on[protected]. The entry was forceful, the Burglar cut the shutter and Stole various computer goods worth Rs. 15.5 Lacs. As soon as we came to know the same, we immediately informed police & Oriental Insurance Company, our insurer. Both agencies came and started their investigation. We also informed the entire IT Channel of Madhya Pradesh and requested IT Magazines of Madhya Pradesh to publish news about this burglary along with the serial numbers of stolen goods. We also requested the respective manufacturer of stolen goods to keep their warranty on hold and to tag them “Stolen” so that if anybody would claim their services under warranty period, we would come to know about them and will reach up to them. Finally after rigorous investigation for 4 Months, Police closed down the case because they could not uncover the theft and issued a “Khatma Report” on 30 March 2011. We submitted “Khamta Report” to Insurance Company and the surveyor started preparing the survey report for the theft of 15.5 Lacs.

Interestingly, the theft was later on uncovered in the Month of April 2011, and very huge amount of computer goods were recovered and ceased by Indore Police from the burglar. We immediately informed Oriental Insurance company. During the police enquiry, the burglar admitted that he has not only committed theft at our warehouse but at another shop at Indore also and some amount of recovered material belonged to that another shop also. We got the ceased material back which belonged to us through District Court and Finally, the surveyor of Oriental Insurance company prepared another survey report and this time the balance loss of goods which was re-valued by surveyor was 6.98 Lacs. We again applied for claim of the newly set amount and submitted all the required document along with the copy of challan submitted by police and certified by the court in which the case is going on. But from then, we have been meeting and writing letters to the Divisional Manager of Oriental Insurance Company but not received single reply in written so far. However, we are getting very funny answers verbally from them that the they still have some doubt about the theft. We requested them to give us this query in writing, but they did not give us in writing. Also, We reminded them so many times that the theft has been uncovered and the case against the burglar is going on in the District Court of law under section 380 / 457.

Despite of all this, the Insurance company is neither answering us about the status of claim nor they are settling our claim. In this regard, we contacted the Chief Regional Manager so many times also but did not get any satisfactory answer.

I request honorable members to please suggest me how should I proceed further.

Sub: Complaint related to Group Nagrik Suraksha Insurance Policy, THE ORIENTAL INSURANCE COMPANY LIMITED,RJKOT

Sir,
With reference to above subject my complaint reletted matter as under.
1. Name of the complainant: DR.MAGANLAL SHIVABHAI MOLIYA
2. Address of the complainant: ASSOCIATE PROFESSOR, DEPARTMENT OF EDUCATION,SAURASHTRA UNIVERSITY, RAJKOT. 360 005 (GUJ.INDIA)
3. E-mail/Telephone/Fax :...

The bike has been stolen by Someone in Gangapur City, Sawai Madhopur Rajasthan in the month of May, 2011. The required documents have been deposited to concerned officials of the oriental insurance company ltd jaipur. The survey has been done but suryeyar has not submitted the report and no further response has been given.
The detail of the case is as follows-
Policy No. 241108/31/2011/3439
Bike Model No. Bajaj Pulser 135 CC
Vehicle No. RJ 34 SC 7141
Claim Amount Rs. 51763/-
Consumer Name - Chetan Kumar Gupta Gangapur City Rajasthan Mobile No. [protected]
Insurer Company- The Oriental Insurence Company Ltd., Jaipur

The incharge of the case- Mr. A.K. Datta, Manager, The Oriental Insurance Company Ltd., Jaipur Phone No.[protected], 5113678

With Regards

Chetan Kumar Gupta
Consumer
Mobile No. [protected]

Husband of complainant insured with Oriental Insurance Company, Divisional office No. 14, 80 FIE, Patpar Ganj, Industrial Area, Dehli vide policy nos. 271700/48/2009/363 and 271700/48/2009/365 woth of Rs. 250000 and Rs. 300000/- who died on[protected] but claim repudiated due to limitation while intimation and all documents have been submitted to the concerned office on demand after due intimation at proper time.

The Oriental Insurance Co India Ltd. Dear Sir / Madam, The Claim submitted on 16th Nov'11 and Claim No. 30000580, claim of Mrs Arati Bhattacharyya - Insurance Policy No.311500/48/2012/3961, Claim Amount Rs. 35,680 has not been received yet. I have followed it up with E-meditek where they are saying it is discrepant stating reasons which are not valid. All the papers required were submitted along with the Policy issuance scan.. Regards, Cell No [protected]

I take a insurance last 10 years in insurance company but they do not pay a claim amount last year in 2010 11 claim number in e-meditek tpa is 903654 i add all detail bellow.



Regional Office (ahmedabad) Sakar-5, 7th Floor, 709, Behind Natraj Cinema, Near Gandhigram, Railway Station,
Ahmedabad - 380009, Gujarat
Phone No :[protected], Fax No :[protected],
EMail : [protected]@emeditek.com
REPUDIATION LETTER
WITHOUT PREJUDICE
Date : Jan 25, 2011
The Oriental Insurance Company Limited
Relief Market, Near Vepari Gin,
Kalol - 382721,
Gujarat
Sir / Madam ,
Reg:
Hospitalization claim of : Shardaben K Patel
Employee Name : Kanubhai C Patel
Employee Number : - Na -
Hospitalization Period : Dec 20, 2010 - Dec 25, 2010
Hospitalization At : Devasya Hospital
Diagnosis : Adpkd + End Stage Renal Disease
Our reference No : OI/INDO/12011/00903654
Policy Number : 143601/48/2010/3602
Repudiation Letter No. : EMSL/REJ/12011/00108719
We are in receipt of the claim form & associated documents of Shardaben K Patel. On scrutiny of the same, we observe that he / she was admitted in Devasya Hospital. patient was admitted with c/o dyspnoea, pedal oedema and bilateral renal crepittation. DX as ADPKD + END STAGE RENAL DISEASE patient was operated for left radiocephalic fistula at wrist at nail hospital. hemodialysis done in devasya hospital. ADPKD [Autosomal Dominant Polycystic Kidney Disease] is genetic disease so this claim is not payable as CLAUSE 4.15 Genetical disorders and stem cell implantation / surgery..
In view of the above, we are left with no option but to repudiate your claim .
We regret the inconvenience caused and view this as an opportunity lost to be of service to you.

Yours Sincerely,
For E-Meditek (TPA) Services Limited
Dr. Hitesh Patel
CC :
1.

I take a insurance last 10 years in insurance company but they do not pay a claim amount last year in 2010 11 claim number in e-meditek tpa is 903654 i add all detail bellow.



Date : Dec 22, 2011
THE ORIENTAL INSURANCE COMPANY LIMITED
RELIEF MARKET, NEAR VEPARI GIN,
KALOL - 382721,
GUJARAT

Sir,
Reg:
Hospitalization claim of : Suryakant C Joshi
Employee Name : Suryakant C Joshi
Employee Number : - Na -
Hospitalization Period : Nov 29, 2011 - Nov 29, 2011
Hospitalization At : Sal Hospital ( )
Brief Diagnosis : Cad triple Vessel Disease severe Lv Dysfunction
Our reference / claim No. : OI/HFFP/122011/00934420
Policy Number : 143601/48/2012/486
Discripancy Letter No : EMSL/DISC/122011/00469918
Agent Code : - Na -
Development Code : - Na -
This has reference to the Claim papers recieved by us on Dec 15, 2011 in respect to the above hospitalisation.
On the perusal of the papers, we observe that the following documents / informations are required by us to process the mediclaim further:
1.

Kindly Provide The Details Of The Patient Since When He Is Under Contineous Coveragfe Of The Policy With Si Details.
Thanking you and assuring you of our best services always.
Yours truly,

Dr. Sunit Devani

( Customer Care, EMSL )

Tear from here Attach this leaf with reply papers
From : THE ORIENTAL INSURANCE COMPANY LIMITED To : EMSL
Hosp. claim of : Suryakant C Joshi
Hosp Period : Nov 29, 2011 - Nov 29, 2011
Hosp. At : Sal Hospital
Brief Diagnosis : Cad triple Vessel Disease severe Lv Dysfunction
Reference No. : OI/HFFP/122011/00934420
Policy Number : 143601/48/2012/486

I/We am/are enclosing following documents in reply to your discripancy letter dated Dec 22, 2011

Kindly Provide The Details Of The Patient Since When He Is Under Contineous Coveragfe Of The Policy With Si Details.
Date : __/__/____
( Signature )