Oriental Insurance Company Complaints & Reviews

Dear sir/madam
Myself satyakesh mishra i am writing about cashless facility not given by paramount health insurance company. I completed all formalities and fallowed all rolls and regulations there's is created unnecessary confusion by health insurance company.
I am very upset about this concern because this was not should hepening with us.
I am always fallowed all rolles and regulations of hospital tpa and helth insurance company also.

I requesting to you please check it if we are eligible please consider.

Respected sir this is ref to mediclaim under pol no171301/48/20/01139 oriental in’s comp claim no 1713/48/2020/00002912 insurance name tinani mohandas f. And patient name maya mohandas tinani wherein claim lodged for rs 367215. Claim has been settled for rs 204949. Disputing rs 162266 amt. Sir i humbly request you to kindly look into matter seriously we have every proof of expenditure and bills and receipt. It is open injustice with us because payt of claim is very less. Money has been borrowed with interest from outside to make payt to doctor who never dish charge patient without payment. Looking to our record of 20 years of your customer i request you to immediately settle disputes amt. Sir i once again request you to kindly personally look into the matter.

Policy no : 143691/48/2020/207 - oriental insurance company limited.

Claim no : hh[protected]

Amount claimed : 24757 rs.

Claim settled : 21948 rs.

Received amount : 19753 rs.

With reference to above detail, i request you to clarify the deduction on which basis of clause, charges toward doctor's visit, infusion pump, others not payable.

Claim bearing no hi-oic[protected]

I had submitted the claim for rs 25307 out of which rs 19157 is only received. The money deducted against bill 3634 - rs 4650, which was medicine bill and casting tape roll etc.
The same amount submitted by us to the hospital the reason is as on today unknown. Rs 1500 deducted against missing of x-ray report in fact the same submitted along with x-ray.

Kindly look into the matter and request to settle the balance amount rs 6150 without loss of further time.

Dhimant shah

My medi claim with raksha tpa offered by the oriental insurance company, my member id with raksha tpa is o[protected]ippb the claim passed on 23.10.19 by the status available in raksha tpa app. But still the amount not credited to account, they are not responding to the query raised either phone or mail, requested to settle the claim as soon as possible.
Claim no : [protected]

My full name is kumar naresh kukdeja & currently working in axis bank ltd.
My policy no - 124500/48/2020/3052
My claim no is 20563258 & i have registered my claim on[protected]:42
Patient details - ridhi kumar kukdeja
Claim details - claim amount rs 18, 736 & claim approved - 14, 371
Current status - processed ready for payment on[protected]: 59

Very bad service provide by the oriental insurance. I insured my car by this company last 2 years. And now recently my car become accident. They cover only 2-3 part in zero depth policy. Please avoid oriental insurance cover. Maruti dealer also suggest me don't take this company policy in future.. And agent (Survayer) talk to me very rudely...
Really this is my own experience... Very genuine...

Dear sir/mam,

By 19/05/2019 my daughter got hospitalized and discharged by 22/05/2019. She had to suffer from a small surgery. As per my agent instruction, i couriered my all prepaid expenses and postpaid expenses to my concern agent mr. Rajdeep tiwari ji (Ba[protected]). I did not avail your prepaid facility as nearest nursing home told they are not in panel and my agent instructed me to pay hospital and claim lately from insurance company but after getting done that courier still my claim not come in my account as of now. I don't know what problem is behind this because i trust on my agent also because previously he always supported me to get done this and i always got my claims well on time from oriental insurance co. As per my agent information he is telling soon it will come but some where i have gut feeling something happening not in right direction. You are requested to see this matter on top most priority as already 5 month has been delayed in this matter. I hope soon you will address this and will resolve this issue as fast as you can.

With reference to the intimation of claim date of loss 25-JUN-19 against policy number 233105/31/2020/372 claim has been registered and Claim number is 233105/31/2020/000253. After submission first surveyor missed pics and deposited to branch late after that branch manager of company gone overseas and now as per agent audit is going on. 3 months is going to over on 24th september and till today i don't have any information when claim will be settled. on the name of me and my wife 4 vehicle is insured in oriental insurance which earlier covered with ICICI prudential and i have not get any complaint when ever the claim arrise.
First time in oriental loss happen and i am not getting claim amount. I want to ask you if your surveyor miss pics whether its my fault. If branch manager is going on our of station whether he is not assigning his responsibility to other and if audit is going on in branch whether they are not doing any new business. why problem or hurdle is their to settle claim which is pending from 3 months. please look in the matter and do the needful.

Dear team,

We are calling on the toll free number for claim intimation from 8th september 2019.

But i found the associate whom is talked is totally unprofessional who has kept my call on hold with out refreshing the hold more than a 25 minutes and he is very arrogant and unsupportive on call his name is mr anwar.

Since 8th of september 2019 i am receiving different contact numbers for branches which never connects. Every time i call on those numbers it gets immediately disconnected, said number as follows [protected]
[protected]@orientalinsurance.co.in
[protected] lipi gupta.

I am in mumbai and associates of oriental insurance company have provided me the number of mr rajiv kumar gupta who is in delhi and moreover he is not looking for claim intimation.

I have called from [protected] from which you can trace all the calls.

Hi

I need to complaint regarding my one of motor insurance taken 5 months ago in month of march
For which i made a payement in whole but till now i havent received my payement yet..
I dont know how many months it takes..
But need your help asap..
I tooked my insurance from ahemdabad..
My insurance policy number is
151401/31/2019/7213
My vehicle no. Is
Mkindlyp09qg2928..
Help me out in this and give me a proper resolution..

Dear sir,

This is with respect to my rejection of the cashless facility of my insurance namely

The oriental insurance company ltd. Favouring mrs sushma chandra. Policy no. 272900/48/2019/17341.

To my surprise on submitting the above policy for cashless payments to fortis hospital towards knee replacement, the same was rejected on account of the policy being only
2 years old and not conforming to the minimum 3 years requirement

The said officers have failed to see the endorsement schedule no 272900/48/2019/[protected] which categorically states condonation of
The break period of 50 days period and to be in continuation of the previous policy 272900/48/2016/14521 and 272900/48/2018/21741 thereby making the policy effective from 2012 which is well within the minimum period of 3 years required for the tkr

My operation is fixed at the fortis hospital o the 3rd sept 2019 and thus you are requested to immediately clear the cashless facility and instruct your officers to clear the same to enable me get my operation done

Please do the above immediately as i am in great pain and need to be operated asap

Please do not make a senior citizen run around to get her claim which is legally due to her

Best regards

Sushma chandra

Dear team,

With a heave heart, i am writing this mail as my reimbursement claim settlement pending with oriental insurance since last 1 year.


Though the amount has been approved but the payment to my hdfc bank a/c has not been credited till now.

A long follow up mail has been shared with the respective team members regarding this matter (If you require, i will share the same).

I have received a lot of reminder sms from medi-buddy regarding confirmation of the receipt of payment. (Last one received on[protected].

However, currently in portal it is showing status :- claim closed[protected].

How could it be possible? Please close loop & confirm the same.

Claim no :[protected]

Claim amount :- 7291

Approved amount : 7191

Insurer claim id :- 520000/48/2018/015654

Patient name :- amulya chandra das

Tpa : medi assist

Regards

Debasis mohanty

[protected]

We have taken group insurance policy no. 215502/48/2019/2013 dated 29.09.2018 from your company mayapuri branch for the benefit of our employees posted at various site covering benefit hospitalization.

In this regard it is intimated that of our employee mr. Harish kumar s/o sh bhola ram working at our site upl, crn no - 2883, igstpp, jharli, jhaggar, haryana was injured on 27.11.2018 while working in the plant and was injured badly as one heavy iron plate fell on his leg. He was immediately provided the necessary first aid and taken to the hospital for treatment.

The matter was also immediately reported to your office on the date of accident i. E. On 27.11.2018 vide following e. Mails marked to mr rajender parshad and to mr. Vijay kumar vide their following official e. Mail 1. Rajender. [protected]@orientalinsurance.co.in

He remain hospitalized from 28.11.2018 to 01.12.2018 in the hospital for treatment and he incurred an expenditure of rs. 52, 376.00 from his own pocket during the treatment. ]

Since he was covered under the above said group insurance policy taken by us from your company, we farwarded his madical bill along with all the relevant docoments for reimbursement.in this connection our employee visited personally to mayapuri branch on dated 23.01.2019 and again on 13.02.2019 for handing over the claim. But to our surprise your representative mr.
Rajender parshad refused to accept the claim on one or other pretext.

Since all the original bill was there in the claim our representative returned back with documents and we do not prefer to send the same by post for the safety of original documents enclosed with the claim.

Inspite of our repeated telephonic request he bent upon to refuse / to not to accept the claim.in this regard we send our request by e. Mails to him but no positive response is received from his. The copy of the e. Mail is enclosed herewith for your reference.

It is a clear cut a breach of agreement we jointly entered for the safety of our employees and needs immediate attention.

It is requested to look into the matter on top priority so the hardship faced by of our employees is sorted out and you fulfill your contractual obligation under the policy.
In this connection we are forwarded the scan copies of all the documents for their kind consideration. All the original documents shall be provided to them as and when required for necessary action. It is humbly requested to sort out the matter on priority to end the hardship to a innocent employee.

Hope for an early action.

Ramesh chand m. No. [protected]
Cosmos systems

Sir i have KTM RC 200 and my bike crash in road accident on 28 i submited my bike on 1 july the surveyor of oriental is pass my bill that time and misplace my submited document after i collect my bike now surveyor is saying that my insurance cant be claim because insurance had a gap period between privious insurance pl? Help me that its insurance surveyors duty to see all document and carefully submit the ducument and even my insurance had a gap period of 1 month and gap period is allowel for 3 months

I have logged a claim for my fathers treatment at Jivraj Mehta Hospital. The details of claim is as under.

Patient Name - Madan G Dave

Policy No - 141300/48/19/06773

Insurance Company Claim No - 141300/48/19/002242

Claim Amount -60300/-

Additional Claim Amount - 34000/-

I understand that this claim is rejected as per final repudiation letter (as attached) received from Oriental Insurance. According to me this is a illegal rejection and should be reconsidered. My father has insurance cover with Oriental Insurance for more than 15 years So any preexistence disease is covered after five years.

My father has quit smoking since 2010. For reference certificate from the Doctor is attached.

Anticipating a proper justification for rejecting the claim.

Not received household package policy from co. Bhadrabranch. Nor received receipt for payment of premium amount since 28/1/2019. The branch is not replying. Policy no. 144000/48/2018/26937due on 31/1/2019 for which i paid premium video cheque no192 drawn on bob vasanabr. Ahmadabad. Please. Take up the matter with co bhadrabr. Ahmadabad & oblige. Thanks

Sir,
The detailed measurments were taken on site immediately after i was called by dr. Das, at pagalkhana r. O., sadar, nagpur & drawings were immediately prepared, submitted & revised as per the satisfation of d. O amravati. Estimates were prepared for civil, furniture, electrical, hvac & submitted, revised & querries were satisfied from mumbai (Ho). The mails & other communications can be submitted if needed or can be asked from the sadar office, nagpur. No fees were paid, no travelling allowance paid from nagpur to amravati to me as well as hvac consultant nor any fees paid after ringing up, sending mails till date. The matter is almost 2 years now, kindly give justice by paying fees as per the norms.
Regards
Ar. Sanjeev raoot

Sir, i was called for visiting the site, preperation of plans, estimates for the d. O amravati from sadar nagpur office being on the panel of architects. I discussed the requirements of staff to be accomodated, did site measurments in details & submitted the plans & rectified as dicussed by do & ro, nagpur. Prepared estmates for furniture, electrical, hvac as per their requirements. Submitted the documents, replied to the querries as & when required for nearly 9/12 months & was not paid any consultancy charges till date after so many requests & phone calls, & mails to the concern offices. You can check the mails & communication done by d. O & r. O for the above interior work at do amravati.

Refer to my so many mails to raksha tpa and oriental insurance co. But they send letter they have mentioned "said treatment does not require 24 hours hospitalization and comes under opd protocol"

Please note that 2* 500 mg mabtas injections doctor has given and before giving the injection they have done some test of blood and reports of haematology & biochemistry was attached even after test and after positive reports they have stated first solumedrol 125mg in n. S. 100ml after that dr. Has given 500 mg mabtas (Rituximab) in n. S.500 ml and after that wait for one hrs and they have started the same solumedrol 125mg in n. S. 100ml and after that 500 mg mabtas (Rituximab) in n. S. 500 ml so its take time and after completion of all drips they don't discharged and keep admitted whole night to check side effect if any.

This is not first time that we are admitted for mabtas and last time our bill was passed and we don't understand this time why its not payable kindly consider this that we are having the policy since last 10 years (Since 2009) and we are very thankful for kind supportby passing our mediclaim even in starting 4-5 years there was no claim and we was continuing and after starting of disease mediclaim has supported us and this time we are in very poor position as no one is earning person and my husband mr. Sanjay is a disable person and unemployed since last 5 years.
We are having the policy since last 10 years (Since 2009)
Last year we have submitted our claim for hospitalization on 11-may-2018 and on 28-06-18 we was reimburse the bill for same injection given - mabtas 2*500 mg so we don't understand this time with what reason claim is not payable