Oriental Insurance Company Complaints & Reviews

SIR WE HAVE SUBMIT A CLAIM FILE OCT-2018 accidental date 16/10/2018 BUT TILL DATE WE HAVE NOT RECEIVED A CLAIM PAYMENT OR ANY QUERY ALSO WHEN WE R GOING TO TPA MISSING OUR ORIGNAL CLAIM FILE AND ALL DOCUMENT SO PLEASE HELP US ALSO PLEASE GIVE INTEREST WITH OUR CLAIM AMOUNT
my policy no is 141102/48/2019/7842
my phone number [protected]
mail id [protected]@gmail.com

My son admit in amcare hospital zirakpur 12.05.2019to 14.05.2019 for medical treatment. A medical expense of rs 39000 is incurred. The hospital have given me bill & reports of the medical treatment. All these original documents and films issued to me by amcare hospital is being submitted by me in raksha tpa oriential insurance sector26 chandigarh. But the insurance
Company has rejected my claim. I have paid 11 years regular premium. I do not know why they have rejected my claim. Please help me.
Ramesh sharma
[protected]@gmail.com

I bought my two wheeler insurance from coverfox of oriental company I put my bike on 4th of June 19 & on 6th from workshop intimate the claim after that also still no response from anybody not from coverfox & also not from oriental very bad experience
Policy No : 131300/31/2020/3855

Need strike action on this coverfox & oriental company both are cheating with customers

Surendra singh shekhawat my address is pl. No. 55, chitrakoot colony, opp. Bharat gas agency niwaru, 302012, contact number is [protected], my policy no. Is 243600/31/2019/2172, bike registery no. rj 14 dq 8517.
I am your company regular costumer my bike had met with an accident on 04/03/2019 then i sent my bike to “advent automobiles pvt. Ltd 216, mission compound ajmer road jaipur 302006” to get repair. Then your company’s surveyor came to survey my bike and after seeing the parts damaged he still didn’t pass the claim of all parts he didn’t add all damaged parts in his claim file, and the behavior was very bad and till now he didn’t pay the claim everytime whenever i call they are like come and give us that document come and provide us this everytime they give me the same excuse whenever i visit or call after i provid every single document still they didn’t pay and whenever i call for enquiry about my claim they always ask me for different different documents just always use to give me excuses though i provided every single required document and after providing all needed document they are not paying the claim money.
on 16/05/2019 also i sent an e-mail to your executive p. Maheshwari about my this issue but they also didn’t gave me any sufficient response and today (Date - 24/05/2019, time – 12:16 pm) i got a call from [protected] this number and they said that you have to come and do a sign. This is how they are bothering me.
now, if i didn’t get my claim in next 7 days then i am gonna take a serious action against this i will go to the consumer court and will post reviews about your so bad service on every social media platform and every other website where i can.
Please open these attached file.

Respected sir my mother name v vasanthi policy number is 423000/48/2019/1212. Members id[protected]. My mother was suffering from headache from past few months when we go to our family doctor suggested for eye checkup then doctor advised to narayana netralaya. Their my mother got checked and doctor prescribed some drops and told yag laser treatment should be done for both eyes then The hospital bill sections asked for do we have any health policy and we said yes and submitted all following documents to the hospital. And took and appointment for treatment on 15 may 2019. After two days we got call from hospital that our cashless treatment has been denied indicating a letter to come for better reimbursement. But we have to pay cash and made treatment to my mother. By the way all documents and I have given to our agent prabhu for reimbursement. I hope we get better settlement from your company.

It is deeply disturbing that despite having submitted the truthful submission vide our letter dated 13th march, 2019 and through numerous verbal communications thereafter in clarification of query in response to your letter dated 04.03.2019, still, there does not seem an end to rigmaroles.
Your perfidious approach is writ-large when you conveniently denied of having received our above-referred letter dated 13th march, 2019, though received by you under recorded delivery, but preferred to close the claim file as no-claim. All these unfair acts and conduct is not only akin to rubbing salt on wounds of the sufferer but is a clear breach of trust violating the policy-holder’s interests regulations, 2017, especially against the provisions of regulation 27 of irdai (Health insurance) regulations, 2016.
My honest submission in my above-referred letter was/is sufficient to consider sympathetically, inter-alia, to reimburse the genuine expenses incurred on the treatment on my wife, which by all norms was instantaneous and sudden and myself as an insured or the insured person was never ever aware of nor ever felt any such complexity of pains etc.in the past or prior to policy nor ever diagnosed remotely rather my wife was quite hale and hearty as fit as fiddle. My wife had no signs or symptoms of such ailment prior to policy or even before hospitalization on 30.07.2018. Even, two ecg on record, prior to intervention, go to establish that there was no indication of any heart ailment.
There is no reason to assume it as pre-existing disease by any flight of imagination, especially, in view of the categorical opinion of the renowned cardiac surgeon dr. Sarju rahlan of prestegious dayanand medical college & hospital, ludhiana confirming vide its certificate dated 10.08.2018 that she had no previous history of any kind of treatment of hospitalization regarding coronary artery disease. The same is attached as ready reference. For the sake of brevity, my letter dated 13.03.2019 may also be read together here and reconsidered for the sake of justice. Any unpredictable or unknown ailment may take place with the human body which even the premier medical institute of the region could not diagnose at the very prima-facie by having undergone diagnostic procedures or through conservative observation by the attendant team of doctors.
So, it is absolutely wrong to presume it as pre-existing ailment by any stretch of imagination. It does not stand to any logical reason either under the protection of policyholders' interest regulations as envisaged by irda or in the ambit of insurance policy to capriciously apply that tool of settlement which preferably suits to your ends to squeeze an innocent customer monetarily & mentally by putting the insured on a disadvantageous pedestal by wrongly & illegally propounding as pre-existing ailment. Such an unfair term is void ab-initio. Rather, a misadventure is being made to decide the fate with pre-conceived mind and fallacy. I vociferously lodge my protest against this unfair act & conduct. Yours plea in the matter, without any trace of animosity, is ex-facie frivolous, malicious & misconceived intended to cause irretrievable loss to an innocent insured and thus, deserves to be deprecated in the given situation.
It seems that the envisaged concept of an insurer has been thrown out of the window by illegally denying the cashless facility. Thus, you even preferred to maintain a deafening silence and failed to settle & pay the rightful claim within 30 days on receipt of documents as per regulation 9 (5) irdai. The violation thereof is also punishable u/s 102 (B) of the insurance act, 1938.
Sir, your unlawful principle of coercion would not apply here in my case by taking a false shelter of an irrelevant plea distantly not related to the present claim. Instead, upright claim of a consumer should have been decided cordially while demonstrating coherence, cogency & candor. Such irrational tool of nitpicking, after any genuine claim, ought to have been avoided and rather, the contractual, statutory and regulatory obligation under the policy should be performed with professional diligence.
So, “healthy conflict resolution process” religiously demands that my claim be reimbursed in a quick-fix manner without any further delay in the fairness & fitness of things. I hope your good self shall not compel me to move on to any other path of conflict for rightful resolution. Humility and honesty come to a decision expediently.
Looking forward to having your prompt & positive response

Yours humbly,
(Vinod kumar jain)
B-34, 4641, street no.12, durga puri,
Haibowal kalan, ludhiana
Cell no. [protected]

It is deeply disturbing that despite having submitted the truthful submission vide our letter dated 13th march, 2019 and through numerous verbal communications thereafter in clarification of query in response to your letter dated 04.03.2019, still, there does not seem an end to rigmaroles.
Your perfidious approach is writ-large when you conveniently denied of having received our above-referred letter dated 13th march, 2019, though received by you under recorded delivery, but preferred to close the claim file as no-claim. All these unfair acts and conduct is not only akin to rubbing salt on wounds of the sufferer but is a clear breach of trust violating the policy-holder’s interests regulations, 2017, especially against the provisions of regulation 27 of irdai (Health insurance) regulations, 2016.
My honest submission in my above-referred letter was/is sufficient to consider sympathetically, inter-alia, to reimburse the genuine expenses incurred on the treatment on my wife, which by all norms was instantaneous and sudden and myself as an insured or the insured person was never ever aware of nor ever felt any such complexity of pains etc.in the past or prior to policy nor ever diagnosed remotely rather my wife was quite hale and hearty as fit as fiddle. My wife had no signs or symptoms of such ailment prior to policy or even before hospitalization on 30.07.2018. Even, two ecg on record, prior to intervention, go to establish that there was no indication of any heart ailment.
There is no reason to assume it as pre-existing disease by any flight of imagination, especially, in view of the categorical opinion of the renowned cardiac surgeon dr. Sarju rahlan of prestegious dayanand medical college & hospital, ludhiana confirming vide its certificate dated 10.08.2018 that she had no previous history of any kind of treatment of hospitalization regarding coronary artery disease. The same is attached as ready reference. For the sake of brevity, my letter dated 13.03.2019 may also be read together here and reconsidered for the sake of justice. Any unpredictable or unknown ailment may take place with the human body which even the premier medical institute of the region could not diagnose at the very prima-facie by having undergone diagnostic procedures or through conservative observation by the attendant team of doctors.
So, it is absolutely wrong to presume it as pre-existing ailment by any stretch of imagination. It does not stand to any logical reason either under the protection of policyholders' interest regulations as envisaged by irda or in the ambit of insurance policy to capriciously apply that tool of settlement which preferably suits to your ends to squeeze an innocent customer monetarily & mentally by putting the insured on a disadvantageous pedestal by wrongly & illegally propounding as pre-existing ailment. Such an unfair term is void ab-initio. Rather, a misadventure is being made to decide the fate with pre-conceived mind and fallacy. I vociferously lodge my protest against this unfair act & conduct. Yours plea in the matter, without any trace of animosity, is ex-facie frivolous, malicious & misconceived intended to cause irretrievable loss to an innocent insured and thus, deserves to be deprecated in the given situation.
It seems that the envisaged concept of an insurer has been thrown out of the window by illegally denying the cashless facility. Thus, you even preferred to maintain a deafening silence and failed to settle & pay the rightful claim within 30 days on receipt of documents as per regulation 9 (5) irdai. The violation thereof is also punishable u/s 102 (B) of the insurance act, 1938.
Sir, your unlawful principle of coercion would not apply here in my case by taking a false shelter of an irrelevant plea distantly not related to the present claim. Instead, upright claim of a consumer should have been decided cordially while demonstrating coherence, cogency & candor. Such irrational tool of nitpicking, after any genuine claim, ought to have been avoided and rather, the contractual, statutory and regulatory obligation under the policy should be performed with professional diligence.
So, “healthy conflict resolution process” religiously demands that my claim be reimbursed in a quick-fix manner without any further delay in the fairness & fitness of things. I hope your good self shall not compel me to move on to any other path of conflict for rightful resolution. Humility and honesty come to a decision expediently.
Looking forward to having your prompt & positive response

Yours humbly,
(Vinod kumar jain)
B-34, 4641, street no.12, durga puri,
Haibowal kalan, ludhiana
Cell no. [protected]

A copy of this letter along with other evidentiary material on record is being sent to my counsel for his record & future reference.

I am surendra singh shekhawat my address is pl. No. 55, chitrakoot colony, opp. Bharat gas agency niwaru, 302012, contact number is [protected], my policy no. Is 243600/31/2019/2172, bike registery no. rj 14dq 8517.

my bike had met with an accident on 04/03/2019 then i sent my bike to “advent automobiles pvt. Ltd 216, mission compound ajmer road jaipur 302006” to get repair. Then your company’s surveyor came to survey my bike and after seeing the parts damaged he still didn’t pass the claim of all parts he didn’t add all damaged parts in his claim file, and the behavior was very bad and till now he didn’t pay the claim everytime whenever i call they are like come and give us that document come and provide us this everytime they give me the same excuse whenever i visit or call after i provid every single document still they didn’t pay and whenever i call for enquiry about my claim they always ask me for different different documents just always use to give me excuses though i provided every single required document and after providing all needed document they are not paying the claim money.
on 16/05/2019 also i sent an e-mail to your executive p. Maheshwari about my this issue but they also didn’t gave me any sufficient response and today (Date - 24/05/2019, time – 12:16 pm) i got a call from [protected] this number and they said that you have to come and do a sign. This is how they are bothering me.
now, if i didn’t get my claim in next 7 days then i am gonna take a serious action against this i will go to the consumer court and will post reviews about your so bad service on every social media platform and every other website where i can.
Please open these attached file.

My name is Mohd Shehzad from delhi and I have claimed a mobile in Oriental Insurance Company Limited which has happened in the last week of December 2018 but now how many times I have called on Customer Care, customer care executives do not answer correctly Please help me and tell me my claim, how long will be clear, my docket number is 7940, mobile number[protected] please help

Patient is a non smoker / non alcoholic and a claim of rs92k had been denied,
We had approached meddi assit office and the oriental insurance office many times regarding grievance, they use to say it will be done shortly and is under process, it is almost 4 months after and still the matter is not resolved.

Please do needful at the earliest,

Thanks in advance.
Sunil kumaran

I m satish kumar. I purchased honda motorcycle - activa 5g on dated 22-may-2018 purchased by ashwani honda hisar and insuranced by the oriental company limited on zero depth policy and my insurance policy no. Is 261501/31/2019/1325 which was done on 22/04/2019.
On dated 8/4/2019 my vehicle crashed (Accident) and handed over to ashwani honda to repair on date 9/04/2019. I got my vehicle on 18/4/2019 that costs rs. 20696.82 but the insurance was of zero depth but still they took a sum of amount rs. 2500 from me and when i raised the question then they told me its the rule of our company to take money even on zero depth insurance and i personally talked your surveyor vikas, he too was unable to give me satisfied answer and if it is rule, your company never told me during insurance time and that's what making me angry about this company. There can be only one desirable resolution and that is refund of my money. If you are unable to refund then you are making fool of your costumer. You should have told during the insurance time only that we have to pay the money even at zero depth then we may have opted for another option. Refund my money or i will be forced to take action against you. I will lodge a consumer right report and influence people near me and my locality to not to insure any vehicle from your company. I am totally unsatisfied from your company's work.
You may contact me on [protected] or [protected]

Kamlesh modi

I sent my above claim in the month six month back. But till date i have not heard anything regarding my claim. Whenever i made inquiry with agent, said that we have sent to insurance co, but they are not clearing the claim. My health is not good you will find from my medical claim papers. Even though insurance co. Harassing me. I have approached local office but no response. They said it is not in our hand insurance co. Is not acting on your claim

My insurance number is 253291/31/2019/380.
On saturday, 9 march 2019, i had met an accident on my bike due to which i had to claim the insurance. The bike showroom has saturday off so on monday 11 march 2019 morning i submitted my bike to the showroom and then on tuesday 12 march 2019 i went to the oriental insurance company office near prince chowk dehradun.
I submitted the required documents and a surveyor number was provided...

MEMBERSHIP NO. O[protected] OF VISHAL HINDUJA ORIENTAL INSURANCE CO. TPA: RAKSHA TPA
CLAIM NOS.: -[protected], [protected], [protected]

Sir,
I have submitted above valid and perfect claim towards BREAST CANCER OF my wife, BHAVNA VISHAL HINDUJA. I state that
I have mediclaim insurance with you only.
This is my very first claims.
I categorically state that I have submitted all the relevant documents/support to my claim in ORIGINAL.
Due to lack-luster attitude of your RAKSHA TPA, my claim was delayed and had to make series of follow up and verbal fight with the representative.
the claim passing officer in Raksha TPA, Mr. Sameer Satpute never lift the phone nor call back. Please you try and confirm.
On complaint to higher up, they agreed and apologized for the delay.
NOW I DO NOT COMPLAINT ABOUT THE SAME, BUT COMPLAINING ABOUT NOT PASSING PART OF CLAIMS ON THE GROUND SUPPORTING NOT ATTACHED.
I complaint to higher up in RAKSHT TPA again of the same and request to check at their end again. He assured me to do the needful on re-submission of claim with photocopy of all supporting medical papers/report
I have submitted part claim that was rejected vide claim no [protected]. Out of the same, they passed only Rs.3000/- rejecting Rs.7050/- again ground that ORIGINAL NOT SUBMITTED.
Again Claim no [protected] was passed partially, with Rs.1500/- deducted on the same ground.
I have written letter to them that I have attached for your ready reference.

I STRONGLY PUT THAT NOT A SINGLE TIME I HAVE FAILED TO MISS ATTACHING ANY SUPPORTING DOCUMENTS, AS CHECKED AND RECHECKED AND AFTER PINNING IT GOES FOR MAKING STATEMENT. MY PEON EMPHASIS THE COUNTER TO CHECK ALL ATTACHED DOCUMENTS BEFORE PUTTING STAMP OF ITS RECEIPT. IT IS THEIR DUTY TO CHECK THE PAPERS PROPERLY AND THEN PUT STAMPS OF ACKNOWLEDGMENTS. I FEAR FOUL PLAY BY THE STAFF, AS I HAD HEATED ARGUMENTS FOR NOT CLEARING CLAIM FOR TWO MONTHS INITIALLY.

PLEASE LOOK INTO THE MATTER URGENTLY AND REPLY. HOPE YOU UNDERSTAND THE SITUATION BETTER. HOW COME THEY GOT ONE ORIGINAL AFTER REJECTING IT AND HOW COME OTHER ORIGINAL ARE MISSING?????

I STRONGLY OBJECT ON PASSING CLAIM PARTIALLY AND REJECTING ON THE GROUND AS NOT RECEIVED ORIGINAL. WHERE CAN I BRING AGAIN ORIGINAL? YOU CAN VERY WELL AUTHENTICATE ORIGINALITY AT RAKSHA TPA SIDE, IF THEY HAVE MISPLACED IT.

I CLAIM RS.8, 250/- TOWARD CLAIM NO. [protected], RS. 1800/- TOWARD CLAIM NO. [protected] (COMBINE CLAIM NO [protected] ON RE-SUBMISSION) AND RS.1500/- TOWARDS CLAIM NO [protected].

VISHAL HINDUJA
[protected]

ENCL.: - LETTER TO RAKSHA TPA

Insurance of my mobile was done by the company in September.I applied for claim on mobile repair in June 2018 and gave the documents that were requested by the company.even without a computerized bill, then the company gave written letter of repair store.the company said that your claim process will be completed soon but now the company is not giving any answer to my mail.for which I wrote a letter to him but he could not getting reply.A just settlement of complaints made as soon as possible

Dear sir,

I claimed for post medical on dated 24.01.2019 at health insurance tpa (Authorise tpa of oriental insurance), on 25.01.2019 i received a message with request no noida-in-212210.

My insurance no - 215301/48/2019/3053
Patient name - mrs. Manali das

It is already passed 04 months, till date i did not received any message / mail.

As i called to customer care hitpa, mr junaid informed me it will take more 07 days to finalised on dated 12.03.2019.

It look like simply harassing to customer.

Very bad service.

Thanks & regards

Smruti ranjan das
[protected]@gmail.com
+91-[protected]

Dear
Sir
मैंने अपनी दो गायों का इंश्योरेंस यूपी पशुधन परिषद की स्कीम से उप चिकित्सा अधिकारी डॉ सौरभ गंगवार राजा रिजोला पटियाली कासगंज के द्वारा कराया था जिसका कवर नोट नंबर 128366 vanay kumar mishra village ladhauli post bahora patiyali kasganj up pin code 207243 mob [protected]!
13 जनवरी 2018 को जिसमें मेरी एक गाय 5 सितंबर 2018 को खत्म हो गई जिसका के सर्वे 8 सितंबर 2018 को सर्वे करने आया था और डॉक्टर गंगवार ने पोस्टमार्टम तैयार किया था 10 दिन तक मेरी गाय का ट्रीटमेंट हुआ था जो कि डॉ सौरभ गंगवार ने ही ट्रीटमेंट किया था आज मेरी गाय को खत्म हुए 8 महीने होने जा रहे हैं और जब मैंने आप की एजेंसी hibl मैं पता किया तो उन्होंने मुझसे कहा आप नेहरू प्लेस मंजूषा बिल्डिंग में जाकर पता करें जो आपके कवर नोट के पीछे लिखा हुआ है तो जब मैं नेहरू प्लेस गया तो वहां पर उन्होंने मुझसे कहा मेरे पास रिकॉर्ड नहीं है और आपके सर्वेयर ने आपकी फाइल नो क्लेम कर दी है आप उससे फोटो मंगा लें और आपका कुछ नहीं हो सकता आप की गाय के सीन वाली जगह पर डेस्क लगा हुआ है इससे पता होता है गाय के सींग नहीं है मैंने उनसे कहा सर जी जब मैंने गाय का इंश्योरेंस करवाया था तब भी मेरी गाय का फोटो खींचा था तो उसमें सीन थे और जब मेरी गाय मरी तब भी उसका फोटो खींचा था तब भी उसके सिंग थे अब इसमें मेरी क्या गलती है तो उन्होंने कहा कि अपने डॉक्टर से पता करो उन्हें क्यों नहीं लिखा कि इसमें सिंह नहीं है मैंने कहा वह आपके ही तो एजेंट है अब इसमें क्या हो सकता है जब मैंने डॉक्टर से पता किया तो डॉक्टर ने यह कहा कि मैंने सिंह वाली जगह पर डेस्क लगाया है इसका मतलब यह नहीं कि गाय के सींग नहीं है इसका मतलब यह है कि मैंने शिंग मापा नहीं और ऐसा मैंने इंश्योरेंस जितने भी किए हैं उसमें सब में ऐसा ही किया है इसके बाद मैंने कंजूमर court mein complaint ki आपकी की जिसका कंप्लेंट नंबर 1268598 है

Dear sir,
I informed u that the oriental insurance co. Ltd, is not approved a full claim amount of our health insurnce. It's detail as below:
Patient name : neetaben
Policy holder: dashrathbhai joitaram patel
Policy no.144000/48/2019/8402
Provisional diagnosis:unilateral primary osteoarthritis, left knee
Date of admission: 6 jan 2019
Summary of authorisation:
Total estimate:rs. 255093
Initial amount authorised:rs.234600
Revised amount authorised:rs.190493
Dedction:rs. 64600
Final amount authorised:rs.190493

My policy no. Is - 243400/31/2016/14361, i had an insurance of my bike from this company and when my bike gone through an actual accident and i filed for a claim but the claim had not get paid. Surveyor behaved very bad with me, i had already registered a case about this on consumer court but still i didn't get my claim. Company refused to pay my claim. Sir kindly please take some action on this and please help me to get my claim.
...

My name is surendra singh my bike insurance policy no is 243400/31/2016/14361 accident inform date is 14/08/2016 bike register no rj 14 dq 8517 this my bike is fully insured and real accident case but insurance company is not given me claim, i am already registered case agents thi insurance ompany but not give me claim. My mobile number is [protected].