Oriental Insurance Company Complaints & Reviews

I am work in hdfc life insurance company last 5 year and my corporate medical tie up is in oriental india insurance but as per policy rules all tpa services will be given through mdindia. Recently my wife mrs sara khan admited in apollo hospital ahmedabad 8th aug18 and discharge date 10th aug18. I have reached my hometown and sent all docs mdi india office 14 aug18 but due to mdi old office shifted to new address courier was returned. I have sent (30 aug) courier again mdi new address and courier was delivered 4 sep.18

Due to mdindia change office courier was returned.

I request to oriental claim team please consider my claim and paid my claim amount.

Health insurance policy no. 13500/48/2018/4224
I had submitted reimbursement claim for rs. 182986/- at kalyan oriental insurance company limited on 23/07/2018. My claim is finalised only after constant follow up with oriental insurance company at kalyan and payment is received for rs 153394/- on 10/10/18. It is indicated on the discharge voucher cum claim settlement letter that rs. 12548/- is disallowed.
I would like to state here that:
A. There has been an abnormal delay for more than two & half months in disposing off the case by insurer.
B. This delay gives a message to go for cashless rather than reimbursement if an insured requires timely benefit from insurer.
C. Surgery would had been carried out at fortis hospital by availing cashless service, however, as estimate for the same was found to be high surgery is carried out at other hospital.
D. I had requested to details of amount for rs. 12548/- disallowed from my claim. I need to know which items are disallowed from the bills. But till today i have not received either from sr. Executive: relationship management, health insurance tpa of india ltd or oicl, kalyan
Sir, in fact, i had discontinued renewing health insurance policy with new india assurance company being better terms and condition and claim settlement procedure with oicl as i have been told by the agent.
It is therefore requested to clarify above points and details of amount disallowed for rs. 12548/- from my reimbursement claim may please be made available treating this as my grievance.

My policy number-261494/31/2018/1968 claim no 261402/31/2019/030004 regarding total loss was repudiated mentioning that i am not the real owner of car. How this can be possible. I am attaching each and every proof that i am the real owner. This company is just making fool of persons and not providing claims if bribe is not given to their surveyour/investigator/branch manager/regional manager everybody.
I request not to buy insurance from this company. Everyone is corrupted.

Sir mrs saroj tomar resident of 205 sheel kunj roorkee road meerut is insured under mediclaim policy from oriental insurance for rupees 500000.

she was admitted in fortis c-doc hospital b16 chirag enclave new delhi on 5th october 2018 under supervision of dr subhash shalya.

She was discharged after treatment from the hospital on 15th october 2018, at the time of discharge the tpa that is raksha health insurance refuse to pay the complete amount from the total bill of rupees 325251 the tp sanction the amount of rupees 285221 hence. Rupees 40030 rupees was to be paid by me while the insurance was cashless.

two days delay in surgery and one day post surgery admission is properly justified by dr subhash shalya how could the tpa deduct the amount while the insurance is cashless.

the points which are objectionable r are 1. rent of three days rupees 8400.

2. All investigations rupees 14736.

3. Doctor charges for the three days 9600 rupees. 4. Diet charges 5500 rupees total 38236 rupees.

sir i request you to look look into the matter and order the insurance company or tpa company to pay rupees the aforesaid amount that is rupees 38236.

Otherwise i will have to move to the honorable court.

Copies of bill and justification letter by dr subhash shalya is enclosed with the mail

Mediclaim policy number 121800/48/2018/7832
Inbox
X

Prakash mirchandani
Thu, oct 11, 11:09 am
To arun. Satpute

Dear mr. Satpute,
I would like to make the following changes to the above policy.
1. I would like kavita mirchandani, the 2nd name on the policy to be the primary holder. She is an income tax payer. I would like to be the 2nd name.
2. I would like to seperate my daughter disha mirchandani from the above policy and put her on her own individual policy.

Kindly guide us on how this can be done.
Also, i am not in the country and returning only on 4th november. Can this be done online? If not can it be done once i return? My wife and daughter are in mumbai though and if action is to be taken by them by for signing physical forms and submitting them, then this can be done.
However, i would like the coverage to be continuous with all pre-existing conditions covered as they are in this policy.

I look forward to getting your advice and guidance.
Regards

Prakash mirchandani
Sat, oct 13, 8:30 pm
To arun. Satpute

Mr. Satpute,
You have sent me a reminder to renew my insurance and put your email address in case i need help.
At least have the courtesy to reply!
Regards

Prakash mirchandani
Fri, oct 26, 7:50 am (6 days ago)
To arun. Satpute

Mr. Satpute
Kindly answer.
Regards

Arun satpute
Fri, oct 26, 9:20 am (6 days ago)
Dear madam please check and reply to insured. सधन्यवाद/thanks & regards, अरुण सातपुते/arun k. Satpute मंडलीय प्रबंधक/divisional manager मं.का.नं.9/ mumbai city

Prakash mirchandani
11:02 am (6 minutes ago)
To arun. Satpute, rajani. Shingade

Dear mr. Satpute,
I have been waiting patiently for a reply. So much so that my policy has now expired. What do you want me to do? I am so disappointed in being a client of such an unprofessional company.
I think i will have to write to some insurance ombudsman to help me since you seem to be unable to.
I cannot afford to let my policy lapse.
Kindly guide as to what is to be done. I am currently abroad as i had mentioned in my very first letter to you almost 3 weeks ago.
You have not been able to answer me in 3 weeks so much so that you have put me under distress of having the policy lapse.
Kindly tell me who i should escalate this to. Since you seem to be unable to help and whoever you have passed it on to seems to be even more helpless.

This is the correspondence i have had. While waiting for reply, my policy has lapsed. Kindly help.

I am not able to get the settlement done for my claim since last 3 months vidal is asking the same information again and again. Request your help.
Company is oriental insurance and tpa is vidal this is a corporate policy request your help please i am suffering since last 3 months. My e card no is - del-oi-h[protected]a

Please help me with the resolution...

Dear sir.
My policy no. - 211200/31/2018/75510
Vehicle no. - jh 09y 5010
का insurance claim 8th months से pending पङा हुआ है।
अभी तक, कोई कार्रवाई नहीं हो पाया है। और कोई सुझाव भी नहीं दी गई है। मैं total documents sevear के माध्यम से दे चुका हूँ। मेरी claim refund कब मिलेगा? मैं बहुत परेशान हूँ।
कृपया ध्यान दें।
धन्यवाद ।
आपका विश्वासी- vinay kumar

Hi sir,
I had a motor insurance policy with you. I requested a claim on aug 4th, and i have submitted all the documents to the surveyor on 9th august. But till now there is no settlement. I have been following up with coverfox, but they are not providing any update. Tried to reach out to your customer care, but not connected.
I hope you will take necessary action to expidite the process. Please contact me on mobile in case of any queries.
My policy number is 131300/31/2018/11259

Dear sir/ma'am,

This is regarding of the claim of bike, the claim intimation date in march'2018,
Till now i have not receive my claim amount, for the same i had called in customer care & they have given me the local branch office number.
But sorry to say i had called in that local office twice every time they are asking the details like policy no claim no but not providing the solution.
I request you to please support me on this to get my claim.

Hi, my car claim status is not communicated to me despite various mails and whenever i/ any representative from my side visit the jind branch, manager always denied that he don't have any file with him and also visited your csd brach in asaf ali road but only a false hope given to me that your claim is in progress and will be intimated to me shortly. I have also given a request in written but no response was communicated to me by any mode. Its my right to get information about the claim.

None of below named person responded to me and just plying with customer hard earned money to get there share in my claim.

Telling that "tera koi claim nahi hai yaha" "tu le k dikha diyo claim" " kuch nahi milne wala tujhe.

I thing these person at higher designations are just sleeping in offices to get salarry and perques.

Not worried about services to customers.

Pankaj kumar (Csd orientail ho)
Virender halu (Brach jind)
Krishan chander
Rajesh arya
Suresh chandra
Y keshab rao
Sanjay tayal

I have intimated the claim on 16aug2018 and serviour inspected vehicle and gave approval and vehicle got repaired and i paid and got it and submitted all the documents to the company but till now i haven't received any updates or refund for my claim
Policy no - 211200/31/2018/111218
Vehicle no - ka09mb9480
Insured name - adishesha i have been mailing more than 30mails but still haven't received an response from them

I had purchased a policy from oriental thru policy bazaar, however due to some issue... Agent had requested to cancel that policy asked me to make new policy

Which is made, however pending for more than 48 hrs as i am yet to get the cancellation and refund confirmation

Policy number : 211200/31/2019/138371

Oriental insurance company

Car number : wb04g3847

Call me @[protected] or [protected]

Need the solution urgently along with cancellation and refund status

Dear team,

This is regarding patient:- sunil, claim no. 17733986

It's very harassing and misfortune to confirmed me, your company call center staff toll unjustified denial from your side.
It's a basic small centre where treating consultant is our family physician and we are taking treatment from him also.

Can you tell if doctor having duty timing of 8 to 10 hours and same physician taking 2 rounds a day than it's crime??? It's punishable???

What you think that small basic set up should have 10 to 20 mbbs, md doctors to take multiple rounds for every complaints and make bills in lacs like other multispecialtiy hospital??

Stop all this useless excuse. I need my money back otherwise i get it through legal and with compensation charges.

Thanks
Sunil h/o mrs neelam sharma

सेवा में

श्रीमान
दि ओरिएंटल इंश्योरेंस कंपनी लिमिटेड

विषय :- पॉलिसी नंबर 215100/48/2018 /4482 के क्लेम संबंध में।

महोदय,
मै जगमोहन सिंह मेरी पॉलिसी नंबर 215100/48/2018 /4482 है। क्लेेेेम नंबर [protected]। महोदय
मुझे दिनांक 24-05-18 को रात में अचानक पेट में दर्द हुआ। जिसके बाद मेरी पत्नी सुनीता मुझे घबराहट में डॉक्टर सुषमा जिंदल अस्पताल, दिलशाद गार्डन में इमर्जेंसी में भर्ती कराया।
क्योंकि मैं बेहोशी की हालत में था। इसलिए मेरी पत्नी ने मेरे इलाज पर आने वाले खर्च का भुगतान जल्द से जल्द अस्पताल को कर दिया। जिसके बाद मेरा ग्ल ब्लैडर का आपरेशन हुआ। जिसमेंं लगभग 57 हजार रूपये का खर्च आया है।
मेरा मेडिकिलेम कार्ड और पेपर तब मेरी पत्नी के पास नहीं थे। जिसके कारण पेमेंट करना पड़ा।

इसकी जानकारी मैंने फोन एवं ईमेल के माध्यम से दिनांक 26-5-218 को tpaको दे दी और 2 जून 2018 को अपने इलाज के मूल पेपर टीपीए (मैजिस्ट्रेट ओम्न बिल्डिंग द्वितीय तल ए-110 सैक्टर-4 नोएडा) में जमा कर दिए।

महोदय, इसके बाद अस्पताल एवं मुझसे दि ओरिएंटल इंश्योरेंस कंपनी लिमिटेड के बिजिटिंग अधिकारी ने खुद आकर मेरे इलाज सबंधित सारी जानकारी ली। इसके बाद जब मैंने पेपर जमा करने और इन्क्वायरी होने के 15 दिन बाद जानकारी लेनी चाही तो मुझे कहा गया कि आपके केस पर क्वारी है कि आप इलाज पर आए अपने बील की मूल रशीद जमा करे।

महोदय, यह रशीद हमने अपने अस्पताल के पेपरों और घर में हर जगह ढूंढी लेकिन यह रशीद हमें कही नहीं मिली। इस बारे में मैंने टीपीए अधिकारी को जानकारी दी कि जो इलाज की रशीद आप मांग रहे हैं। वह हमसे कहीं खो गई है। जो कई बार ढूंढने पर भी नहीं मिल रही है। जबकि बील की मूल प्रति मैं पहले ही जमा करवा चुका हूं।

महोदय, इस संबंध में दि ओरिएंटल इंश्योरेंस कंपनी लिमिटेड के फोन बैंकिंग अधिकारी द्वारा मुझे बताया गया कि आप इस रशीद की डुबलीकेट कापी अस्पताल से लेकर जमा करवा दें । जिसके बाद आपका भुगतान कर दिया जाएगा। जिसके बाद दिनांक 7 जुलाई 2018 को मेरे द्वारा अपने इलाज की बिल रशीद की डुबलीकेट रशीद शपथ पत्र के साथ जमा की गई। जो की मैने अस्पताल से प्राप्त की।

महोदय, इसके बाद जब मैंने फिर से अपने क्लेम के बारे में जानकारी लेने के लिए फोन किया तो मुझे फिर कहा गया कि आपके केस पर फिर क्वारी है कि आप इलाज की रशीद खोने का एक एफिडेविट बनाकर जमा करे। जिसके बाद आपके क्लेम का भुगतान हो जाएगा।

महोदय, इसके बाद मेरे द्वारा अपने इलाज की रशीद खो जाने संबंध एफिडेविट बनाकर दिनांक[protected] को टीपीए में जमा करवा दिया गया। इसके बाद जब मैंने लगभग 15 दिन बाद एक बार फिर से अपने क्लेम के बारे में जानकारी लेनी चाही तो फिर मुझे कहा गया कि आपके केस पर फिर से क्वारी है कि आप अपनी ईसीईजी रिपोर्ट और हीस्टॉपअथॉलाग रिपोर्ट जमा करें। जो की मेरे द्वारा पहले ही 2 जून 2018 को जमा करवा दिए गए थे।

इसके बावजूद मैंने दिनांक 25 अगस्त 2018 को एक बार फिर से इन पेपरों की फोटो प्रति जमा की।

महोदय, अब मैं और मेरा परिवार बहुत परेशान हो चुके है। मेरी पत्नी ने जिन लोगों से कर्जा लेकर मेरा इलाज करवाया था। वह अपने पैसे वापस लेने के लिए हम पर रोज दवाब बना रहे है। जिसके कारण हम मानसिक तनाव में आ चुके हैं। क्योंकि हमने इस भरोसे पर लोगों से कर्जा लिया था कि दि ओरिएंटल इंश्योरेंस कंपनी लिमिटेड से क्लेम मिलने पर हम कर्जा लौटा देंगे।

महोदय, 2 जून 2018 से लेकर अभी तक मुझे अपने इलाज के पेपर जमा किए लगभग पांच महीने हो चुके हैं। लेकिन मेरे क्लेम का पैसा मुझे आज तक नहीं मिला है।

महोदय, दुखद यह भी है कि दि ओरिएंटल इंश्योरेंस कंपनी लिमिटेड के पास मेरा फोन नंबर और ईमेल रजिस्टर हैं। इस के बावजूद भी मुझे एक बार भी मेरे क्लेम संबंध में कोई भी जानकारी कभी नहीं दी गई है। जब मैंने खुद फोन किया तब मुझे कहा गया कि अब यह चाहिए अब वह चाहिए। मेरे द्वारा दि ओरिएंटल इंश्योरेंस कंपनी लिमिटेड को हर पेपर समय से पहले जमा करवा दिया गया था। भारतीय न्याय व्यवस्था के अंतर्गत मुझसे जो शपथ पत्र मांगा गया था। वह भी मैंने इस शपथ के साथ जमा किया हैं कि जो रशीद खो चुकी है। उस रशीद का मेरे एवं मेरे परिवार द्वारा के किसी भी सदस्य द्वारा अन्य किसी संस्था में प्रयोग नहीं किया गया है। इसके बावजूद में मुझे मेरा क्लेम नहीं दिया जा रहा है।
महोदय, मुझे क्लेम न मिलने से मैं और मेरा पूरा परिवार मानसिक रूप से प्रताड़ित हो रहे है। दि ओरिएंटल इंश्योरेंस कंपनी लिमिटेड मुझे मेरे क्लेम को लेकर कोई स्थिति स्पष्ट नहीं कर रही है।
अतः आपसे निवेदन है कि कृपया मेरे क्लेम संबंध में जल्द से जल्द निर्णय लेकर मुझे भुगतान करने की कृपा करें।

निवेदक

जगमोहन सिंह

पॉलिसी नंबर 215100/48/2018 /4482

I am complaining about my claim which is pending from mediassist since last 6 months. Initially when i submitted the claim they took time saying oriental is taking time for endorsing child in the plan and later they kept asking me the documents which i already submitted through email to them. I applied for claim and informed mediassist executive named chandrashekhar that i need money as my father in law is hospitalised and is suffering from carcinoid tumor and we are in need of money to do his operation. Recently my father in law passed away but still i can't see any process done by mediassist on my claim. You guys tell me what is the use of money if that money you don't get on time to save someone's life. This is seriously rediculous. I would request you to please process my claim on priority and pls credit the amount as we are in need of money. Below is my claim details :

Employee id : ma01331aa
Company name : inventurus knowledge solutions pvt ltd
Name : aarti arvind shrivastava
Date of birth : 16th november, 1986
Claimed generated by name : b/o of aarti arvind shrivastava
Date of submission : 25 th may, 2018
Insurance is from bank : oriental insurance
Third party who is in between inventurus knowledge solutions and oriental insurance is mediassist tpa pvt ltd

I personally visited andheri for submission of my original documents. I travelled all the way from ulhasnagar to andheri for submitting the documents with my 2 months old new born child. Initially they took time to endorse child, then they were searching for documents, and now they keep asking for same documents again and again and i only do follow up with them on call, then they tell me on call that they need so and so documents. We take medical insurance so that we get benefit on time not after time. Even the claim which was submitted on my name to shree hospital on 18 th april, 2018 for maternity that claim amount is also pending.

Waiting for quick action and response

Regards
Aarti shrivastava

R/sir,
This is in reference of car claim of hr-35h-4757. My car is accident on 08.08.218. I would like to inform you that i have submitted my car claim to oriental insurance. I have received an email from that mr. Khetrapal having phone number [protected] is allotted surveyer for your vehicle. I cordinate with mr. Kketrapal and he said he is allotted surveyer for my car and survey the vehicle in the evening or tomorrow. Mr. Khetrapal surveyed the vehicle and take photos and instruct the hyundai rewari to complete the vehicle. After completion of vehicle he has reinspected the vehicle and take photos also. After that i received call from harsh hyundai rewari to take the vehicle. I have submiited the full amount of invoice and take my vehicle on 20.08.2018 and submit the concerned documents at the hyundai rewari. At the same time any other surveyer visited the hyundai and collect my documents. The survey and reinspection is done by surveyer khetrapal. But the document is collected by other surveyer mr. Vinod [protected]. My claim is pending since one month. I have been suffering a lot to cordinate the matter. Please look into the matter sothat claim may processed. Please call me on my number [protected] for any query.
Enclosure:
Insurance policy

My policy no. 224400/31/2019/226 date from 24/04/2018 to 23/04/2019

Reg no. Up 64 ab 9340

In my car door and front/rear bumper and backlight is damage. So, i had requested with estimate to the oriental insurance company shaktinagar branch for replacement of car parts on 01/10/2018. Surveyor told me that amount of door is not applicable in my policy, but my policy is in zero depth.

मेरा क्लेम न. [protected] समायोजन के लिए रक्षा टी.पी.ए. फरीदाबाद में पिछले लगभग एक वर्ष से लंबित है जबकि मैं उनके द्वारा भेजी गयी सभी queries /प्रश्नो का उत्तर समय से दे चुका हूँ, जिसके मेरे पास सभी प्रमाण है | पिछले लगभग चार माह से इनके द्वारा मेल व फ़ोन के माध्यम से मूल फाइल के खोने का हवाला देकर मुझे कल व परसों कहकर भ्रमित किया जा रहा है | एक ओर रक्षा टी पी ए फरीदाबाद, ओरिएण्टल इंस्युरेन्स बुलंदशहर ऑफिस द्वारा मूल फाइल न मिल पाने का हवाला देकर स्कैन फाइल के आधार पर “ “claim no. [protected] is medically admissible” होने की सहमति देता है व क्लेम सेटलमेंट की अनुमति मांग रहा है |वहीँ दूसरी ओर बुलंद शहर के ब्रांच मैनेजर न तो ऐसी अनुमति ही प्रदान कर रहे है और न ही कोई अन्य कार्यवाही कर रहे है | इस सब में मुझे गत एक वर्ष से भ्रमित किया जा रहा है | मेरी सर्जरी सितम्बर 2017 को हुई थी तथा उसी समय से क्लेम फाइल टी पी ए के पास है, जबकि मैं इसके बाद एक बार और निर्धारित प्रीमियम जमा करके पॉलिसी रिन्यूअल करा चुका हूँ |
महोदय कल्पना कीजिये कि इस एक वर्ष मे, मैं स्वयं मरीज होने के साथ साथ किस मानसिक स्थिति से गुजर रहा होऊंगा | मेरा आपसे निवेदन है कि इस claim का settlement अविलम्ब कराने का कष्ट करें |
प्रार्थी : डॉ. वीरेंद्र कुमार वार्ष्णेय
28, कावेरी एन्क्लेव फेज-1
स्वर्ण जयंती नगर, अलीगढ (उ.प्र.)
मोब. [protected]
ईमेल : [protected]@rediffmail.com

Dear sir
In june 2018 in bought oriental insurance car policy no 211200/31/2019/81334. At the time of taking policy i was given wrong information about it that it is a cashless policy. Unfortunately my car collided with another vehicle and i had to claim the insurance. But at the time of claiming it i came to know that it is a non cashless policy. I was so shocked how can n representative can lie in such a way. I proceed my claim and payed the amount to service center which was around 15000 rs. After that till now i have not received the reimbursement amount and it is already two months. It is completely defaming the image of the oriental company.
The company surveyor named mr. Survesh (Mob no-[protected]) is a very non sense person, he does not how to talk to customers. His behavior is completely intolerable. He never receives phone, when picks he talks like he is my customer and i have to pay him money. Iam unable to receive any information regarding my claim after two months. I dont know he has even submitted the claim or not.
Please resolve the issue and provide me the necessary information and proceed to reimburse my amount as soon as possible.

Regards
Jatin yadav
[protected], [protected]

Dear sir,
I am darbara singh son of sheyokaran singh from village kurar district kaithal state haryana... Sir i was a farmer my rice crops in 16 acres are fully destroyed.. By the rain, so i am also a in pradhanmantri fasal bima yojna by your oriental insurance company... So please check my crop and gave me my benefits...
Thanks and regards
Darbara singh..
Kurar, kaithal, haryana
[protected]..[protected]