Oriental Insurance Company — Compensation for rejection of mediclaim

1 Review
Mangalore, Karnatakamangalore, India
 Hareesh Shetty
Mailbox of shetty. [protected]@rediffmail.com print cancel

From: hareesh shetty
Subject: fw: ticket received - ticket received - my claim no 1333373. Policy from jeeves i s p ltd bangalore[protected]
Date: wed, 16 nov 2016 12:07:59 ist
Dear sir
I am a senior citizen suffering from severe back pain,
Having served in a nationalised bank as branch manager,
Giving ur insurence company lots of business, am admitted
To hospital for treatment. As could not move the hospital
Is 36 km from my village. By great difficulty i travelled
There and took medical care tablets and daily three to
Four injections, i was likely to be operated but due to my
Old age i did not seek operation for fear of
Complications, and stayed there, for a week getting
Treatment and they have asked me to take rest at home and
Continue medicine for a month after one month i visited
Once again and the physicia has advised me to continue
Medicine treatment for another month still i am under
Their treatment and have more than rs 6000 bills incurred
For post hospitalisation treatment yet to be submitted to
Medi asst. And hospital submitted my bills of rs 27281
To med asst of medbuddy. They have declined the cash less
Felicity without deputing their personel to hospital tp
Verify the position of the senior citizen who was unable
To move, and asked to submit the claim directly to their
Office, inspite of me having oriental insurence policy and
Having lot of business for 35 years in banks they did not
Care and deliberately harrased me for settling the claim.
They have sent me the papers that rs 932 is declined from
My claim of rs 27281, and there is nomissing documents to
Be submitted by me, there is no reason for denial as per
Their letter which is attached herewith,
Later on i complained to them to settle the claim, then on
18102016 they gave me their ticket no 720324 and told me
Their representative shall call /talk to me within 24
Hours, they did not do it, again i reminded them to settle
My claim on 19102016 a ticket no 724811 is given to me and
Told their men will contact me within 24 hours, again
There was no reply from them again on 1112016 i contacted
Them a ticket no 807078 is given with a promise that
Within 24 hours they will talk to me.
Pl note they did not attend to hospital for verification
Again 3 times they did not respond to their tickets within
24 hours, this lethargic attitude to harass old aged
Senior citizen and givin them hardship and mental agony
And leaving them to die in hospital in spite o[censored]s paying
Huge sum as policy premium attracts compensation of rs 16
Lakhs plus rs 27281 with interest at 18%.
As u have enrolled them to give service as principal u
Have to compensate me with this amount of compensation for
Dereliction of duty for lack of customers care, harrasing
And giving mental agony and i could not get cashless
Medical benefit if die a compensation of re 80 lakhs has
To be credited to my legal heir. Thanking u
Sandhya shetty
Mob [protected]
— original message —

From: "hareesh shetty"shetty. [protected]@rediffmail.com
To: hospital. [protected]@mediassistindia.com
Subject: re: ticket received - ticket received - my
Claim no 1333373. Policy from jeeves i s p ltd bangalore -
Since 19th oct neither u have settled/credited medi claime
Claimed amount nor credited rs 8 lakhs compensation nor ur
Representative contacted me within 24 hours since 19 th
Oct. Hence compensation amount has to be increased to
Double that is rs 16 lakhs for harassing senior citizen
And giving mental agony and hardship. Pl credit the
Claimed amount with 16% interest within 24 hours from now
Thanking u
Yours faithfully
Sandhya shettyy

On wed, 19 oct 2016 16:17:35 +0530 hospital medibuddy

Dear hareesh shetty,

Thank you for writing to us.

We would like to acknowledge that we have received your
Request and a ticket has been created. Please refer the
Ticket number 724811 in the subject of this email and
Quote the same in all your future correspondences in line
To this query

A support representative will be reviewing your request
And will send you a personal response within 24 hours

We thank you for your patience in the interim and assure
You that we are committed to serving the best interests of
Our customers.

Medi assist support team


Print cancel

Compensation for rejection of mediclaim

Complaint Status

[Nov 16, 2016] Oriental Insurance Company customer support has been notified about the posted complaint.
Updated by Hareesh Shetty, Nov 17, 2016
My complaint id no 1428454 dt 16112016.
Urther to my talk i had yesterday with u and mr rajesh on
his mobile no [protected] and request u to credit rs 27281
minus rs 932 deductions made by u. To my sb a/c.
Contrary to the mediclaim rules u have denied me the
cashless facility and requested to submit bills for
settlemnt to ur office, which i properly did. Till date u
have not credited rs 26349 to my sb a/c stated in my claim
form, as per the advice of my physician i got admitted to
hospital as i could not move due to back pain and
hardening of one leg, even now after taking so many
medicines injections i am unable to walk without
assistance and still in medication, due to ur non credit
of amount i have gone on mental agony and hardship,
inconvenience hence kindly compensate me with rs 8 lakhs
compensation within 48 hours plus credit the claimed
amount immediatly
in ur claim details received by me there is no denial
reasons, nor there is any missing documents. Hence i am
legally and phisically empovered to receive the claim
amount for the treatment of my disease/hospitalisation

thanking u

yuors faithfully
sandhya shetty
mob [protected]

pl note medibuddy reply is enclosed/attached as photo to this mail

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    Oriental Insurance Company - Compensation for rejection of mediclaim