Oriental Insurance Company — Delay in settlement of Health Claim

Address:	Nizamabad, Andhra Pradesh, 503001
Website:	oriental insurance

My name is Omkar Reddy and I am working in Accenture, USA and my company has taken a Group Health Policy No: 421300/48/2015/P2_Ex with Oriental Insurance Co.Ltd, which covers me and my family including my parents. My Emp.ID No: is 10865397, joining date: 15/04/2013, policy period: 17/10/15 to 16/10/16. My father was hospitalized and operated for Heart problem. the total hospital expense came to approx: Rs.3.75 lakhs. My younger brother who is working in HCL Company, has covered him in his Health policy also taken from Oriental Insurance Co. Ltd. He had already claimed Rs.2.83 lakhs from Vidhal(formerly TTK TPA). As his Sum insured was exhausted, I had applied for reimbursement from my company as I too have covered my father in the Policy. I gave all the bills and discharge summary copy(as original was already submitted to Vidhal TPA), totalling to Rs.83, 500-approx, but till date even though after many teletalk and request the claim has not been settled, though I had contacted both the Oriental Insurance Co, who has taken the insurance and also MediAssist who is the TPA. Their response was really very unsatisfactory and not what a customer expects from PSU which boldly claims that they are always there for customers needs. As the policy is expired and not renewed with them the company and the TPA is not at all interested to take up the matter and settle the claim. I feel being a public sector company their duty is to first attend to the customer's need and settle the claim at the earliest. I hope after submitting my grievance this matter will be taken up and resolved at the earliest, .My mail.id is : omkarreddy.[protected]@accenture.com. For any queries you can contact my brother, Mr.Ravi Reddy in his mobile no: [protected]