Universal Sompo Complaints & Reviews

Sir this is 23december2013 teft case of 12 tyre truck from up state, allahabad. My cl no 13048696, up police was registering fir so the case was filed in allahabad court under section156/3 after calling so many time to insurance company surveyor was sent each time i called a different name was given and he came after six month in may 2014, all the document regarding truck and the 2 keys of truck was given to mr divaker,
As i have received information from allahabad court i have given to insurance company but i was told to bring police fir and final report of police then the insurance will be settled.
In december2016 i received final report fom court given both to finance company and insurance company but insurance company did not accept original police fir and final report and told to send it to varanasi branch.
On 8dec2016 final report and fir was sent by fax to varanasi and when it was finalised that originals are alo to be given to varansi branch it was registered post on 22feb2017 but no response was give. At first i was told case is old, file is closed, it will take time. Sir how much time from 15 days i am talking with insurance tollfree number now my call s are also not picked up as every agent is saying i cant here u and then diconnect with the same mobile i am talking to other persons they can hear me and only insurance agents cannot here me sir now u tell me what to do

Sub:complaint against universal sompo general insurance co. Ltd

Ref: medi claim under iob health care plus policy: 2817/52877690/03/000, policy coverage: upto rs.2 lakhs, insured name: subrata mondal, patient name: subrata mondal,. Treatment period: nov 10, 2016 to nov 14, 2016, tpa: e-meditek, tpa id no: [protected]a, tpa claim no:[protected], irda reference no:[protected]. Empaneled hospital name: narayana hospital, andul road, howrah (Near shalimer rail station

With reference to the above admission, hospital final bill was: rs.49533.00
Tpa approval against the claim was: rs.37210.00, thus the deduction was: rs.12323.00
I approached both tpa & insurance company for its clarification but they didn’t bother to reply to my repeated mails. Then i reported the matter to irda. When irda initiated the issue, they clarified the reasons for deductions by a letter but it didn't satisfy me. Then i requested irda to escalate the issue for further scrutiny but they didn’t move it further to resolve. Therefore, i request you to take up the matter with the tpa & as well as with the company. I am ready to cater you every needed support as advised by you. Following few points are my main agenda.

It is their empaneled hospital and should operate within the protocol of the policy of the firm.
The tpa had deducted the hospital claim amount on each and every expense category and the major head are investigation-rs7630/-, consultant charges-1450/-, room rent-1200/-, admin charge-1100/-, oxymeter charge-500/- etc.
Universal sompo, in thier letter to me, had admitted that their tpa had deducted rs.1600/- erroneously and they are ready to pay me the amount if claimed. If i wouldn't take up the matter then this faulty deduction would had gone un-noticed. So this seems to be case of forgery. The insurance company deducted one amount saying that the investigation is not related to the main ailment. Now my point is, if it is so then they should have taken up the matter with the hospital. Why the patient should suffer for the wrongdoings of the hospital?
Once my expenditure was well within the limit of my coverage & in their empaneled hospital, they should have approved the whole amount without any deduction. I request you to take appropriate action against them for the harassment and ill-legitimacy and refund me the amount rs.12323/- which i paid to the hospital with suitable compensation. Please kindly do the needful at the earliest. Feel free to contact me in case you need any information / clarification.
Regards
Ubrata
Mob:[protected]

Dear sir,
My son was admitted in last 18 feb to 20 feb and my total hospital charges are 23948 rs but TPA approved only 13180 rs. TPA tell me dr charges not get above 500 rs but dr charges are more than 500 hundred and also befor admitted I verify with u r Costomer care team about charges they tell me all charges are paybal . So pls understand my problem and I expected u solve my problem
My policy no. 2825/56589773/00/000
Admitted person name:- vyankatesh kamlesh bhoyar
Thanks & regards
Kamlesh bhoyar
[protected]
[protected]@gmail.com

Health Care Policy No-2817/52877690/03/000
IRDA Ref No[protected]
Above policy is meant to cover Rs. 2 Lakhs
Hospital Bill - Rs 49533/-, TPA approved - Rs 37210/-
Deducted/Unpaid by TPA - Rs. 12323/-
I was admitted in Narayana Hospital (Howrah) & it is their empanelled hospital. Hence, the cost of my treatment incurred by the hospital must be within the scope of mutually agreed terms & conditions. So the claim forwarded by the hospital should have been approved by the TPA. The patient does not directly claim anything. So why the patient is being penalized for any irregularities done by the hospital. Once the patient takes admission in any hospital, he absolutely have no control over his treatment. It is the doctors & the hospital authority to take care of everything. It is beyond my experience that how an Insurance company deny considering the amount levied for consultation, lab investigations monitor charge, consumables and administration charges. I need your good office to initiate suitable action for the approval of full claim.

Dated 11/10/2016 i took universal sompo general health insurance based on your suggestion. Below mentioned email you have sent me to down load the insurance policy. Last two months back my wife was admitted to hospital because of dengue fever. I admitted her to a hospital which was cash less for universal sompo general health insurance. I gave a universal sompo card to hospital and treatment started. She was hospitalised for two nights and three days. When bill settlement was going on, we were not getting proper response from universal sompo. No response through email hours together. When we call them they used to give different land line numbers and passing responsibility from one person to another. Or some time used to say person is not in chair contact after half an hour. After making call to so many times, they started responsing through emails all quires. Universal sompo went on finding any loop hole to reject the claim and finally when they dint get any reason, they said, treatment denied saying paitent dint have fever when admitted to hospital. Dengue fever time fever comes on and off. When blood platelets count reduced drastically and patient was too much tired based on doctor suggestion patient was admitted to hospital. Hospital accounts dept too was fed up with the poor unrealistic response from universal sompo they finally said what pathetic company you have taken health insurance. Lastly bill was settled with cash payment.

I contacted universalsompo general health insurance on 09/01/2017 requesting them to cancel my health insurance policy. Same day they replied saying send the bank mandatory form along with cancelled cheque. Next day 10/01/2017 i sent them bank mandatory form along with cancelled cheque through email and requested to refund my money. According to universalsompo general health insurance catalog if insurance is cancelled within three months 50% amount will be refunded. 11/01/2017 i contacted them to know the status of my refund. Universal sompo executives told me to resend email to [protected]@universalsompo.com. Agreed sent again email along with documents. They started daily doing the same thing when contacted asking to send fresh email and this went till 14/01/2017. On 14/01/2017 i shouted on them and they asked this time send fresh email with any other email id. Earlier was i sending all my emails from my yahoo email and now sent from gmail id. After some time they confirmed we have received email and before evening status will be sent to your email id. Again on 16th i contacted them they started same thing send new fresh email. I lost my patience and repeatedly said on 14th you have confirmed me that you received mail. Now they are saying wait we will respond you..

I have met with accident on 27Nov at Una amb road(himachal Pradesh) ..i and my wife had some injuries, also my car got damaged badly.. Some people help us on road to take us hospital and after getting first aid .people helped us to hire taxi to home..immediate my parent also inform road side aissitence and Sompo claim dept about accident
..Later on serveyor and hyundai started take care ..
But is almost 5 week, i haven't heard back...
I am planning to riase a case againt them in consumer court ..
I am very worried about my car ...there are so many unusual delay and harasment for custimer..
Insurance company :Universal Sompo

My vehicle met with an accident on 06/11/2016 & intimated the claim on same date with cover note no- [protected] and spot was also conducted, as vehicle was released from police station on 12/11/2016 I have kept vehicle at automotive and informed insurance company alos submitted all the documents on 13/11/2016. Initially Mr.Lakshman from universal sompo said, we will settle in total loss. then after 10 days Lakshman has said to take the vehicle in my custody and keep safe to avoid parking charges. after 23/11/2016 we are calling but there is no response from insurance company. I am a daily wage employees and like this harassment making my life miserable. All the documents are valid as per my knowledge and insurance company is making so much delay, not even saying when the claim is settled... till date no one has called me... if you cant settle the claim, i & my family will suicide, i am not able to pay finance and cant take finance. My family is dependent on this vehicle. kindly help me in settling the claim on priority.

Dear sir,
My vehicle registration no. Ka433572 i purchased a insurance from your company on 07/04/2015 premium of rs. 28500/- and i have vehicle loan also with indus ind bank.. That bank also purchased insurance to my vehicle with cholamandalam general insurance on before purchasing with your company. And simultaneously i was applied request for cancellation of your company insurance policy and refund the premium.. After that dated 23/02/2016 i have recieved refund cheque of rs. 6180/- cheque no. 336873. I have receive actually rs. 28500/- but i have received only 6180/- on which basis your refund the premium i don't know... I continously follow up with your employee mr. Gowrish bangalore branch employee.. He is not given proper respnse... Requesting you to kindly resolve my issue with 15 days...

My claim for alto 800 LXI is not passed fully just 1/3rd damage of the car is passed by the company. Due to wrong overtake by a car my car got dented from front left and sideway as well as from back side. But company has passed claim only for the damage occured back side saying that This is not done in sigle accident. This incident lost my faith in the company. I m very disappointed with the service provided

Dear Sir once again your employee cheat and fraud with me When my car claim cleared by your side but now your employee Mr Sunil Dhiman fraud with me when I talk him about my car repair he said we repair your car totally but he lie with me he not repaired my car from workshop plz Help me or I'll take other way for justification
My policy no is.2311/56287741/00/000
Car no.PB-10-FB-5525

Thanks & Regard
Vishal Kumar

Dear sir
Nobody your employees hear me last 7 days your employees harassment me regarding when I complain this for Mr Rajiv Kumar your employee Danish call me His nu is [protected] he misbehave and abused with me when he talk he put me some personal Questions he talk like illiterate person then I complain this metter to Mr Rajiv Kumar's email not any action taken by his side plz l don't want any more relations with your insurance company plz Refund my money
My policy no is.2311/56287741/00/000
My car no.PB-10-FB-5525

Thanks & Regards
Vishal Kumar

Dear sir/madam
I am t. K. Raghunath having covered medical insurance from iob, 5th block branch, jayanagar bangalore,
My policy # is2817/50332613/06/000, during aug 2016 i was hosptalised and need to claim the balance amount from insurance (Vidal), when i approached for vidal health care will all supporting documents and they came back and requesting for vidal health card, which i was not got it right from the begining, and the same was informed to mr. Prasad who keeps the representative for this helath insurance tie-up with iob, when i contacted and informed him, he said asked to forward the policy # and email id, so that he will send the vidal card through email and asked me to take the print, i said it is fine.
But after sending email, what’app msg, and try to contact over phone, he has not picked the call nor replied to any of my mode of communication.
This is totally upset about his behavior and his services to the customer, when we are in need of claim
Absolutely no services from him
I request you kindly cross check with him and take necessary action, under intimation to me.

Regards
Raghunath
[protected]
Raghunath. [protected]@gmail.com

My vehicle no. Ts 09 eh 5199. This vehicle was insured by sompo. Due to accident a claim was made in the 1st week of april, 2016. Since three months vehicle is with workshop at modi deccan volkswagen at uppal hyderabad, in view of non clearance of insurance people by misinterpreting situation for extraneous considerations... Korrapti. My certificate of policy number is 2311/55377623/00/0009

Sir I Pintu Rastogi this company not giving claim because the doctor mail that the patient mean I my brain case very critical that, s not true this universal sompo company is fraud not giving claims so sir please help to get claim the doctor is using bad language I admitted from 2days because I m having headache my number [protected] please call immediately please the hospital name jevandeep doctor name Dr deepak Rastogi

I had undergone a medical procedure under local anesthesia for an eye ailment in an operation theatre at KEM hospital in mumbai. The only medical charges i incurred were approximately 22000 INR. Post treatment, i filed a claim with Universal Sompo General insurance company (since i have purchased their insurance policy) as the procedure i underwent conforms to the eligibility criteria as mentioned on page 2 & 3 of their policy.
But after a delay of more than a month my claim has been declined with a verbal statement from the company that the claim was not admissible as it has been done on an out-patient basis (which is completely untrue) and no night-stay was involved.
Page 2 and 3 clearly mention that 'Day Care Treatment' are covered under my insurance policy, yet they refuse to pass my claim.
Policy No. 2817/54709319/00/000
Claim No.[protected]

This is unacceptable and i would like to voice my strong protest against the high-handedness of the company.

Investors in Universal mediclaim should understand that the company makes big claims while selling their policy but are on the backfoot when its comes to settling claims!!

Hello I Tried to Pay my renewal amount for my insurance policy on 30/5/2015 by Net banking but it got cancelled and money get deducted. In how many days I ll get refund? Transaction no. IG0ACKNNT2 Amount: Rs. 854 Bank: State Bank Of India

Dear Sir/Madam, As per above subject mentioned I Mr. Davinder (Senior Citizen) holder of the above policy. In late dec 2013 or early jan 2014 the compliant suffered eye problem of diminshing vision due to fluid accumulation in the veins of the retina. The complainant consulted Dr. Rajendra Prasad (AIIMS) and was advised that the only treatment by injuction through OPD procedure. The insurance company through TPA was duly informed in advance. Copy...

Respected sir/ mam, I have given premium of Rs 39000/-. But your agent issued the policy of Rs 25000/-. He did not given us cover note of remained policies.your agent is saying that ha has done policy of 25000/-. But taking premium of Rs. 39000/-. He is making me upset with his response. I have submitted my premium in company's account. Company is responsible for this type of problem. Company will have to solve my problems. Pls take some action against that agent Mukesh. It will be good for the company's reputation.

Dear Sir, I had taken a health insurance policy from Universal sompo.I filed my claim dt. Jan 28, 2014 but not final till dt 09.04.2014, they did not give me any response dt 09.04.2014 They gave me four query dt. 22 march 2014 I replied all queries in written. they gave me again a lot of queries dt. 31march 2014 . I am very disappointed with this policy and I am in fix what to do now. please give me suggestion and help me

Universal sompo General Insurance Co. Ltd. Period of Insurance date-: 12 /Apr/2012 My Policy No-: 2314/52191057/00/000 Agent in Insurance -: Amit Jain my car accidents date -: 21/Feb/2013 22/Feb/2013 company informed than company issue complain No. CL12050184 car name -: Tata Indigo, car no -: up/32/BN/6723 today not claim company . Company agent all document me summit. and company agent sunil 100 rupees stamp paper court notary agreement 1,45,000.00 may month 2013 cashless payments and it process 10 day payment give me promise , today is not give claim payment and the company response in not batter. my car bank of India finance its region bank pressure and tax etc problem . (my contact information) my contact no, [protected] my email id -: [protected]@gmail.com My add. -: B-1 maharishi nagar Bitholi khurd sitapur road lucknow. pin 206020 Car Insurance Claim