Vipul Medcorp Tpa Pvt Ltd — Wrong information provided by staff

Address:	Thane, Maharashtra, 401303
Website:	www.vipulmedcorp.com

Insurance company: oriental insurance co'
Tpa: vipul medicorp

Subject: misleading information by tpa - vipul medcorp callcentre of oriental insurance co'

We had purchased a mediclaim policy which was effective from 1-may'16. (Vipul medcorp id no' [protected]). On 28-jun'16, my father-in-law needed to be hospitalised due to emergency hence i called their call centre[protected] at 9.04pm to check the list of network hospitals. The call centre said they do not have any network hospital in virar or nearby places & advised me to get admitted into non-network hospital & then claim for reimbursement. Following which we got his admissions in sanjeevani hospital (Near virar station).

The very next day @ 12 noon, i again called your mumbai office to confirm the given information - the lady (Ms. Sampada) over the phone gave the same information that we can get admitted into non-network hospital & claim for reimbursement. On 29-jun'16, 3.32pm i sent an email to them with regards to admissions intimation; also followed by a call to their call centre @ 4pm for which they shared the admission intimation number with me. Please note, during all these calls - i had given our vipul medcorp id no' for their staff to check the type of policy we hold.

Post discharge, on 11-july'16, we handed over all documents for reimbursement at your wadala office followed by a acknowledgement from them as a receipt.

After numerous follow ups (Emails & calls) we were given a understanding by mr. Swetaketu swain that company has refused to pay any reimbursement for jio phase-6 silver plans.

Their call-centre staff admits that its their error since they provided me misleading information at the time of admissions. Even if we say, it was one of the error, but then nobody bothered to come back to me even on my emails, even on my 2nd & 3rd call that silver plan doesn't support reimbursement. When their own staff is not aware about the policy t&c's then how do you expect client's to remember all these t&c's; that too even without receiving the policy copy. Yes, please note, till date - we haven't received any policy copy, all we received was the id number via email. The below details are extracted from online on www.taps.vipulmedcorp.com

Policy number: 111700/48/2017/204
Patient name: mr. Babulal nagjibhai fifadra
Vipul medcorp id no' [protected]
File number: 17rb03oie0248

My in-laws are very middle-class & this policy was taken to support their financial condition in case of medical emergency. Rejecting this policy on ground of your staff providing misleading information would be in-appropriate. We had doubts hence we called their call-centre - they never said that we couldn't get reimbursement if we get admitted in non-network hospital. Where is our fault? You can even check call recording at the call-centre.

If we were been given this understanding on day-1 or day-2 o[censored]s intimating them, then we would have taken discharge from that hospital & would have got admitted into a network hospital via ambulance on day-2 itself.

We have also approached the grievance cell at oriental insurance, however they are not responding & it is now being a mental harassment to us. It's been around a 50-60 days now, may i request you to please look into the same at your earliest.

Regards,
Sameer