Not Receiving Claim amount due to 2 yr waiting period

POSTED BY ON January 24, 2014 12:21 pm ONE COMMENT

I Ronak S Patel having policy of Orientalinsurance Company Ltd Happy family floater policy with included my two children and wife Since 10/1/2012 to 9/1/2013 and renewal continue for next year for duration 10/1/2013 to 9/1/2014 and at present Policy renewal for duration of 10/1/2014 to 9/1/2015.

On date 23/12/2013,My son hospitalized for operation of phimosis posthitis and as per guidance of my agent,i intimated this matter with fill up intimation form at Oriental insurance company Bharuch office and claim raised on 31/12/2013 with necessary documents with guidance of my agent.

But on 11th Jan-2014,my agent suddenly saying that oriental insurance company reject my claim with reason that my policy is not completed two years period. This matter not inform me my agent at time of policy taken and not even at time of my son hospitalization. I suffered my claim amount Rs.10191.20.As per my Agent information that If I want to surrender my policy for Period duration of 10/1/2014 to 9/1/2015, oriental insurance company Ltd , return my this year premium amount (for 10/1/2014 to 9/1/2015).So I Email company Customer service department on 7/1/2014 but till date no reply received from Oriental insurance company Customer service department.

Please guide me.for receiving my claim or this year premium receiving back.

I waiting your reply. So,I Requesting you for passing to my claim or return my amount Rs.7629.00 with surrender my Policy No 171900/48/2014/3202 duration 10/1/2014 to 9/1/2015.I waiting for your reply what ever possible.

I will waiting for your reply with Email.

One reply on this article “Not Receiving Claim amount due to 2 yr waiting period”

  1. Hi Ronak

    I know you are really not happy on this . But I think its clearly your mistake for not understanding what this policy offers you. Any health insurance company (not just oriental) , always have WAITING PERIODS . And this is a very standard clause .

    For first 2 yrs, major ailments are not covered, and for first 3-4 yrs, pre-existing illness are not covered. If your agent didnt inform you about it, I know it will seem to be a mistake form his side and it is to some extent. But You cant blame him for this totally. What did you do at the time of taking the policy ? If you didnt take any effort to read the policy document and understand what policy offers and what not, I must say, this is what happens .

    I really dont think there is any solution to this and you will have to take the charge on your soulders only. Its just a case of uninformed decision from your side.

    I also have health insurance policy , and I know clearly about what it covers and in which situations.

    This is my take. I know I am not favoring you on this and blaming you more than company, but thats what the reality is .


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