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Health Insurance - Ombudsman

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Offices in India

Medindia provides you with the address, phone numbers and e-mails of all the insurance Ombudsmen Offices in India.

Ahmedabad
Bhopal
Bhubaneshwar
Chandigarh
Chennai
Delhi
Guwahati
Hyderabad
Kochi
Kolkata
Lucknow
Mumbai

AHMEDABAD
2nd Floor, Ambica House,
Near C.U. Shah College,
5, Navyug Colony,
Ashram Road,
Ahmedabad - 380 014
Telephone:- 079-27546150, 27546139
Fax:- 079-27546142
E-Mail:- insombahd@rediffmail.com
Area:- Gujarat, UT of Dadra & Nagar Haveli, Daman and Diu.

BHOPAL
1st Floor, 117, Zone-II (Above D.M. Motors Pvt. Ltd.)
Maharana Pratap Nagar,
Bhopal - 462 011
Telephone:- 0755-2769200, 2769201
Fax:- 0755-2769203
E-Mail:- bimalokpalbhopal@airtelbroadband.in
Area:- Madhya Pradesh and Chattisgarh.

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I filed my complain against UNITED INDIA INSURANCE CO.LTD IN MUMBAI OMBDUSMANS OFFICE IN AUGUST-2012 CASE NO.OF THE SAME IS 953.NOW THEY ARE TELLING ME THAT,THERE IS NO OMBDUSMAN APPOINTED and CASES FROM DEC/2011 ARE PENDING I AM UNABLE TO UNDDERSTAND WHAT IS HAPPNING? WHEN LL IT BE APPOINTED,TO WHOME SHOULD I CONTACT REGA .THIS
ATULM Monday, March 11, 2013
i had taken a health insurance policy from, Medical check up was conducted and they informed me that I have complaint of Diabetic and so any claim related to that will be disallowed. I never had diabetic problem and I took another test to confirm this, my sugar level was found 98. I am requesting star health to provide me a copy of their report which they are refusing- what should I do?
mpoovali Wednesday, January 09, 2013
Dear sir, My self and my wife has mediclaim policy from future generalii No.2011-H0023996-FHI.

My wife was ill and got hospitalised in Adinath Hospital, Indirapuram on 02.09.2011 as a case of dengue fever.

Hospital send request for cashless which was refused by Insurance compony on baseless ground and ask for rembursment.

My wife remain admitted till 07.09.2011 and Hospital raised a bill of Rs. 33752/-

Insurance person visited the hospital and varified the presence of pateint in Hospital.

Initially insurance compony was not resonding for claim and when ever contacted gives the answer that claim is under process but when complaint was registered with IRDA

Insurance compony rejected the claim on the following grounds;

1. Pt. has given a wronge residential address - How a residential address can be cause for no claim even when Pateint presence in hospital was confirm=
ed by insurance compony and all corospondance even renewal of policy was with same address.

2. My self is a doctor and director of the Adinath Hospital - how does being my self doctor and director of treating hospital leads to no claim for insura=
nce compony.

Insurance compony representative repeatedly visit the address and harash my wife and her sister in law once they was alone in the house.

Now you are requested to see the matter and ask insurance compony to pay the claim with intrest and panalty for harashment.

Thanks with regard

Jain

jaina Tuesday, January 24, 2012
Please file a case against rejection of claim in Consumer Court of your area. As regards, harrassment, please lodge FIR against insurance company.
PRABHAKAR_VERMA Thursday, September 05, 2013
hi, I need to newly get medical insurace for both my parents both of age 59, my Father has pre existing disease - Diabetes and my Mother does not have, so please advise on which insurance I can take. I will need the maximum renewal age. Thanks Wincy
winbe Saturday, December 10, 2011
my mother is insured by icici prudencial life insurance but it is not paying my claim. icici pru life is very bad company. it is not paying any one claim if any misshappening. i have lot of people who is suffering such tipe of problem by ICICI pru life. i am suffering since last 2 year. how can i get my claim?
sonuP Wednesday, August 10, 2011
I HAD FILED AN HEALTH CHECK UP CLAIM WITH RAKSHATPA FARIDABAD ON 9-06-2010.AND SUBSEQUENTLY I HAD CONFIRMED THAT THE SAME WAS RECD IN THERE OFFICE ON 10-06-2010.I AM INSURED WITH NEW INDIA ASSURANCE COMPANY ROHTAK.NOW THE TPA IS NEITHER REPLYING NOR PAYING MY CLAIM .WHAT ARE THE OPTIONS AVAILABLE TO ME .IF I TAKE CLAIM TO OMBUDSMAN WHICH IS IN CHANDIGARH.I SHALL HAVE TO WASTE ONE DAY TO ATTEND HEARING AND SHALL HAVE MONETARY LOSS ALSO .IS THE TPA GOING TO REIMBURSE THE EXPENSES I SHALL DO FOR GOING TO CHANDIGARH IF THE CASE IS DECIDED IN MY FAVOUR. IS THERE ANY PRECEDENCE AND THE TPA BEING PENALISED FOR HARRASING THE INSURED PLEASE ENLIGHTEN ME ON THIS.
surjee Friday, October 29, 2010
is there any mechanism to lodge a grievance complaint to LIC ombudsman,kochi through Online service
Sreemon Thursday, September 09, 2010
I have a query, my insurance agent had done some forgery, he had done shifting between available funds with out my knowledge, and so there is loss of more than 1200 units in my policy. can any body tell me how can i bring him down?
drkapil Saturday, August 07, 2010
sir,further to GAJANAN's comments. It is true in spirit. But,the practical experience is the Ombudsman personnaly calls the Insurere/TPA officer. The opposite insured/ claimant has to put in his argument. That is the imbalance that has been brought forward. GAJANAN is right in saying that it is on submitted written documents, the ombudsman has to given decision.But, the scenerio is different. It would not be a big deal if the less informed Insured gets the help to put his correct submission in contrast to callous mechanical attitude adopted by TPA/Insurers in the first instance.
suvarnamk Wednesday, March 24, 2010
Sir,
Why is there no transparency? Why does the ombudsman not allow the insured to take help of the expert at the hearing? There is imbalance between the Insurer (with all insurance/mediclaim acknowledgement)& the Insured who is ignorant of intricacies of Insurance/Mediclaim terminology. This is imbalanced justice.

suvarnamk Friday, February 12, 2010
Ombudsman office runs on documents and evidences and not on the arguments. So the experts, agents and lawyers are not allowed.... You can show your documents and share your views directly.
guest Tuesday, March 23, 2010

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