I have taken group insurance of 6saal for my family in year of 2018.
My mother and father hospitalized on 23rd due to COVID19 infection and I have informed [protected]@ericsonTPA team and Jio.[protected]@edelweissfin.com, but when I called Jio Erision TPA team on 27th March as I am not getting any response from them they said forward email to [protected]@erictionTPA.com and I got intimation numbers for my parents.
I submitted all the required documents with claim form, they generated claim Ids.
Mother hopitalization claim id - 133145 and father 133156
They have asked me to submit doctore's prescription for investigation reports then I uploaded the same in Ericson TPA portal, emailed a soft copy as well as hard copy sent to them via post.
After few days they rejected my claim said, intimation not done within 48hrs, then I emailed and called then mutiple times they just saying waiting from Insurance approval and today they rejected my both claims.
It looks like a big scam and I am finding my self so helpless and do not know what to do further.
| hope you will investigate into this so that many persons like me can get some remedy.
If you need any details or information I can forward it to you
below are the policy and hospital detail.
Hospital Name: Mahavir hospital Dahod Gujarat.
Name - Santosh Saklecha
Policy No. - 2839/62271303/00/000
RMN-[protected]
UHID-USER 1667466
Age - 56
Name - Shantilal Saklecha
Policy No. - 2839/62271303/00/000
RMN-[protected]
UHID-USER 1667467
Age - 66
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We are RECIVED from Erision TPA to you Reimbursement PROVIDED - 3 Claim No 140111 and 140111.1, 140164 as per Erision TPA Mail New Claim No third No is 140164) this claim related we are follow up last 2 Month and reimbursement amount of Rs.56139/- this amount related all Medical Bills, Lab Bills, Hospital Bills C&T Scan Bill and payment Receipts, Form A and Form B, Mail and Courier to Erision TPA and in this mail and Courier copy of Hospital Internal Papers, Personnel information, Aadhar and Pan card also attached Nirmala Shah Bank Details(Account No, Bank and Branch Name and IFSC Code) with all original Documents. This document already delivery to you by professional Courier also All Documents Scan file already send to you.
Courier Receipt already Send to you also you are deliver to all papers . Attached delivery Receipt which is provide by Courier TO Erision Tap postal office Address .
When courier Original all Papers that time am ALREADY inform to you also you are deliver courier of our paper that time also mail to you. So we are already send to you copy of courier Receipt and Delivery Courier Name is Shree Maruti Courier Service and Doct No/C.N.NO.is - 2101 [protected] dt 22/04/2021.
We are send to you and expenses Original Bills also send Hospital Bills total amount of Rs 56, 139/- also send Scan copy of Post bill amount of Rs( Doctor +Medical Bill ) 4126/- Scan already mail So Total Amount of Rs 60265/-. Payment details of- and Again Send Payment Details. Original Bill of 4126/- till process of Amount 60265/-
After Discharge Post Bill send to you by courier and Name is Tirupati Courier and Doc No is[protected] Today Courier to your Chambur Address, Also Mail exp and Courier Receipt.
This all information given to, 18th time.
Name - Nirmala Prakash Shah
Bank----- Bank of Maharashtra
Branch - 00340 Salisbury Park, Pune
Account No - [protected]
IFSC Code- MAHB 0000340.
SIR
WHEN SHE REQURIED ADMISSION IN HOSPITAL NOT GET AVAIBLE ANY BED ALSO THIS COMPANY CASH LESS FACILITY AVAIBLE FOR HOSPITAL. IAM SEARCH SO MANY HOSPITAL BUT EVERY HOSPITAL REPLAY TO US THIS NOT IN HIS PANNEL AFTER THAT WE ARE PAID HOSPITALBILL AND CLAIM TO REAIMBUSMENT . THIS INSURANCE COMPANY NOTHINGANY RESPOANCE ALSO THIS IS VERY POOR. WE ARE EVERY MAIL COMMUMANACTION TO & CC FORMATE TO UNVERSIAL SAMPO, ERISION AND JIO BUT NOTHING ANY RESPOANCE . THIS NOT PICK UP CALL NOTHING ANY MAIL OF PAYMENT . SO SEARCH TO THIS PROBLEM IS FACE BY ME OR ANY BUT THIS IS SOMANY PEOPLE ARE FACE. MY TWO RELATIVE SAME PROBLEM FACE . SO REQUEST TO ME HOW TO LEGA ACATION AGAINST OF THREE COMPANY ATTACHED MY LST MAIL 18TH MAIL COPY.WITH CC TO ALL AUTHORITIES.
THANKS
Rupesh Shah
[protected]