KUNJUMOL B
New member
- Policy Name
- MEDISEP
- Company Name
- Oriental insurance
- Customer Care Number
- 1800 425 0237
- Loss Amount
- 21041
- Ratings
- Opposite Party Address
- Finance ( Health Insurance) Department,
Govt Secretariat Thiruvananthapuram,
Kerala: 695 001
Respected Sir/Madam,
I am Kunjumol B, aged 58 years, working as a Grade II Attendant at ESI Hospital, Kilikollur. I am a beneficiary of the MEDISEP scheme (ID: 2251301).
On 15th September 2025, I was admitted to Upasana Private Limited Hospital, Kollam, with severe fever and chest pain. My treating doctor was Dr. N. Pankajakshan, MD (Senior Consultant Physician). On the first day of admission, all necessary details were submitted to claim treatment expenses under MEDISEP.
The hospital insurance office later informed me that the pre-authentication request was approved, and that a claim under the “Pneumonia Package” amounting to ₹ 66,400 was submitted, assuring me that the treatment expenses would be covered.
However, at the time of discharge on 20th September 2025, I was shocked to hear that only ₹ 27,300 was approved by MEDISEP, and I was forced to pay an additional ₹ 21,041 from my own pocket. Since the next day was Sunday, arranging this money caused me severe difficulty and unnecessary mental stress. Finally, I was discharged only on 22nd September 2025.
This is deeply unfair, as MEDISEP promises financial protection for beneficiaries, but in my case, I suffered both financially and emotionally. Therefore, I kindly request:
1. To clarify why only ₹ 27,300 was approved instead of the assured package of ₹ 66,400.
2. To provide details of which part of the bill was disallowed, and under what rules.
3. To confirm whether the balance amount I paid (₹ 21,041) can be refunded.
4. To update me on the current status of my MEDISEP claim.
5. To ensure that other beneficiaries do not face such difficulties in future.
I am attaching copies of the hospital bill, discharge summary, medical reports, and related documents for your kind reference.
I request your urgent attention and a fair resolution of my complaint.
Thanking you,
Yours faithfully,
Kunjumol B
Grade II Attendant
ESI Hospital, Kilikollur
MEDISEP ID: 2251301
Contact No: 9656932887
Address:
Kallanvila Veedu,
Edavattom, Vellimon P O,
Kundara, Kollam.
PIN:691511
I am Kunjumol B, aged 58 years, working as a Grade II Attendant at ESI Hospital, Kilikollur. I am a beneficiary of the MEDISEP scheme (ID: 2251301).
On 15th September 2025, I was admitted to Upasana Private Limited Hospital, Kollam, with severe fever and chest pain. My treating doctor was Dr. N. Pankajakshan, MD (Senior Consultant Physician). On the first day of admission, all necessary details were submitted to claim treatment expenses under MEDISEP.
The hospital insurance office later informed me that the pre-authentication request was approved, and that a claim under the “Pneumonia Package” amounting to ₹ 66,400 was submitted, assuring me that the treatment expenses would be covered.
However, at the time of discharge on 20th September 2025, I was shocked to hear that only ₹ 27,300 was approved by MEDISEP, and I was forced to pay an additional ₹ 21,041 from my own pocket. Since the next day was Sunday, arranging this money caused me severe difficulty and unnecessary mental stress. Finally, I was discharged only on 22nd September 2025.
This is deeply unfair, as MEDISEP promises financial protection for beneficiaries, but in my case, I suffered both financially and emotionally. Therefore, I kindly request:
1. To clarify why only ₹ 27,300 was approved instead of the assured package of ₹ 66,400.
2. To provide details of which part of the bill was disallowed, and under what rules.
3. To confirm whether the balance amount I paid (₹ 21,041) can be refunded.
4. To update me on the current status of my MEDISEP claim.
5. To ensure that other beneficiaries do not face such difficulties in future.
I am attaching copies of the hospital bill, discharge summary, medical reports, and related documents for your kind reference.
I request your urgent attention and a fair resolution of my complaint.
Thanking you,
Yours faithfully,
Kunjumol B
Grade II Attendant
ESI Hospital, Kilikollur
MEDISEP ID: 2251301
Contact No: 9656932887
Address:
Kallanvila Veedu,
Edavattom, Vellimon P O,
Kundara, Kollam.
PIN:691511
