- Policy Name
- 441200/48/2025/303 (Year: 2024-25)
- Company Name
- The Oriental Insurance Company Ltd. (OICL), Insurer of the MEDISEP Scheme, Regional Office, Thiruvananthapuram – 695001
- Customer Care Number
- 1800-425-0237
- Loss Amount
- 462092
- Ratings
- Opposite Party Address
- 1. The Government of Kerala, represented by the Secretary, Secretariat, Thiruvananthapuram – 695001.
2. Dr A. Jayathilak IAS, Additional Chief Secretary, Finance Department, Government of Kerala, Thiruvanathapuram
3. The Manager, The Oriental Insurance Company Ltd. (OICL), Insurer of the MEDISEP Scheme, Regional Office, Thiruvananthapuram – 695001.
COMPLAINT
(Filed Under Section 35 of the Consumer Protection Act, 2019)
1. The Complainant’s son, Mr. Aloknath A., met with a severe road traffic accident on 27 August 2025 near Parippally, Kollam.
2. He received inadequate medical care at Parippally Government Medical College Hospital and later at N.S. Memorial Institute of Medical Sciences, Kollam.
3. He was shifted to SP Fort Hospital, Thiruvananthapuram, where emergency surgery and treatment saved his life.
4. Total treatment cost amounted to Rs4,52,842/-, supported by medical bills and records (Case ID: ALOK NATH A., CASE/P3/F/891/13004341/1).
5. MEDISEP reimbursed only Rs90,750/-, leaving an unpaid balance of Rs3,62,092/-.
6. A first grievance was filed on 05/09/2025 (MEDISEP ID: 2404521), but no response was received.
7. A second grievance was filed before the District Grievance Redressal Cells on
23/09/2025 (Grievance ID – D2404521G102055), but no response was received to this grievance either.
8. The failure to respond or act constitutes a clear deficiency in service, negligence, and unfair treatment.
1. Direct reimbursement of the full treatment amount of Rs 4,52,842/- (or a reasonable portion thereof).
2. Award Rs.3,62,092/- as compensation for financial loss.
3. Award Rs.1,00,000/- towards mental agony and hardship.
4. Order 9% annual interest on the balance amount from 03-09-2025.
5. Direct the Opposite Parties to bear litigation costs.
6. Grant any other appropriate relief as deemed fit.
1. Copies of medical bills (Rs. 4,52,842/-).
2. Discharge summary from SP Fort Hospital.
3. Operation notes and treatment records.
4. MEDISEP reimbursement sanction (Rs. 90,750/-).
5. First grievance dated 05/09/2025 (ID: 2404521).
6. Second grievance dated 23/09/2025 (ID: D2404521G102055).
7. Copy of MEDISEP ID.
8. Any additional supporting documents.
Place: Kollam,
Date: 02.12.2025
Anilal V.
(Filed Under Section 35 of the Consumer Protection Act, 2019)
1. Complaint in Detail
1. The Complainant’s son, Mr. Aloknath A., met with a severe road traffic accident on 27 August 2025 near Parippally, Kollam.
2. He received inadequate medical care at Parippally Government Medical College Hospital and later at N.S. Memorial Institute of Medical Sciences, Kollam.
3. He was shifted to SP Fort Hospital, Thiruvananthapuram, where emergency surgery and treatment saved his life.
4. Total treatment cost amounted to Rs4,52,842/-, supported by medical bills and records (Case ID: ALOK NATH A., CASE/P3/F/891/13004341/1).
5. MEDISEP reimbursed only Rs90,750/-, leaving an unpaid balance of Rs3,62,092/-.
6. A first grievance was filed on 05/09/2025 (MEDISEP ID: 2404521), but no response was received.
7. A second grievance was filed before the District Grievance Redressal Cells on
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23/09/2025 (Grievance ID – D2404521G102055), but no response was received to this grievance either.
8. The failure to respond or act constitutes a clear deficiency in service, negligence, and unfair treatment.
2. Relief Claimed
1. Direct reimbursement of the full treatment amount of Rs 4,52,842/- (or a reasonable portion thereof).
2. Award Rs.3,62,092/- as compensation for financial loss.
3. Award Rs.1,00,000/- towards mental agony and hardship.
4. Order 9% annual interest on the balance amount from 03-09-2025.
5. Direct the Opposite Parties to bear litigation costs.
6. Grant any other appropriate relief as deemed fit.
3. List of Documents
1. Copies of medical bills (Rs. 4,52,842/-).
2. Discharge summary from SP Fort Hospital.
3. Operation notes and treatment records.
4. MEDISEP reimbursement sanction (Rs. 90,750/-).
5. First grievance dated 05/09/2025 (ID: 2404521).
6. Second grievance dated 23/09/2025 (ID: D2404521G102055).
7. Copy of MEDISEP ID.
8. Any additional supporting documents.
Place: Kollam,
Date: 02.12.2025
Anilal V.