[Resolved]  Medi Assist India TPA Pvt Ltd — Services not rendered

Address:

Surat, Gujarat

Hello
I am having Reliance Healthwise policy on my name. On 21st May Cashless facility was requested from a network hospital (Metas Adventist Hospital, Surat) of TPA i.e. Medi assist and it was rejected with a reason that Room Charges are high, but a question arises when Insurance Company’s policy has given a feature that there is no caption on room charges than how can TPA question or reject on that basis. Secondly Medi Assist TPA is not giving any services to hospitals or Individuals as major hospitals in Surat are denying to offer Cashless facility from this TPA even after they are in List of Network Hospital of TPA and Insurance Company because their old dues are still pending. TPA Customer care number is not responding or it’s always busy; even if it gets connected it’s on IVR which is very less helpful in case of emergency. Thirdly When I called at Reliance General Insurance customer care they also didn’t take a complaint against TPA and told they can’t do anything in regards to TPA working. I want to ask who has selected the TPA and whose responsibility it is to handle TPA, Customer or Insurance Company. I talked to XXX and she was not ready to take complaint, and told me TPA decision is final. I would like to suggest to think twice before taking any Medi claim who is offering Medi Assist India TPA Pvt Ltd as TPA.

Thanks