Medi Assist Insurance Tpa Pvt. Ltd Complaints & Reviews

Delay in Disbursing Mediclaim Amount - Claim No: 38651813

Dear Medi Assist Insurance TPA,

I am writing to formally express my concern regarding the undue delay in the disbursement of the mediclaim amount associated with Claim No: 38651813. This claim was raised on 20th July 2024 for the medical treatment provided at Shree Paediatric Hospital, Akluj. The beneficiary of this claim is Shivansh Pradeep Phule.

I have been diligently following up on the status of this claim via email for the past four months, but each of my inquiries has been met with the same response: “We are working on it and will resolve your query.” Despite this continued communication, there has been no progress, and the issue remains unresolved.

Given the significant amount of time that has elapsed and the lack of any meaningful updates, I request immediate action be taken to expedite the disbursement process. The prolonged delay is causing unnecessary stress and inconvenience, and I expect a swift resolution moving forward.

I kindly ask for an update on the status of my claim and a clear timeline for when the payment will be disbursed to the hospital. Your prompt attention to this matter would be greatly appreciated.

Thank you for your understanding and cooperation.

We had initiated the reimbursement process and provided all the documents, responded to multiple annoyed queries and still after 3 weeks of back and forth, Medi Assist moved the claim to "Repudiated - awaiting insurer concurrence" state.

There is no explanation why the claim was moved to this status, what else they need from us. We have mailed them many times, calling on numbers which apparently are not working anymore.

The documents are clear and valid . I am really disappointed and frustrated at this time as Medi Assist customer care numbers are not reachable and no reply via email.

I work in cognizant. My employee I'd is 769491. My baby was born on 10 sep 2019. I have added him in AMC as an additional member from medibuddy portal and have mistakenly chosen 2 lakh cover instead of 3 lakhs and paid the premium for the same in my corporate group policy ( Cognizant).

I asked or assistance from CTS medibuddy helpline and they informed that my child didn't get added and it will take time to reflect him as added in the portal from their end.

The support personal suggested to send an email to [protected]@mediassistindia.com before my baby gets reflected in the portal and assured me that the needful will be done to update the AMC policy cover to 3 lakhs if I sent the mail. I have the call recording for the same as well.

I have mailed for it yesterday itself immediately after the call with helpline and got the response mail that a ticket has been raised and I will get the response within next working day.

However, I didn't get any response from their end. Also when I called today on the helpline the support personal today said that my baby is now reflected in the portal as added and the policy cover cannot be changed now nor my child can be removed and re-added with appropriate medical cover.

Please help me get the policy cover extended to 3 lakhs.

My contact: [protected] / [protected]

Respected sir,
With repeated email and letters from my end ni intination has been received from your end regarding payment of rs. 61157 incurred fir hospitalization, which has been written in your document as "no doc found" as non - payment cause but i have sent to medi assist as well as national insurance company regarding this bill repeatedly. I am hereby again attaching the bill and your intimation letter.
I would be obliged, if you kindly reimburse the money amounting rs. 61157 as per promise from cmri hospital tpa desk regarding total reimbursement of the aforesaid amount in due course.
If no initiative has been seen from your end soon, you will receive court ketter from consumer forum. This issue has already been reported to consumer forum. If within 1 month this issue is not settled my lawyer and consumer forum will have the necessary dealings with you in future as per government norms.
Regards
Mrs. Debopoma basak kar ray