MDIndia Healthcare Services Complaints & Reviews

Please note claim id: MDI6004978, there is deduction of 4800 again pulse oximeter & monitor charges.u father is a cardiac patient hospitalised in ICU in critical situation. If there is pulse oximeter and monitor for such patient how will doctor be able to monitor him 24hours.
Also when father was hospitalised in June 2020 (21st to 24th June 2020) in same hospital the Charges were covered. Again in past I have never seen such deduction for same hospital and same patient.
I urge to please refund the amount for the below deduction.

Below is the sms:
Policy Details :

OIC Underwritten Happy Family Floater-2015 Policy
Insured Person : Mr.jalpesh V Shah
Policy Number : 121700/48/21/04221
Policy Period : 31-Jul-2020 To 30-Jul-2021
Sum Insured : 600000

Hospitalisation Details :

Hospital Details : paarth hospital - MUMBAI
Hospitalisation Period : 11-Dec-2020 To 14-Dec-2020
Diagnosis : [ Conservative ] Ischemic Heart Disease Renal Failure

Claim Status :

1. Insurance Company Claim Number - 121700/48/2021/00002157
2. Claim Number - MDI6004978
Deduction Details :
Rs. 3000 : Monitoring charges are not payable under reasonable and customary charges.
Rs. 1800 : PULSE OXIMETERY CHARGES ARE NOT PAYABLE.

Respected,
I have lodge a claim of amount INR 7480 ( Seven thousand four hundred eighty only) vide claim no. : MDI5993832. I have send all relevant original documents, md india asked for additional documents that were already send at this I replied to additional documents requirement and send the asked documents again via email dated 25/12/2020 .
Now md india is seeking for Pollution control board certificate, bio medical waste certificate which are irrelevant and not required as per guidelines of IRDAI.
Kindly intervein into the matter and oblige.

Respected Sir/Madam

We submit the claim of Eshaan Sandip Mahajan of dated 26.02.2020 to New India Assurance Company, Deccan House, Rajaram Road, Kolhapur. MDI 55720288 under Request ID 8299144. The claim was settled for amount Rs.3884/- against amount of Rs.19803/- on dated 10.05.2020. Deducted amount of Rs.6652/- because the Medical Bills are credit memo. But we submitted original paid receipt of Apple Medical Receipt no.4196 dated 04.02.2020 with original claim file submitted on dated 26.02.2020. The original receipt of rs. 6652/- lost by MD India or New India assurance. The quire of original paid receipt Demanded by MD India on 13.05.2020 we sent our declaration on same day. Then after your reply mail on 02.07.2020, 16.10.2020 you request us to allow 7 to 10 for complied the claim. Then we again we sent the mail on 31.10.2020 about claim status. Then you reply on 01.11.2020 claim processed for zero amount. then we replayed on this mail on 05.11.2020 why this claim processed for zero amount. Then you reply to dated 30.11.2020, 16.12.2020 request us to allow 7 to 10 for complied the claim. then we reply on same day how much time you need to complete to 7 to 10 days period and give us a reason why claim processed for zero amount within 7 days to complaint to IRDA. Then you reply on 7.12.2020 request for original paid respite. Then we submitted to duplicate respite copy then you reply give us original paid respite copy on 29.12..2020. then we give the explanation and demand for citizen chart and Email Address of complaint officer and Phone no. etc. in singed and stamped letter with register Ed within 2 Days. We yet can't get the above same demand by register ed. please give details within 2 days from receiving this mail. If rejected please give us a reason with low and article sub number with stamp and signed authority letter by register post and e mail within 2 days. please see mail of dated 22.12.2020 and 29.12.2020 for Paid respite of 6252/- with stamp and signature for your further knowledge.

From Sandeep Mahajan Contact No.[protected]

Dear sir/Madam,

I am writing to inform you that we have insured medical policy from National Insurance Company. My mother was hospitalised from 1st Sep. 2020 to 2nd sep.2020 in Trimurti Multispeciality Hospital, Nashik due to heart attack. We had submitted our policy documents along with a cashless card at the time of admission at the hospital but during final billing the hospital refused a cashless facility. As discussed with the insurance agent (Mr. Samadhan Aher from National Insurance), he confirmed our claim will get settled within 7 days and asked to pay cash. We had paid 82000 Rs. cash to the hospital. We had submitted a file and hospital bill to the insurance agent (Mr. Samadhan Aher).

We had a conversation with the customer care no ([protected]) many times and every time they provided false or misleading information. We had a conversation with (Mr. Sujit Surana) so many times, every time they had given false information. They missed calculation of the claim amount 2-3 times intentionally. We had submitted a cancellation check of State Bank of India. However, they informed us that the claim amount was rejected by the bank, when I called the state bank of India, They informed us that no such transfer was made. Last 3 months they have given so many reasons and dates. I have recorded calls and email conversations. It is a very disappointing service by MD India. The claim is settled now but the reimbursement process delayed more than 3 months intentionally. I am dissatisfied with the service provided by the MdIndia Nashik branch. I hope you will investigate this case and will find out why they provided false information.

Regards,
Pankaj Bhapkar
Mo. [protected]

I am submit pre & past treatment document on dt 13.11.2020 rs 3321/- in indore office.
But till date i have not receive any amount from md india.

At time of sumbit my cliam md india staff says maximum 21 days settled all claim.
Today is 36 days are gone but no settled by md india.

Hello

This is regarding the deducted amount of Rs. 1, 01, 392 from our total claimed amount of Rs. 4, 59, 119 in our claim with CCN – MDI5681230, in the name of the insured and deceased – Pradip Divetia.

We have got reimbursement of Rs. 2, 39, 137 on 13th August 2020 and Rs. 1, 18, 590 on 15th Sep 2020, after which there has been no communication from your side for the remaining Rs. 1, 01, 392.

We have sent them number of reminders for the same but haven't received any response.

Request you to kindly give us the latest update on the status of the deductions done so that we can get the required clarification from the hospital or take this case further to the Consumer court/Ombudsman.

Regards
Kshama Divetia

(Pradip Divetia's wife)

We had sent the preauthorisation for femto lasik surgery for both eyes for rs 90, 000/- on 25th november, 2020. we received query for refractive error values . we had replied the query reply on 26th november 2020. after few hours on the same day we got message from tpa saying that “ we have received your cashless request and raised query to the insurance company, will revert back to you immediately after receiving reply from the insurance company ...pending”.

since that day we are getting the same mail from tpa. we called many times on toll free number they also informed that same that we are waiting for the reply from insurance company and corporate (canara bank). yesterday on 4th december 2020 we received denial of preauthorisaiton saying “query reply not received hence claim closed”. we we called on toll free number they could to give proper reply and asked us to escalate the same issue in mail to [protected]@mdindia .com.

tpa and national insurance company had taken 9-10 days to check the preauth communicate with each other for approval of claim and at last after 9 days we received denial letter saying claim is closed.

we need proper information for the said claim id for why the claim has been denied. this is for your kind information

I am SHRIPAD BOMBALE, working as Officer with Bank of Maharashtra.
IC Claim Number : [protected]C[protected]
TPA_ MDINDIA
INSURANCE COMPANY _ UNITED INDIA
During lockdown and rainy disaster in Mumbai, I was unable to do cashless treatment for my wife's pregnancy. She was admitted to Deenananth Hospital from 7/8 to 13/8
I have submitted all the required documents afterwards for reimbursement And also I have specifically mentioned the some original documents to be submitted by me after talking stamps from hospital.
1. Claim was settled without discussing the rejected bills just by sending rejected bill list.
2. I have emailed for reconsideration of claim amount. Which was ignored.
3. Rejected reason of some bills is not specified.
4. Not even single day prior to admissions in to hospital was considered.
I WANT TO KNOW WHO HAS SETTLED THE CLAIM? AND WHAT STANDARD PROCEDURE FOLLOWED?
I WANT THE CASE TO CASE DISCUSSION

Then for what purpose MD INDIA is there?
Just to loot IBA employees.

Dear MD India team,

We are yet to receive our payments for the below 3 patients. We are following this issue for past 1 month. There is no proper response from your end. Kindly help us by processing the payment as soon as possible.
Patient details are attached below.
Regarding this issue you can contact us through Mobile/Email
Phone: +91 [protected]
Email: medwinhospital.[protected]@gmail.com
Thank you

Kind regards,
Medwin Hospital

1ST DEC 2020
ID : MDI5-[protected](ANITA JAGGI)
dear sir/ mam, we are contineously getting touch with your employees but we cant get any cashless approval from your side. please revert back to our mail as possible as soon. patient need a surgery and they want pre approval from your side.
prime vision superspeciality eye care
plot no5d, navale nagar, savedi ahmendgar 414003
PH. NO. [protected]/ [protected]/[protected]...

Dear sir
I have submitted domiliciary claim of my wife name priyanjali Pandey and claim id is 5950598.
TPA has asked two ADR
1. Doctor referal letter for investigations conducted and I have replied that the doctor is in indore MP and I am posted in GOA 1200 km from indore and we are unable to contact him and privious TPA vidal never ask for that referal code hence I have not asked doctor the same
Iundertake in future I will take care and provide this referal letter.
Kindly consider my request but not accepting my request in this tough time of corona pendemic.
2. All the investigation reports they are asking for original but we have submitted system generated report.that was not photocopy. I can provide id and PW of lal path lab from they can extract

My MD ID I'd MDI5-[protected]. I have submitted my reimbursement claim form along with all original documents through my Zonal office. Zonal office dispatched it on 11 November 2020. I have not received any message or email regarding receiving of documents . My claim is being delayed.

My name AJI Nanu.My Corona RAKSHAK policy no is 442400/48/2021/4110.My MDID no is MDI5_[protected].I submitted all documents for claim .Myself admitted in primary covid center for 10 days from 07/11/20 to 15/11/20.and 7days home Quarantine.From message received from MD india claim is showing only for 2 days from 07/11/20 to 09/11/20 wrongly .Claim amount shown Rs26000.As per CORONA RAKSHAK policy Guidelines Hospitalisation more than 72 Hours full insured amount of Rs 250000 has to sanction.i submitted discharge summary for 10 days in CFLTC health center.but company message shown 2 days.kindly do needful and inform me details

Claim of 105703 submitted in Aug 2020 for COVID Deaths in 24/05/2020 and 01/06/2020 not yet settled

The claim documents was asked to be submitted on mail which was submitted 5 days ago and the customer support executive doesn't have an update whether the mail is received or not. Being a senior citizen my dad doesn't have time and energy to call and ask everyday. The policy is of 10 years now and the service is extremely horrible. This is the first time we are applying for a claim and there is no way we are able to understand if the documents are atleast received or not.

Please settle my claim amount early as possible
now i am waiting from two month firstly my claim register in md india after one and half month later
please take step early as possible

thank u
for naresh katariya
policy no 280500/50/19/10000172
md india - mdi5-[protected]

My father who is a Senior Citizen has submitted his medical bills for reimbursement since Feb -2020. He has been continously following up since then but the MD India Health care has not reimbursed his amount stating that due to covid, they are low on staffing. Since all the organizations have resumed normal work, this should surely not take so long i.e 9 months to process the request. We have been paying the amount since so many years and this is the only major hospitalization claim we have claimed for. It is been a harrassment for my father who is a citizen citizen. Also MD India health care is not doing any favour. It is their duty to process the legitimate claim which is submitted.
I appreciate if some help can be provided to close this issue.
The claim is for Mr. Harihar Pawar and his cell number is +91 [protected]

Claim number CCN REF MDI5855542
Date 28th september, 2020
ID- MIN 1203049
Resolution- pay the claim

The company has rejected claim of hospitalized senior citizen (spouse of SAIL employee), who was hospitalized with 30 percent lung damage due to post covid complications, with pulseox much less than normal, and in need of IV antibiotics, steroids and electrolytes.

The ludicrous response from MDIndia was that such a critical patient could be treated at home by non medico kin.

Despite Doctors at Sakra World Hospital, Bangalore sending them Lung CT scan reports and all documents relevant to treatment, the mental harassment of senior citizen continued.

Please follow up on this

Sincerely
Amar (Son)

Claim approval is delaying . no improvement in claim status /mail to the concerned hospital for the past 10 hrs.
why there is a delay.
patient is suffering.

I am raising this complaint to dispute the claim settlement done by md india tpa.
Claim no : 5722269 and 5785483
Patient name : dayaram waman pagare
Policy details: united india health insurance policy for retired employees of bank of india.

I raised a claim for amount of 471388/- but only 134150 amount is settled giving below reasons:

1. Rs. 183074 : usual & customary :as per maharashtra gr claim payable upto rs.134150 /-.

2. Rs. 85000 : visit & doctor charges already charged hence seprate charges not payable under reasonable and customary charges.
Query — this was a consultant visit charges which were mentioned seperately by hospital but still don't know why it is clubbed with iccu charges.

3. Rs. 30000 : o2 charges already part of iccu charges hence seprate charges not payable under reasonable and customary charges.

4. Rs. 30000 : monitoring charges already part of iccu charges hence seprate charges not payable under reasonable and customary charges.

Dispute on point no 3 and 4 is that this details were provided when requested for iccu breakup and is not seperately but part of the iccu charge. Still these charges are denied stating those are not payable

I am not sure if md india is stating that the patient should not consult any other doctor.

I have repeatedly requested to settle the claim correctly or redirect me to proper greiveance channel but till now have recieved no reply from md india related to greiveiance channel