Medi Assist India Complaints & Reviews

My mother was admitted for 16 days in the month of September 2020 in the hospital. I enquired mediassist what documents required for claim and i mailed all the documents from there which they have listed. The original documents submitted are as below,
1) final bill ( duly sealed and signed by hospital)
2) discharge card (Having details of why she was admitted and what the doctor did the treatment.)
3) all medical bills...

I am working for TCS my employee ID 1222429. As per TCS HIS we can claim for Rs 15000 for home isolation covid treatment. Even though I submitted all documents they are telling some X reasons and irritating the customer.They are not looking into the documents properly and simply sending message not claimable. Customer care is pathetic and they don't know complete information. Kindly look into my Claim I'd[protected] and my contact number [protected].

Recently my mother admitted for covid, hospital comes under network hospital list. After admission they gave estimate of 1337500 rs and mediassist approved 75000 ₹. At the time discharge the hospital gave claim of ₹177906 the mediassist approved only 50000₹. If I ask for details, they didn't provided clearly. If the medical insurance provider can't able to give atleast 50% of claim from amount then what is need for medical insurance. Y we have to pay for that. How we are thinking we are safe if we put medical insurance. Instead we can save the money n spend. At last we have to spend our own money. For this of disease whether the approved amount is ok before approving that just keep yourself in that place. don't use the word cashless.

Dear Sir / Madam,

Referring to subject claim reference, we are following your team for the claim amount approval since last many days. Claim amount approved for this claim is shorter by Rs. 3100/-. We have also provided all documentary evidence for this.

Deduction made is as per below:
25% of OT Charges: Rs. 2500/-
Hospitalization cash: Rs. 600/- (200 per day x 3 days)
Total: Rs. 3100/-

We are not getting satisfactory replies from the MediAssist Team.

Kindly look into this and do a needful for payment of this shorter amount on an urgent basis.

Thank you
Kumarpal R Shah

Dear Sir,

I am Chandan Thadani employee of reputed Bank.
I was hospitalised due to Covid 19 in the month of July.
As you would be aware due to Covid, beds are not available in majority of the hospitals, so luckily, I got admitted to Inlaks and Budhrani Hospital which was not in the list of cashless facilities by Medi assist.
I have submitted all the required bills and documents required to process the claim.
I have claimed amount of 46643/- but the claim is approved for amount of 20450/-.
If the same would have been cashless, I wouldn't have paid a penny because hospitals would have managed everything.
In Reimbursement process,
1. Pathology charges are not approved
2. Procedure charges are approved half
3. Medicines/Drugs are approved half
4. Ambulance charges are approved less then half.

I am doing follow ups for the reason why my claim is approved less with Medi assist team .I have received an explanation stating as per government norms and Covid policy, they have approved claim.

I have paid my hard earned money to the hospital and submitted all the bills required, so how can a reputed hospital can charge anything which cannot be paid by insurance companies.
If the same would have been cashless, insurance company would have paid whatever amount and bill submitted by hospitals and I wouldn't have paid a penny.

I request you to please look into the case and do the needful.

Thanks & Regards,
Chandan Thadani

I made a claim with medi assist insurance company and I submitted all the relevant documents but the hospital did not provide me with indoor case papers and treatment chart attested copy when I left devishiv hospital lucknow so when I went back to the hospital they said they are not allowed to give indoor case paper and treatment chart attested copy however they agreed to give it to the insurance company if they are contacted with when I conveyed the same to company they refused to contact and are asking same documents again and again despite clarifying situation several times

I am empolyee of axis bank ltd and my emplyee code is 197729. Name is parshotam kukreja.. Had submitted my claim in end of july..2020
There was a goofup in almost all the time.. My claim amount was 4lacs plus. But they have given only 198000/- and the claim amount they mentioned 294000/- instead of 4 lacs.
I wrote many times.. But no one is giving proper response.
I have decided to lodge complaint at irda.
Pls expedite
Regards purshotam kukreja
Axis bank employee
#[protected]

Hi OneAssist Team,

I Received SMS from ICIC Bank that RS-1399/- deducted from my credit card to ONE ASSIST PLAN. without my permission..

Please deactivate and refund my money ASAP.

Date of incident : 2 Sep 2020

Dear sir,
I have admitted my late husband bijay kr satnalika in mission hospital (Icu), durgapur on 4th august 2020 and he was declared dead and discharged on 7th august 2020. We have submitted a reimbursement claim of rs 195000/- along with all required supporting, against which an amount of rs 78132/- has been passed as final payment.

Please note as per the terms and conditions of the policy (Policy no 313400/48/2020/1186) we were supposed to get reimbursement of 2% towards bed charges on insurance amount and entire investigation and lab charges on actuals. Whereas, bed charges are passed at 1% (Rs 15000/- against a claim of rs 60000/-) plus investigation and lab charges rs 13413/- against a claim of rs 53650/-.

Request to look into the matter to enable me to get correct reimbursement for your esteemed organisation.

Thanks and regards,

Mina satnalika

Finally after one month of continuous reminder and complain my claim has been registered having no 22655313.
I have submitted claim for amount of rs 199854 but on portal they processing for only rs 158972.
I can not understand when i submitted all the documents why they do not mentioned in portal.
I have sent reminder to them but they have not get back to me by email or by call for clarification.
I hope with this complaint they will consider my concern otherwise i have to approch irda.

Thanks

Hi Team,

I have been behind MediassistTeam to check on my claim status. I have sent all the relevant documents through courier but my bad i missed to mention my claim details post which i have sent a mail on the same as well.

Now when i call to check the status they place my call on hold and its getting disconnected. Im trying to reach their Team since March'2020.

Also, for the mails which i send they close it as resolved without any solution.

Kindly help me in getting my claim.

Regards,
Viayalakshmi

I'm vandana kushwaha. My claim no. 22336921, ma id - [protected]. it has been a month since i approved my claim. But payment has not yet been made.
When i talk to customer care, those people speak for 7 to 10 working days.
I talk to customer care many times but they are told the same word 7 to 10 working days. These people are not paying my claim.
Please register my complaint and process.

Thanks & regards
Vandana kushwaha

Experience shared as a stakeholder

Respected sir/madam,
Recently i come into interaction with medi assist insurance tpa pvt ltd. For my cashless hospitalization process.
I want to bring my poor experience in the notice of the directors, medi assist, driven by my strong belief that it may improve the tpa service in future.
1. Poor access to medi assist person through communication channels available...

Hi team,

I would need your help in getting my medical insurance bill reimbursed.
I had raised a claim 21811118 during the month of march for reimbursement.
There were a few pending documents to be sent through courier, and since lockdown started at that time, i was told to send once things resume.

Once i sent the remaining documents through courier, a new claim was opened for this 22331861.
There was some partial bill settled in this, with only considering the documents reached to them in courier in june, post unlock period.

Rest of the documents were sent and acknowledged for receival initially as part of claim 21811118. These have not been considered at all for reimbursement.

When i try reaching out to the support team, they say they are awaiting for investigation reports, which they have received in 22331861.
Now, the remaining hospitalization charges are yet to be approved and reimbursed, which is not being done.

All that they needed to do was combine the documents of these 2 claims and analyze once and settle the amount.
Since i received the reimbursement for second claim with only investigation bills taken into consideration, now they have to settle the remaining amount from 1st claim for hospitalization charges (Excluding investigation)

I have already submitted all my originals, and the support team asks me to submit originals again.

Please help on this and help me get this closed asap.

Dear sir/mam,
This is to inform you that i did many insurance investigations of religare through
Merlot health services pvt. Ltd. (More details of company please find the attachment)
But i had not received payment of any cases till now last from march 2020., request you to kindly look into the matter and release my payment on behalf or merlot health services pvt. Ltd.
Looking forward for you cooperation.

Thanks & regards,
Harendra kumar
[protected]

Email : [protected]@gmail.com

Hope you all are staying safe. my wifesmt. P. R. Shobha admitted to hospital for the problems stated in the dischargesummary as per above claim reference no. we havesubmitted all the documents, scanning reports and other reports along withclaim form. We have claimed a sum of rs.33, 992.00, a request has been received fromyour end regarding “admission notes” of the hospital, we have gone to the hospitaland requested to provide the same, but the hospital management refused to giveit to me personally by hand instead they asked the mail id of yours to send theadmission notes directly to you. as perthe request of the hospital, i had requested the same to our agent mr. Beharilaln. Chhabria (Agent code: agni1007374), inspite of repeated requests and demands you delayed to furnish the e-mail address. after receiving the e-mail address, we requested the hospital authoritiesto send the admission notes, accordingly they sent the same on 8-7-2020. before receiving admission notes you finalizethe claim and reducing the claim to rs.21, 919.00. All the prices of lab tests, consultation, scanning done at the hospital are very very less compared to the outside wherethey charge more. in view of emergency at the time ofadmission and non-availability of lesser rate beds in the hospital we havetaken the available bed. in the abovesaid circumstances reducing the cost by 33% in the room rent is fine and but itis unfair to pull-of 33% on all other tests, consultation, scanning (I. E. Proretabasis to room rent as claimed by you). this is illegal and unfair in pulling33% on all the claims. we herebyacknowledge for receiving the amount of rs.21, 919.00 out of our claim amount ofrs.33, 992.00. We have received the same with out prejudiced to our rights inrespect of total claim. where fore, we request you and your team to grant me full refund by deducting excess roomrent. thanking you. yourssincerely p. Reddynagendra kumar advocate

Hi team,

From more than 1 month am following up with mediassist support tram for my ticket no : [protected], which was clearly a mistake from mediassist for payment to an invalid account number.
Even though i have provided correct account number mediassist done payment to some invalid account number and transaction got failed.

Support team is least bothered and not getting any response even though i have done followups through call and emails.

Insurer: national insurance company
Tpa: medi assist india
Claim number: 222174
Date of intimation: 2nd june 2020
Date of hospitalization: 3rd june 2020
Date of discharge: 4th june 2020

My claim amount was 1, 09, 659 out of which only 70, 340 are approved.
Rejected charges include:
Surgean charge: 20, 601
Additional surgean charge: 9, 740

I don't understand why surgeon charges are rejected. I have provided all the original documentations on timely manner. I believe surgeon is the main thing that without which surgery is not possible, and the tpa has rejected surgeon charges only.

Sir/mm,
My subject medi
Insurnce policy no : 272900/48/2019/14493 was discontinued from 29/10/2019 because o[censored]tter despair with tpa's working on number of occasions, the last being on 10/10/2019 when i was rushed 1st to dsnss, delhi & then to max ppganj with nostrils and mouth bleeding profusely. The tpa rejected cashless admission & my son had to rush to atm at 12 pm to arrange money despite me paying a hefty premium because of reasons not told to me, it may be my crossing some age landmark inlife.
A week after discharge i submitted my mediclaim form together with xerox of d. S, pxs, bills around 20/10/2019. The claim was for rs 33989/ only.
When tpa did not get back to me till march, 2020, i wrote to mr deepak mittal d. M at oicl, who sent an em to mr suresh gupta of legal, & vig wing of the tpa who accepted that my cashless request was rejected but insured - me did not file any claim and he may raise it now. This being corona period he advised me to send all original papers at his office where staff will receive it. I made a file & couriered it on 20/5/2020. On 8/7/2020 when i enquired the status he replied through email that my claim papers file is not traceable. When i mailed him copy of the courier docket, he replied that since march 2020 he is working from home only, he may have missed it. So that is how things are at this office. Kindly treat it as my complaint against this office and clear my bills of treatment on the basis of photo copies which are with mr suresh gupta. I want my payment of medi expenses of rs 33989/with no further delay. I am enclosing image of courier slip as proof of me having couriered documents.
P. S : most appaling factor is mr gupta is not reachable on phone.
. Bir bahadar malhotra.

I have lodged a complaint regarding non issue of my wifes e-card. I am currently working in bank of baroda and was assigned ticket no.[protected] on 03.07.2020 and was told by the company that they will issue the new card and told me to submit the hrms copy of bob for doing the needful on 04.07.2020 and again on 09.07.2020. But despite submiting the documents, they did not issued me the e-card. Rather they are asking me to contact my hr team....