Medi Assist India Complaints & Reviews

We refer to our email dt.16/1/2020 asking for clarification for rejecting our claim. Till date except the standard reply, we have not received any communication from you. You are requested to look into the matter. Please provide us the email-id of your senior official for further communication.
In case of any contact please note our email id as "[protected]@maximussecurities.com" and mobile no.[protected].

Medi assist does not have a proper policy designed. Before the claim, they told they would definitely reimburse it. But after submission of claim, they say it can't be claimed.
I also have a mail where they try to apologise at the end for their fault. How irresponsible are these people to play with others life?

I have attached their mail of apology.
They have not given the compensation for their act.

My wife undergone for laparoscopic adhesiolysis due to chronic pelvic pain. But i have received reply from the team that it is related to fertility and asked clarification letter from the hospital from the treated doctor regarding the treatment details and justification on whether it is for infertility or not. I have provided the justification letter from the doctor saying that it is treated for adhesiolysis due to pelvic pain and not for infertility. But so for they are not approving my claim.
Please help.

I am from tcs i have raised reimbursement claim raised for august 2019 still not cleared. This reimbursement for raised for my first child admission for jaundice. As hospital people said that reimbursement will be the option to claim as cashless is not possible as the admission was for 3 days and the name for the child was added after 48 hrs so hospital denied. Now i paid the money from my credit card and still my reimbursement is not processed for reason that document is not reached which is not true i have also checked with dispatch team they said doc. Is sent. If they miss the doc. Will i be responsible and where to go for orginal doc. Which they are asking again.

My claim id is 99179527 and 99157622 please do the needful

Hi team,

Medi assist team has denied my claim due to to some in valid reason. I have submitted the medical details all bills, discharge summary. After that they asked for doctors written letter, since they only have common letter pad, they can only issue medical certificate with doctor's sign and seal but will cost you around 430/-, and i paid for that and submitted that also. After getting all these document they denied the claim. I have also shown them the policy details which was published in news (https://www.business-standard.com/article/finance/revised-mediclaim-policy-to-a...⇄
Claim no.:[protected]

The reason provided is (Now this policy witnesses that subject to the terms, conditions, exclusions and definitions contained herein or endorsed or otherwise expressed hereon, the company undertakes that, if during the period stated in the schedule or during the continuance of this policy by renewal, any insured person shall contract any illness (Herein defined) or sustain any injury (Herein defined) and if such illness orinjury shall require any such insured person, upon the advice of a duly qualified medical practitioner / surgeon to incur medical expenses/surgery at hospital / day care centre (Herein defined) in india as an inpatient, the tpa will pay to the hospital /day care centre, or reimburse the insured person the expenses listed in 2.1 to 2.6 below that are reasonable and customary, and medically necessary incurred for the treatment of such illness or injury., on persual of this ccn documents enclosed, this ccn pertains to xxxxx where the asked required additional documents for further processing was not been enclosed even after the query been raised - that is clarification towards the need for suction and evacuation for the present pregnancy not the confirmation for the procedure that it was done or not. Hence this claim stands denied. We regret our inability to admit this liability under the present policy conditions.)

Dear team as per disposition reference no 9254857 and ticket no [protected] already raised 2 months before as i enrolled my spouse name with mediassist policy with axis bank on 20th of oct 2019 and my newly born daughter on 17th jan 2020. But still not updated in records till date as i am in follow-up with your team from last 2 months and claims are received and pending with mediassist from 1 and half months. As on 10 the feb i am releived from axis bank with emp i'd 181826. I am still waiting for response from your team but no resolution provided till now. Kindly do the needful.
Regards
Vikas abrol
[protected]

One of the worst insurance company is medi assist. Guys please don't take any insurance in medi assist. Last minute they will ask some important document to process your claim. Always go with cashless otherwise you can't claim any amount these cheap guys. I was so tired and disturbed because of these guys. They rejected my claim and now they are not returning my original document.

Hello team,
I am working for tcs and they have mediassist as the partner for medical insurance. Mediassist has tagged up with the new india assurance co. Ltd. To provide the medical insurance. I had submitted the maternity claim in mediassist portal with reference number 97827048, i have submitted the hardcopy of documents but helpdesk has misplaced it. Soft copy of the documents was also attached in the portal but they are again asking for the hardcopy which cannot be submitted. Internally i have escalated to mediassist but no action is taken. Need assistance to get this issue resolved.

Please provide information regarding the above treatment and surgery. Whether this treatment covers under my policy no.[protected] and emp code-abpsg-20 emp name : giridhar. G. Potdar.
Since last 5 years my wife has been taking treatment of bone loss in gums. Due to that she is not able eat well and munch. As per doctor's advise she needs to go for surgery. I. E mouth surgery. Hence i request you to provide the information with regards to the treatment or surgery under the above mentioned policy.

Hi team,

Claim nos: 99235002, 99235147, 99235845
Insurance provider: united india insurance corp.

I was admitted for 24hrs and diagonsed for calculus of kidney and ureter. Doctor advised me to take surgery but for 2nd opinion i have consulted another hospital where they confirmed that surgery is not required.

I have submitted all the necessary documents/bills for the admission through wipro drop box. Upon receiving the acknowledgement, i have been asked to provide hospital statement for admission and discharge for supporting my 24hrs admission, i further submitted the hospital admission and discharged timings for claim no: 99235002 under the policy no: [protected]p[protected]_bps/wtsarjapur2-sez.

Now they have denied all the claims stating that the documents which submitted were not more than 24hrs of admissions. Additional pre and post admission claims (No: 99235147,[protected] were also repudiated. Request you to please resolve the issue at earliest.

Since morning we are following up for the claim confirmation.
Over a dozen calls has been made.
Now my latest call has been put on hold
Shamelessly by imran.
No one is bothered to reply or confirm the status.
Patient gopal s pujari.
I want a reply call back
Raghu
[protected]
Patient details
Name gopal s pujari
Policy holder bank of baroda
Employee code 6939
Tpa mediassist
Member id [protected]

Hi,

I have a corporate health insurance provided by johnson controls.

My employee code is : 3134216

My father anil kumar sinha was hospitalized at big hospital, patna on dec 9, 2019.

I later applied for the reimbursement claim availing my corporate insurance.

I couriered all the original documents as bills, reports and everything to the medi assist india office at...

Hi Team,

I was trying to send you my on going claim since last year via email but your email ID is not valid. So i attached pictures which shows that I have provided all the requested documents. My claim haven't been resolved yet and also your people are not responding to my emails.

What is the purpose of running business like this when you can't resolve a single case which is pending since so long. After submitted all the evidence on time, this is not acceptable to drag this case so long and also after proving that i did submit the requested evidence, your people keep on asking the same question and now they didn't even try to reply my emails.

I am really disappointed with your service and I am looking forward to your response and also get my case resolved ASAP.

Hope to hear from you soon.

Also, if you need further information please let me know. My email ID - [protected]@gmail.com

Regards,
Megha.

Sub : short claim amount sanctioned

Sir,

Mediassist id : [protected]
Policy no : [protected]p[protected] o[censored]nited india insurance
Reimbursement claim ref no : 21061898

Kindly refer your letter dated 15/01/2020 regarding my above mentioned claim in which you have sanctioned rs 89973/- only against claimed amount of rs 207023/- towards medical expenses incurred by me for treatment of haemorrhoids at saifee hospital - mumbai.

My observations towards the non - sanctioned amounts is as below :

- rs 20370/- which was charged by saifee hospital for the stapler gun (One time usable) for implanting the staplers. Whereas you are still treating it in miscellaneous income inspite of me submitting the freshly amended original invoice of saifee hospital on 09/01/2020 (As demanded by you).
This invoice clearly mention that this amount was charged for one time usable stapler gun. Hence, i see no reason for not sanctioning of this amount as this was the primary process in the said surgery.

- rs 23000/- was paid by me for pet ct scan at jhankaria imaging. I may mention here that as there is an existence of a big cyst in my pelvic region.in order to clear any doubts regarding any possible infection or cancer, doctor had advised to get this done before surgery so that he is assured to avoid any complication such as spreading of infection or cancer during or after the process of surgery. This should be reimbursed as it was an inseparable part of the process as it might have proved fatal. We may bring in your notice that after this test done and on the basis of its report, dr anup ramani (Senior onco uro surgeon) had given green signal and go ahead for the surgery (Remarks on his prescription can be referred which was provided at the time of filing the claim with other documents). Hence i request to reimburse as the testing was inevitable.

- i may mention here that i have taken lowest category room in single occupancy available in the hospital as per the tariff chart attached earlier. Rs 60366/- was less paid for policy excess / deductible is not not justified and puts burden on me inspite of paying regular premium for so many years.

- i observe that you have not sanctioned many petty charges by the hospital towards bandage, gauge, ecg, dressings, gluco test etc. I may mention here that these are a part of the hospital stay and the surgery. I feel these should be sanctioned.

Sir, i request your goodself to give a sympathetic approach to my above concerns and help me out by reimbursing the said balance non sanctioned amount. Hope you will use your good offices and help me on this matter.

Kindly help


With warm regards,

Anoop kumar gupta
Mobile : [protected]
Email : [protected]@hotmail.com

Bloody #...100 times they keep on asking same documents... And no matter how many times you call they read out the same ready made statements everytime... White collared robbers.

Do you think hospital is there to give you customised document as per your needs.

All uneducated people are hired as support executive who even donot know how to handle the customers call.

My claim was incorrectly processed as the consultation charges of rs3200 are not approved on the grounds that i have not submitted the prescription however strangely medicines bill have been approved for those prescriptions only, all the information is already there then i don't see a valid reason to not process my claim
For this i have contacted your delhi brance twice. On my first visit, the executive sitting on the entry gave his number and asked me to call next day and assured me that this will be done as it is valid claim on my part but when i called and i called for over a week and all calls went unanswered
So i decided to visit again and asked for senior representation, a lady came from inside claiming to be a senior gave me her mail id mona. [protected]@mediassist.in and asked me to drop an email to him next day and she will get it processed as this has been incorrectly processed by them
Now when its been almost 10 days and 3 reminders on emails they are still unanswered.

I don't understand why a customer should suffer for your mistakes and visit again and again. This is clear case of misconduct and on a very serious note this is something which is testing my patience now

I am expecting a early closure to this
Mediassist id:[protected]
Ccn# 21021249
Docs available under attachment: del00435406_bill

I am Thejashree, an employee of HPE company. I have submitted the parental policy accidentally and I wanted the policy to be cancelled since my parents already have lifetime health insurance and tried cancelling wherein it never included that option at all.

Firstly when we have the option to add so we should also have it to cancel as well.Secondly in the parental policy document it is nowhere mentioned that the policy cannot...

I have been following up with mediassist from 6 months regarding the claim reimbursement of health insurance of my parents and the response is becoming worse day by day. They don't even care and every time they say that it will take 7 to 10 working days and its been 6 months. They are not even trying to resolve the issue despite multiple attempts by me. There is no reason being given and they say that the back-end team will resolve the issue from past 6 months. I have raised the claim from 31st august, 2019. I has become tiresome to call every day and get same response and no lead towards my issue.

I submitted a cataract eye surgery claim for rs 34, 895 on 06/09/2019. After 4 month battle with them, they denied my claim on 25/01/2020. I have not been notified formally with the reason yet.

During claim review, i was kept on getting different questions as soon as addressing previous queries. When i asked for more information from customer care, each one telling different reasons. I don't have a direct way to contact claims department. I'm not sure why they are looking for original documents. Even after submitting originals, they are saying they did not receive them and asking to resend the same. How can i send original document, when i sent the one already? These fellows not even agreeing duplicate copies.

After spending days & hours of talking to cust. Care and writing pages of emails, i earned only frustration. Pls, pls, pls do not go for this service provider.

I have experience in submitting claims with us and canada med. Ins. Service providers. I never seen such a worst service there, where no need to submit originals as well. I'm very much worried about other customers' situation who submit expensive claims.

- every time we call customer care, we are getting different answers.
- we don't have any means (Email/phone/text) to convey our response to claims department directly.
- customer care has no rights on our claims
- customer care says, "we will take care of your concerns and queries". But no fortune happens at the end.
- poor website and navigation system, not user friendly. They have option to enter comment on our claim, but we cannot. This is really frustrating.
- we have to pay premium for this useless service.
- not worth a penny.

Our hospital claim bill no 2724 dt 14.12.2016 - rs. 186898/-
Pt name :ivakumar doa 08.12.2016 dod 14.12.2016 —
Approved under 2 claim nos - base policy and top up policy
Claim no[protected] appd rs. 67500/- under base poliocy
Cliam no[protected] appd rs. 88920/- under top up policy

While rs 88920/- settled way back on 10.04.2017 the amt of rs 67500/- pending for more than 3 years???

Taking legal action if settlement not recd by 10th feb 2020//ok