Medi Assist India Complaints & Reviews

This is with reference to the cashless claim[protected] & policy no.[protected] submitted with the details: for surgery of
Provisional diagnosis unilateral inguinal hernia, with obstruction. Hospital requested rs.63000 for total expenses but you have approved on rs.29750. Hence hospital has refuse the surgery. Please let me know why you are keeping such type hospital in your ppn list who is unable to do the services in agreed tariff. What is the mistake of patient. If anythings happened to my patient you are only responsible.

This is with reference to the cashless claim[protected] & policy no.[protected] submitted with the details: for surgery of
Provisional diagnosis unilateral inguinal hernia, with obstruction. Hospital requested rs.63000 for total expenses but you have approved on rs.29750. Hence hospital has refuse the surgery. Please let me know why you are keeping such type hospital in your ppn list who is unable to do the services in agreed tariff. What is the mistake of patient.

I am employee at mnc company and document submitted for my wife name which has mninimum 30 day period to do addition. But medi assist team had not process the document and now it is almost 3 month i am just runing behind to add the name so i can avail cashless benefit for my wife, whome cancer treatment is on progress. Serveral email & call are made but no action or effort to do the work is seen

Yesterday i feel a upset mind of their deals. We can't raise any question about the price and such as. They argued with us that they doing sacrification for the people, that is low prices of medicine.

Dear concern,

Sub:arrogant behaviour if janauahadhi njarakal ernakulam 682505

My name is joseph desouza approached to buy a reapeat medicine which i found a hike of 12 rs from previous bill, as a concern asked the reason for the hike which i rcvd a very harsh response from the lady staff who was tgere in[protected]. She was shouting at me in front of other customers saying dont give the mediceine to me.. Give once the real government medicine available... Request you to ensure the staff behaves properly to the poor patients when and then they approcah your concern..

Regards
Joy dsouza

Hi Sir/Mam,

I am Kaushik Chakraborty son of Late Biplab Chakraborty. (Retired Bank of Boroda Employee, BOB EMP ID#34372)
Clam No. # 20869914, Medi Assist ID#[protected]

I had submitted a hospital admission claim with all the required document on 5th Nov 2019 and after that query was raised by the team. I had submitted the missing documents again and received the Claim Document Receipt acknowledge email on 4th of Dec 2019 with the Tracking # KOL00180899, after that I have received no more update and neither the amount was credited.

I have called the insurance customer care Toll Free no# [protected] and they informed me that the claim is still pending and under investigation since 4th Dec 2019.

My father passed away on Oct 2019 and after doing all the formality for submitting the insurance claim and paying the insurance premiums on time still there is a long delay and no proper update from the insurance team.

Initially, it was told to us from the insurance team that within 15 days of submitting the details we will get the amount, now it is almost 3 months but still we have not received the amount.

Requesting you to please do the needful.

Thanks,
Kaushik Chakraborty
Son of Biplab Chakraborty
Contact No. - [protected]

My claim number after going through all the stupidity that i faced talking to all the agents someone finally maybe a supervisor i am not sure called up and explained me that the documents needed are the once which has detail break for receipt no 1076 and receipt no 3007 which i have dropped in claim drop box at wipro location on 6th january 2020 and the reference number/ tracking number for the same is blr00863800. The claim was under adjudication and now returned with an sms asking for missing documents which when checked on the application is kindly enclose the details for bills 1076 and 3007.

These guys are fraud. They will ask you to submit all the original documents and then once you submit the documents they will again ask you to submit the original documents which of course you wont have as you have already submitted them.

Get this resolved asap and pay for the claim.

I have submitted original docs as maternity claim, one for myelf and another for ma baby to employess of mediassist.in nov end i came to know that person is removed by mediassist as he was not answering any mode of communication. So i have taken this matter with tripti salian and assured me that she will take care and not to worry.in jan she is replying your claim will b process but baby file we are not getting, i asked how it is possible! She said she will find out and let me know the status of it. Still then m waiting for her reply as well as my claim is also not received. Now i don't have their any no. Online no. I am trying it is not working. I told them clearly that m on maternity leave and came to dubai so for me contacting is expensive as well as difficult. Still they don't bothered at all. I will never recommend to go for this mediassist to anyone after this experience and if i came to know that anyone is going, i will try my best for not to opt insurance from mediassist. It is simply harrasment!

I have raised claim, submitted 13 original papers. They put claim on hold without proper requirement. No transparency, no one is ready to talk with me to discuss the claim no response over mail. Worst company, no one is ready to take care of my claim ticket number [protected]. Please put some regulations. I was ignored in the tech support call. After 1 hour wait period the call simple closed without answer.

Please note that i have put a claim fro my son and the claim no is 21210238
. My claim is rejected in query which was not asked to me but my wife. Where as she don't know anything about this claim and query. Also the query person arrived without prior knowledge and information at home and started directly query in my absence as the claim is related to me not my wife. This claim rejected and the reason is not given to me through mail my any source. When i enquire then i came to know that my claim was rejected in query which was not even in my knowledge. Latter i came to know that they came at my home and asked several question to my wife regarding the admission and rejected the claim. Please let me know the valid legal reason for rejection of claim and why query was not done in front of me.

Hi team,
My medi assist claim no:99780950
Insurance company: united india insurance

Up on requested for the following set of original documents:
1. Self declaration letter
2. Intoxication letter
3. Pre & post surgery x-ray films
4. Implant sticker details.

I have sent all those documents via my employer (Wipro) drop box on 17 dec 2019 with tracking id: blr00844021. Got the acknowledgment for the same from the medi assist india tpa. After the receipt of the documents the tpa has denied my claim stating the insured haven’t provided the above documents. Up on contacted there is no proper response and same set of documents is asked again and again. As i have submitted the originals already how i supposed resubmit them. Kindly resolve the dispute at the earliest.

Sub : claim no. 20298857
Policy no.[protected]
Insurer claim no. Tp[protected]
Insurer member id po 27915647

My husband mr. Shekhar deshmukh was admitted in nanavati hospital for fever, cough, cold, chest and left lower back pain on 4th august 2019. The doctor diagnosed the fever as h1n1 and lower respiratory tract infection. After hospitalization the fever had gone but respiratory problem was still there. Dr. Also suggested angiography which we have done after clearing the cough /cold infection.

We have submitted required documents regarding insurance claim of mr. Shekhar s. Deshmukh in stipulated time i. E. On 19th august 2019. We have also submitted internal case papers on 26th august 2019 as demanded by the company. We have also done angiography as suggested by our doctor but not submitted the angiography documents and claim papers, as doctor has given discharge on the same day i. E. On 27th august only.

The claim has been denied by giving remark ‘no need of hospitalization’ on 25th october 2019 with no valid reason. After that, we have submitted the supporting documents explaining the need of hospitalization on 13th november 2019.in december 2019 my agent mrs. Janhavi sathe visited the office to remind them regarding claim. But no response from the insurance company received by us.

It is really surprise, the way your organization giving service to genuine insurer. It look like we have wasted our money by paying premium regularly. Though, our claim amount is much less than premium paid.

Now, request you to look in to matter & advise on settling the claim on top priority as it has alomost more than 4 (Four) months have passed after submitting justification letter from our doctor.

We hereby also request you to our angiography reimbursement with the said claim.

Thanks and regards,
Madhuri
(Wife of mr. Deshmukh)

My medical reimbursement for two claims has been pending for settlement since the past 45 days.
Claim nos. 20950611 and 21078289
Original papers, documents and reports are being submitted. Till today it has not been settled and as a result i am unable to proceed for further treatment. Is the insurance team waiting for the patient to die??
This is the worst insurance company i ve come across. If it had not been the tied up insurance for my organisation, i would never had insured in this company.

Not recommended for any individual.

If rating can be done in public, would have rated -0/10.

I’m really frustrated to keep on calling Medi Assist for each and every time I’m getting the same response “We will escalate to concern team and will get back to 2-3 days”. Who’s that concern team? Is not MediAssit or any other vendor.

Today, again I called (3rd time) and explained the complete story and waiting for some good response. But again the same template “We will escalate to concern team and will get back to 2-3 days”.

I asked if I didn’t get any response, what’s my next step. She said please send an email to Medi Assist and definitely I’m sure I will not get any response except the same template “Thanks for writing….” There is no point of contact for escalations.

My very straight forward questions below:-
What’s the turnaround timeline for my request?
When this will get resolved (timeline)?
When should I call back again? And what’s my next step if there is no proper response?
Who’s the escalation POC?

Date of intimation – 5th july 2019. 5th july same day received process documents from kaushal. After analysis of given documents, we decided to do surgery on 13th july and intimated 1 day prior (12th july) before surgery. On 13th july after surgery done we got to know that "reasonable and customary charges and conventional surgery", clause which we did not even aware and introduced this clause suddenly in process. But when they provided documentation when we intimated you very first time, this clause thing was missing completely. Who is responsible for this gap?? They are just illogically replying by giving this clause reference and not replying us on point to point.. Because we have decided to do surgery on basis of process documents provided by kaushal. Note - same clause it not even mentioned in portal -https://portal.medibuddy.in/Home.aspx on 26th july received reply from kaushal said – expect claim processing by 10th aug 2019. Then they extended date to 20th august. Still i was trying to track but no updates are showing on portal. Then again, they extended to next week. 23th august they raised query for 1 document (Prescription letter). 24th august i tried to upload documents online but failed have provided screenshot as well. So as per request but kaushal and brajendra have couriered original documents to the given address. On september 25th i have got to know that they have mentioned that non-pay amount 72179 inr due to reasonable and customary clause applied. And approved only 31734 inr. When i have asked about it, i have been told that why you spent that huge amount? Why you did not visit cashless hospital? What is the use of cashless facility? You should visit listed hospitals, how can they approve some amount based on other hospital cost? We selected best hospital after doing all market review and we can see positive results on my father health which is most important for us. 1. As per kaushal’s first mail, have followed reimbursement process and submitted all original documents for further claim. Out of that i only got single query raised by team about one missing document, and i have sent immediately. Apart from that no other points observed / pending in case of documentation.

My mother admitted in the listed hospital of mediassist insurance provider.
She was admitted for 4 days and i have provided all the required document.
However they are still again and again asking from some more documents which not sure why required.

She is already passed away and we are already too much disturbed.

We do insurance so that they can help us in our tough time not to increase our troubles declining our claim mentioning a list of documents not provided.

I workin tcs hyderabad where i raised a pre-hospitilization reimbursement on 5-oct-2019
With due respect on 5th oct 2019 i have submitted my pre hospitalization claim ref no. H[protected]a001, i already submitted the documents they are saying it is not received for this i also shared the proof where i submitted documents but till now i did not received any money. It is also mentioned that i have contacted with mediassist so many members from oct 2019 to till today but no one is looking for my claim related query. From the time of oct 2019 iam following up daily but no response from their end i didn't understand my fault.

I submitted claim on 11/12/2019 and mediassist asked me that i have to submit 4 missing documents on 12/12/2019 on the same day i got another email asking only one document is enough to submit. Next day 13/12/2019 i got an email asking signatures in scanned document. On 14/12/2019 they asked me one document. My conversation is going on for 2 weeks and i'm frustrated with the support given by mediassist

My claim i'd:99539921 raised on 5 nov 2019. They repudiated this claim showing the reason that i didn't upload pancard. But they didn't inform or request for pancard in prior. It is not even present in their guidelines.

I have sent them my pancard scanned copy on 29 nov 2019. From then i am continuously requesting to re open the claim but they failed to process it.

Attaching the screenshot of my claim status in mediassist portal

Please take necessary action

Date: 25/12/2019

Issue: 100% cashless was rejected by insurance company even after providing required documents.

I had called the medi assist support team more than 20 times on 25/12/2019 between 7.00 pm to 11.00 pm but my issue was not resolved.

First i had intimated the medi assist insurance team 72 hours before admitting my mother to hospital. Later due to severe pain in back i had to admit her before 72 hours of intimation. Because of the severe pain and unable to walk i had admitted my mother on emergency condition. But i had called insurance team just before admitting her to hospital and raised the emergency intimation (Emergency intimation number being "345642").
The doctor also in discharge summary had mentioned it was an emergency admission but the insurance team is not accepting the fact and has deducted 10% which is not acceptable and later i had to pay from my pocket.
And i had to discharge her during midnight.

I want my money to be refunded back to my account which i had payed from my pocket. I want 100% cashless claim and not 90% which is the current approval. The insurance company should refund nearly 28000 rupees to my account.

I am consumer of medi assist health policy, last month i blessed with baby girl and for 1 month my baby was in nicu and was in critical situation. When i admitted, the hospital said you need to you go with reimbursement we dont have cashless system. So i intimated medi assist and after billing when i submitted my file medi assist said you need to register your baby in same month when the baby born. No where they mentioned this in their enrollment...