Medi Assist India Complaints & Reviews

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...

Dear sir,
Greetings!
maid: [protected]patient
Name: pashabhai shankerbhai patel
Policy no: 302200/50/17/10002766transaction id: kkbk[protected]
We have received mail from your side on 25.09.2018 saying that the amount has been settled for rs. 54376.00 to our central bank a. C. No. =8336 which till date is not reflecting in our account please do check and transfer the same at your earliest.

Thanks & regardssatyamev hospital (P) ltd.

Myself bhargava adiga, claim no. 21030770.
Above said claim was raised for amount of rs. 5420/- but they approved only amount of rs. 3420/- and for rs. 2000/- they mentioned the reason as "excess of reasonable and customary charges".

I was asking that when hospital charged us without any discounts and reasonable charges and also when we are in emergency treatment we can't go for other hospital for reasonable charges. Why this third party company don't understand that and also after asking for remaining amount they rejected the same by mentioning same reason.

Hope this will help.

Hi myself bhargava adiga, claim no. 20688504 and 20898478 i have raised one domiciliary claim for the month of october 2019 and the same claim was cancelled from medi assist team and they raised fresh post hospitalisation claim for the same on 8th november 2019, but still the claim showing as processed ready for payment from last 1 month i. E 14th november 2019. When i asked medi assist team they said that i have to wait some more days for payment. Why should i have to wait that too after they taking long period to process the said claim.

Hope this will help us to get payment as early as possible.

Hello sir

Policy no[protected]

Mediassist fraud and false comment expert company always expert in making less claim settlement.
Their rules and regulations change according to the patient situation.

Fraud fraud fraud fake assumption expert.

I already post complaint against you several times if settlement not done by you i will be plan for legal.

Pls refund my money rs 27000 or settlement on further case early as possible.

Reply must

Call me on this no [protected]

Dear sir,

I dhanendra mallu, employee of bank of india, guntur branch.
My claim no 20589898 which was processed and approved on 17 th october 2019. Since then, i am waiting for the amount, but unfortunately no amount has been credited to account.

I have contacted so many times through toll free number. But no response.

Kindly do the needful at the earliest.

Dear sir/madam

I thippeswamy g, maintainer emp id-21137, working since from[protected] in bmrcl. I and my wife blessed with a girl baby on[protected]. Due to respiratory system baby expired on[protected].
I had applied for reimbursement of bills on my baby, tracking id - blr00595624.
Pls do the needful

Regards

Thippeswamy g
Attachments area

Hello sir

Policy no[protected]

Claim no tp[protected]

Member i'd. 1h2899678

My self abhijeet shivdas pawar. Im from pune.
My complaint regarding wrong claim settlement.
Your team provide only 35% approval which was very very bad.
You makes lot of fake assumption during making bill at the time of discharge i had to pay rs 27000.
Because...

We have cleared all the documents as per policy but claim has not been approved by company and giving back unnecessary remarks which already resolved multiple times earlier. This company is not taking any responsibility against my issue and rounding me every time. I have decided sue against my policy conditions. Kindly guide me to resolve it. Or provide any similar options for same. Do the needful. This is the second reminder to u too.

Name : deepak kumar sain
Contect [protected]
City : indore

I have provided necessary information at the time of your initial review, later for your letter dated 27/11/2019 i have submitted the attending doctor certificate regarding commencement of symptoms and past treatment scan copies on 29th nov 2019 itself. So far i have replied and submitted additional documents for all the five document required letters from m/s. Medi assist.

I was admitted at vasudeva vilasam nursing home towards the treatment of varicose veins and gastritis only as the final diagnosis, all previous treatment papers were already submitted.

Since the claim is long pending and i have submitted documents based on all your document required letters (More than 5 letters), pl process and settle the claim at the earliest.
Regards,
T. Rajendran

Respected sir
Please look into the matter above claim. Sir in my serious condition as per doctor srinivas narayan prescribed he told me urgent qurired for operation, so there fore i am admitted in fortis hospitals limited, kolkata. The bill amount rs: 108745.00 but unfortunately you have sanctioned only rs: 62548.00. Sir my request on your good faith that why i suffered! My policy no: 313102/48/2020/38, medi assist id: [protected].
Therefore i am requesting you to look into the matter. I am waiting quick response from your end as early as possible.

National insurance company, my claim was for rs 3119 for medical treatment of rina kar (Policy no. 103000/50/18/[protected] wife of subal kar. But settled amount from your part was only rs 119. I do not accept this settlement and wish to withdraw my claim and desire to pay back you rs 119/-. I wish to avail my due medical test reimbursement (1% of the insured amount) when this will be done in near future. Please let me know how to give you back rs 119/- : by adjusting with medical test reimbursement to be submitted in coming days or to be paid to you by cheque?

Urgent reply is requested

I have submit claim no.21173343 at 1.30 pm after 2 hrs message received that please send additional document. Hospital send additional document.
I am continuously calling to company but there is no proper answer give there executives and hold call for 20 min every time.
If i have not received claim within 30 min.
I will complaint against company in court.
Ec. No.117913
Ambadas ajinath nagargoje
Bank of baroda.

I have registered claim on 22 november 2019 through cognizant medibuddy app. Claim number is still not generated inspite of follow up on call everyday. It has been 25 days i haven't received any response till today. I have never been connected to any senior official for resolving the issue. Everytime they say senior is not available. This is worst experience with mediassist.

Tracking id : h[protected]....