Medi Assist India Complaints & Reviews

24.08.2019

Medi Assist India TPA Pvt Ltd
Tower D, 4TH Floor, IBC Knowledge Park,
4/1 Bannerghatta Main Road,
Bangalore – 560 029

Sir,
Sub: Policy No: [protected]P[protected] / IP [protected]

Please refer to my letter Dt 12th Aug, 2019 and arrange to reimburse Rs 61, 213/- without further loss of time. Please note that, the delay in reimbursing my claim is amounting to breach of contractual obligation and against the terms of the policy.

I am also enclosing bill for Rs 6020/ being the charges paid to Manipal Hospital on 22.8.2019 for the removal of DJ stent under general anaesthesia.

Encl:
1. Bill Dt 22.8.2019 – Rs 6020/-

CC: Marking copy to Consumer Complaint & Redressal

Dear sir/madam,

This is pravin bagul. Ma id no.- [protected].
I was admitted in hospital from 30/04/2019 to 06/04/2019. My claim id is 98568896.
Claim is approved on 24 june but till date reject no any information and new claim number 98800766 by your end what is reason for rejection pls upadate
I need information about my claim status.

Pravin
[protected]

I have submitted reimbursement claim to Medi Assist India who is TPA for New India Assurance. They have asked all documents including hospital case papers. I have submitted. They have again asked hospital bed capacity and registration number. Hospital has given declaration form stating their registration, bed capacity and doctor credentials. But they are not accepting the letter. They are not even providing guidance or any template document. They are reluctant to share any information. It is very clear they are treating the case with very bad intention. They are not providing any support for same. I don't know why they are accepting hospital declaration form. My claim number is 20128723. whenever I call their helpdesk, each time they are giving different answer.
The hospital is renowned and their facilities are stated in their website. They are not even speaking with hospital staff.
Policy is policy#[protected].

My father admitted in hospital for eye operation on 16-july-2019, want to use the cashless claim[protected] and hospital also process cashless claim as well. But very huge delay in processing the cashless claim so my father discharge getting delayed two days. Finally we don't want to utilize the cashless claim so we have paid the full amount in own cash and discharged on 19-july-2019 as well.
Cashless claim[protected] is cancelled...

I have submitted the claim for reimbursement of baby of shruthi on 05-may-2019, the payment has not approved till date, its been 4 months from claim submission for reimbursement.

I have done followed many times and no proper response from support team.

I have given all the necessary documents personally to mediassist bangalore office.

Please provide the claim status.

I have raised a complaint with customer care for my wife's name not showing in mediassist portal. I have been following up with them since 8 days. Due to this technical issue, i could not submit the claim within 30 days time frame. My complain id is 8175142.
They are not even telling me how to submit claim offline (As online process is having some technical issue).

This is in reference to -
Employee id - 129981
Employee name - satyabrata chaudhury
Medi assist id - [protected]
Policy holder - bank of india
Insurer claim no. - [protected]c[protected]
Insurer member id - 1299811

In spite of making several representations with proper hospital documentation for the reimbursement, alongside showing reasonable grounds for the delay in informing the company within the stipulation of 24hours just immediately after admission into the hospital, it has been found that my application was not only scrapped out but also the company is denying the acknowledgement of receiving my representations.
In response to my every representation to the designated email id, whereby i'm forwarding them the reasons of delay unequivocally, the company is sending an auto-generated email asking me to show reasons on the delay.
Kindly look into this matter and do the needful to release the reimbursement amount.
Thank you.

I have raised 2 reimbursement claims one for my self and other for my mother. Claim number 98659464 got approved on 26th july 2019 but still i haven't received the amount. And claim number 98659459 got approved on 6th august even this i haven't received the amount. After making multiple calls and escalations there is no response and none to help. Mediassist looks like just fooling the customers without giving the amount even after approvals...

I have submitted claim[protected] on 24th july 2019, regarding which i received message the claim is settled, and amount is transferred to my account vide transaction ref. No.[protected]gn00201 on 31st july.
But i haven’t receive any money in my bank account.

I have also sent mail to [protected]@mediasistindia.com (Ticket id 8100944)
With bank statement, but there is no satisfactory response please look into the matter, and do the needful.

I also tried to send mail to [protected]@mediassistindia.com, but it failed.

Member id: [protected]
Insurer id: [protected]d

I got admitted in udai omni hospital to undergo a surgical procedure @ udai omni hospital. Prior to admission, hospital tp team obtained cashless approval from mediassist. Doctor suggested biopsy prior to extraction of tumor from the bone (Tibia). Hence they performed a surgical procedure to extract the tissue from the bone through general anesthesia and i was admitted in hospital for 40 hours. When the discharge summary was presented to mediassist, the claim was denied explaining this as a oral medication and investigation.

Further concerned doctor shared a clarification on the procedure (Surgical procedure) which was carried out on me. However, your mediassist team has not responded to it. I personally following up with your customer service folks and their response has been pathetic as if they do not bother about the taruma one patient is undergoing. Very un professional response. Can you please clarify how this surgical procedure is considered as oral medication and investigation according to your rule books. Looking forward to your response at the earliest.

I am abb employee and the insurance company auto renew my policy. For the next year. & also didn't the cancel request.
I do not want to add my parents for this insurance because which my sibling already have made from outside and now it is waste of money here. Forwhole the year the insurance company is deducting nearly 27750rs of amount from my salary account.
I do have my personal commitments personal loan which i need to...

Hello Sir,
I am Umesh, a corporate employee.
i have submitted a medical claim on 25-Jun-19 on my mother to Medical Assist who is TPA here and the main insurance company is United India Pvt Ltd.

There is no proper response on call to them and no right information available on web site on claim status.

claim tracking number is: H[protected]

Dear sir/madam,

I am tcs employee. My employee id : 399035

My father (Mr. Amarendra nath chakraborty) got admitted in rabindranath tagore international institute of cardiac sciences on 2nd august 2019 under emergency. He was later moved to intensive care unit. As he is the beneficiary of the mediclaim facility provided by your company, the cashless has been raised for the project (Claim id #[protected]. He got discharged yesterday i. E. 6th august 2019.

The total bill as sent by the hospital to you is rs. 95394. Here is the document attached - amarendra_bill. Pdf. (See attached file: amarendra_bill. Pdf)

And the amount approved by you is rs. 23794. Here is the screen shot for your reference -

The rest of the amount (Except the non medical items) has not been approved by you because you have mentioned "proportionate deduction due to higher room rent occupancy". Here is the screen shot for your reference -

Now here is my concern -

As mentioned in the attached document (Mediassist_payment_breakup. Pdf) (See attached file: mediassist_payment_breakup. Pdf), i am eligible for twin sharing room for my parents. I have not opted for single or twin sharing. From emergency, my father has been moved to intensive care unit (Icu) which is multi-sharing room and also economy ward and from there, he has been moved to general ward. Could you explain how come the icu is of higher eligible room than single or twin sharing room. Can you explain me why the intensive care unit (Icu) has been mentioned as higher than the eligible room rent. Because of this, the amount for the rest of items has been approved proportionately.

Taking the reference, my father got admitted in the same hospital back in 27th april 2017 (Claim id #[protected] in the very same situation and he was the beneficiary from your insurance company back then as well. This issue did not crop up back then and apart from the non medical items, you approved the claimed amount.

This is the worst ever experience witnessed by me with any of the insurer. Since 5th of aug in am stuck in hospital for the claim reimbursement to hospital and even after taking to their supervisor manish and manohar and their executives habiba monam poonam sana and many more, all are useless in terms of serviceing and etiquette while talking to customer. Today is 6th aug and i am still waiting for the settlements. Every time time they are doing a wrong entry and asking for more time. I am really feeling that i did a blunder to take the policy from medi assist. Because of the casual approach and false commitment i m getting harassed and tourchered which is impacting y health also. If any thing will happen to me the medi assist will held to be responsible as because of them my medicines has been stopped and i unaware of the medication. I will take th issue to irda ombudsment also.

Dear team,
I did not get any response from your side for the below-mentioned query.
My claim id is 20066332 for amount 25k. All the hard copy for the
Hospitalization is already submitted except medicine bill breakup which is
Of rupee 4642. I want to exclude the amount and process the rest amount.
As the hard copy is in my native (Bargarh, odisha) and i am at bangalore it
Will take a long time to get it and send it to you. Please do the needful
And process the claim deducting the medicine breakup amount.

It already has been 19 days still there is no update from your side as i
Called to customer service multiple time and every time they said it will
Be done in 24hr and our team will get back to you.

Regards,
Lukeswar biswal
11013517
Hcl infosystem

Dear all,

This is you to inform that in the month of july 11th, i requested team to return back my original document (As reimbursement not processed). The same when i did not received on 19th july, raise another complain, but got information that additionally it was again required 6 days. I am chasing for my document to produce different policy vender, still only i am getting commitment but there was no action. I need a call with their managers or supervisor who have to look this matter.

Now i can not produce bill to next vender as cut off date has already been lapsed. They will not reimbursed my claim.in this situation, let me know what i have to do. Call me on [protected]

I have a tpa of mediassiat through my company Walmart. Recently my father had bleeding in urine . On investigation he was found to have very large prostate glans around 100gms . My doctor advised me a holmium laser surgery . He was very specific that since he is on disprin any other surgery would lead to increased risk of bleeding.
Now the insurance part . The insurance our rightly rejected my claim STATING WE DONT GIVE MONEY FOR ADVANCE...

I had accident at my home town hajipur and gone through surgery if my knee at max hospital, saket, delhi on dt.31st january 2019.
I have submitted all the requisite documents and regularly followed up with your kolkata office and talked to concern person and he assured me that all the documents which have been submitted to kolkata office is ok but again he demanded the scan copy of same documents and same was emailed to him.
But today i have checked the status of claim and found that claim has denied.
So it is a type of fraud by insurence company and we are survivor of that.
I did not thought that a reputed insurence company will do like this.
Afterall on whom we will believe. The matter happened with me is a very sad for me because i have lost my genuine money which was hard earned by me.
So, please look into the matter and kindly do needful so the people will believe on this system and special this company.

Thanks and regards
Biren kumar roy

When called for help around 9 people have disconnected my call without giving a proper reply or resolution from which 4 people have just said hello hello and disconnected... Today same thing happend again as disconnecting saying hello.. I called again swati or sweta answered the call and she dint had proper knowledge as was giving blunt answers... And when i asked for manager she said ok kept me on hold for 10 mints and disconnected my call... I called back again gautam has anwered the call.. The worsttt experience i had with that person... He dont deserve to be a member to help customers specially for their medical issues... Veryyy unproffesional. When i asked him for manager after discussing the complete issue as i am waiting for reinburesemnt from more than a month... And soon i will not be a part of the company where im working now as, i have just have 5 days left in the organisation. I am trying to complete the procedure as soon as possible. Gautam has said he will not transfer my call to the manager as my issue about pending claims is not valid... He said i will not transfer the call whatever you want to do you can do.. You can escalate and do whatever but i will not tranfer your call. He also said your isuue of claim is not valid... Action has to be taken against this person... Im still waiting for claims having hopes on ashwini and nagamani

Awaiting your response in this..

Dear sir
Please find that i was the employee of bajaj allinz life insurance co. Ltd. Lacated at bareilly
Under corporate mediclaim policy i covered my parents after passing a long time my mother went to catract surgery to sunayan charitable hospital, which was not under your cashless panel. So i informed to your company to help me.
They suggested to go for operation with telephonic approval.
I did that suggested by your company and submitted all relevant documents to you
But after giving so many reminders and passing approx six years did not recieved any claim amount yet
Please do the needful