Medi Assist India Complaints & Reviews

This is big problem of medi assist health insurance company.There is no one to talk about here.i want to know my health insurance cover of employee bcoz critical condition of my mother.i want to know how to cash less treatment of my mother and what is the sum insured of my mother kindly contact to me in my mbl n.[protected] anurag goojar...kindly proceed

According to the details provided in the mail and the attachment from your team, it is understandable that the maternity benefit capping is 50000/- .
But, according to our company policy details, it is actually 60000/-.
I have also attached the screen shot of the same for your reference. Please do the needful and make the corrections accordingly and update me with the new Approved breakup.
Please quickly close this as this might end up in delaying the discharge process from the Hospital.

Complaint no 19625503

I am submitting my above mentioned claim no from past one month but didnt receive any resolution, i am calling there call center every day to enquire about my claim but i am getting the same answer from all the team members that the back end team is working on it ...

I am fed up of following this case. Today i have called again and asked the executive to provide me their manager no.to call and speak but whatever contact no. I was given was switched off...

Really a pathetic service i received from medi assist team.

These people are asking me the signature of MD Pathalogist from the hospital where i was submitted on emergency basis but i have informed them multiple times that tge MD Pathalogist is not available and i asked them to exclude the amount of 2220/- for which they need the signature from MD pathalogist and refund the remaining amount but these people are not doing that also.

Now i am going to take this issue to IRDA team.

My ticket no. Is 7232473, i need quick resolution otherwise i will move further as stated above.

Regards
Ambili a s

I had already provided all the necessary documents related to claim but again and again they are sending the same mail that additional document required, I am fed up with follow up from last 25 days, there is no document pending from myside, please resolve my issue and processed my claim asap.Even they cross checked with hospital too and even hospital also confirmed regarding the genuinity of the document and regarding all the necessary bills.

TPA is not considering doctor prescribed PET scan and deducting the money(21403) saying it as advanced receipt though It is done only after doctor presumed TB as cancer and reffered for the scan. In the discharged summery from Shakti hospital Odisha, down the paper doctor has written/reffered to do scan to diagnose cancer. Also deduction happened for hospital discount(34377)though in my policy no where it is mentioned.

Hi,

please provide the formate for legal heirs affidavit. I have visited the lawyer and he is telling that there will be formate to be enter on bond paper I have droped the mail for the formate there I no responce for yours end and more over over you people are asking for 500 rs affidavit but our lawyer is telling that no need of 500. Please suggest on this and resolve as soon as possible.

Regards,
Surya
[protected]

We express our inability to extend cashless facility for claim 19733353 under policy issued by the new india assurance co. Ltd on 03 jun 2019 18:52:59.

I was shattered to see the above msg. I was admitted in hospital and opted for cashless treatment. At the time of discharge, i was stranded in the hospital for 8 hours as approval was not given for my claim by the insurer. I had no money to pay and faced embarrasment in the hospital.

There was no proper justification why the claim was rejected. Hospiral admin staff were co-ordinating to help me obtain claim approval, inspite this the claim was rejected.

I have a long term ailment which requires proper observation and frequent medical check ups, this is all a part of miliary tb treatment. Hospital had provided adequate details supporting the same.

I was extremely dejected and feel that my claim was not properly reviewed. I would like to receive a proper response from the insurance company so i can take this matter to court for justice.

My claim required me to submit a cancelled cheque with my name printed on it. As i did not posses one i was asked to send a bank statement via email and via currier which was acknowledged by them. Despite this they still are asking for a canceled cheque. If a bank statement was not valid i should have been informed prior. Their customer care executives "tejas, vinod and linda" asked me to repeatedly to wait for 48 hours since may 27, 2019 which i duly did without any response. I was informed by tejas that it was intimated yesterday, may 31, 2019 even when i have been raising a ticket since monday. Inspite of my queries if i have to submit some other document or cheque they do not respond.

Dear sir/madam,

This is very sad to note that, query is not raised in one go. Each and every time we got something new which need to fulfill.

Now it seems like we intentionally getting the claim declined. I have resent the all original document and all original bills now there is only one document which is ecg shared in xerox copy as advised by doctor.

This is not possible to arrange the bill of breakup, the hospital distance from delhi to approx 500 km. Kindly co ordinate with hospital is any issues. Hospital details already there.

We have tried to contact to hospital over phone to understand the breakup of bill but they denied stating that "we have standard process to charge the consolidated amount including doctor fee, bed charge, medicine charge and other fee".

Kindly consider the same for the reimbursement.


Thanks & regards,

Greesh chand

Asst. Branch head

[protected]

I have sent all the required documents as you have requested on 29/04/19 i got a reply that you will proceed,
On 01/05/19 again you have requested for policy details, hence i have provided and attached the policy copy (Really it's a silly query, though its basic details u could have in your database). I have also sent a clarification letter form maax super speciality hospital shimoga regarding credit bill receipts instead of cash bill and cash paid receipt also. My transactions regarding reimbursement is since march 23rd,
You have paid the partial amount and remaining rs.5490/- not yet paid for reimbursement claim no.98078675

Neither not responding for mail or call nor closing the ticket.. It might b small amount, money is valuable.

Dear sir/madam,
This is to inform you that our hospital (S. R. Medical institute & research centre, lauries complex namner road, agra). Our hospital is already empanelled with your tpa and our hospital id is 141862. But few days ago, our hospital is not display in your panel list. Our hospital is now nabh pre entry level accredited. Our hospital nabh accrediation reg. No. Is peh-2019/0849 and is valid from 29th apr 2019 to 28th apr 2021.
Kindly send us reason why our hospital is not display in your panel list.

For s. R. Medical institute & research centre
Agra (U. P.) -282001
Tel. No.:[protected]
Mob.: [protected], [protected]

Sir i m an frustrating about medi assist cautomer care service. I have an insurance in your company. While i admited in a private hospital through claiming my insurance. Hospital authority request an initial letter with single ward category but at final claim bill your insurance company mentioned general ward category. So we faced an issue with hospital authority. While i contacted 5 times to your customers around 6 hours continuosly but none of one responded. Literally i requested, begged. Every one told work had been done in 30 min. But finally everyone lying. All trying to far away. Sir i am really dissatisfied and disappointed with your customer care service. Infact i don't have director number while i had that much of anger towards you to complaint against caustmor care service and i lost my patience, time too. So please respond quickly.

I don't like this product plz sir are madam plz return my amount as much as fastly possible plz sir
My mobile.. [protected]
My account [protected] this is my account number plz sir as soon as fastly amount give it to me.. I am waiting for u r call. Thank u sir are madam take it fastly sir or madam i need fastly amount / this is the my indian bank account fastly do it thank u

We moved out of the first hospital fearing loss of our first baby.

We were not provided any information reg the treatment give to my wife.
Bills - we paid all in cash as they don't have paytm/phonepay/pos machine
We had to a lot of followups for bills to submit the insurer. But the doctor insisted to give the bills citing the time frame.
Reality is we need to submit the bills to the insurer within a certain time.

We were fed up with the hospital in all ways.

Now when we submitted the bills to the medissist, we were being asked additional documents and i have sent a detailed email with an explanation.

Ir,
I attended a call from one assist regarding their insurance plans, i told them i dont want this service but they charged me 1299 for its subscription for one year. I just don't want the subscription and please cancel my subscription for my icici credit card ending with 3000. Other wise cancel my credit card, i don't like to spend money on all these things.

Dear team,

This is with reference to claim no[protected]Patient : hemlata ramesh patil), kindly clarify the reason for deduction of below charges while sanctioning cashless amount

1) consultation charges : rs 4400
2) physiotherapy charges : rs 1087
3) troponin i blood test : rs 2302

Yesterday we were following up with your cashless team for almost the entire day, however could not get satisfactory reply on the same.

Hence we approached your grievance team and spoke to divesh (Spoke twice), nelson, pooja and then neha. They were unable to give me satisfactory reply and i was told that they are unbale to get in touch with kolkatta team of doctors and asked me to speak to them on numbers :[protected] and [protected]. However no one was picking up the phone calls and was unbale to get any reply.

However again i called up grievance team and spoke to pooja and she told me to speak to ashwini (M : [protected]) who she informed me is your client relationship person. However the lday did not pick up my phone call even after calling her multiple times nor did she called back. Later on my calling mulitple times, she switched off her cell.

I had no option but tp pay the bill yesterday as further delay would have resulted in further occupancy chargs being charged by the hospital

I tried calling ashwini even today, however she did not pick up my calls even today nor had the courtesy to call back

Is this the kind of service we can expect from your team?

Pls confirm on priority the above clarification and refund the amount

Regards
Abhay patil
M : [protected]

I send city scan copy to your ahmedabad c g road branch at 24-apr-2019
But still no response from your side. I call 3 time call of this number [protected].
They tell me we have received. But no body tell status. Please do the needful.

Please answer as soon as possible

Here is receipt i attach for the given city scan report submit at medi assist c g road, ahmedabad branch...

Policy no : 215302/48/2019/1463
23/10/2018 to midnight of 10/10/2019
Insured name : kitab kaur dahiya (72)
Policy amount: 5 lakhs
Claim amount : 1, 97, 406/-

1. This is to inform you that mrs. Kitab kaur dahiya (72) admitted in kalra hospital from 9.12.18 to 12.12.2018. She has no any prior heart disease.

2. I have submitted my claim vide speed post no. Z79438693 dated 7.1.19 with all the originals papers which i received from hospital including original bill. After that, i did not receive any message from medi assist till date. I sent a message to medi assist on 9.4.2019 they sent back a query to me.

3. As per your requirement i am sending the 2 years policy, account cheque, hospital final bill and the letter from hospital. All the original papers are with medi assist. This is my last response to you.

In view of the above, i request you to solve this case and release the payment at the earliest.

With regards.
Yours faithfully,

Kitab kaur dahiya c/o assim prakash dabas
409. Vpo kanjhawala,
Dist. North-west
Delhi – 110081
[protected]
[protected]@gmail.com

My name is justin jacob (Emp:id 366321) working in wipro technologies. My mother's cashless claim was rejected by mediassist by mentioning pre-existing disease. My doctor confirmed that the disease is not pre - existed. I consulted medi assist cochin office and they are saying only to reimburse. But since my cashless hospitalization was not accepted, i am forced to legally move against mediassist by raising complaint to insurance ombuds. Expecting reply on this.

Hi i am kumarswami

I took insurance on 27th feb 2019... On 25th mar 2019 i was admitted in hospital... Due to some health issue... I have submitted all bills to claim the amount which i had paid in hospital. But claim was rejected by medi assist... When i contacted them they said with in 30 days you have hospitalized hence you will not entitled to get claimed amount. When policy was taking they did not mentioned any time period...

Please help me in this regard...