Medi Assist India Complaints & Reviews

Sir,

This is in regards to above subject matter details ; i bharatbhai v savalia, age : 63 years am having national insurance policy no :[protected]. I have undergone a cancer surgery for which all documents have been submitted along with required reports and bills on 23rd nov 2018 for claim. The amount of claim was rs. 3, 07, 545/- (Three lacs seven thousand five hundred and forty five only), while the approved amount as per 12th february intimation through sms was rs. 1, 50.183/- (One lac fifty thousand one hundred and eighty three).

On 13th february my visit to your office and had a discussion with representative, he asked to submit hospital declaration on gst. However as per clause no 82, the hospital is not legally required to obtain gst no and hence attaching the declaration on the same by hospital.

Request you to please let me know the reason on deduction of following amount to me as soon as possible.

Description

Bill amount

Payable

Non payable / reason

Other miscellaneous charges

200

—

200

Ot charges

38000

21250

16750

Surgeon charges

124997

84997

40000

Anaesthaesthist charges

30000

25000

5000

Consultation / visit

25000

—

25000

Medicines/drugs

53725

—

53725

Deduction details:

Description

Deduction amount

Remarks

Copay

—

—

Hospital discount

16687

—

We have paid hospital bills by taking some financial support from relatives with a polite commitment of returning in 15- 20 days. Now my situation is worst to explain it in writing to you.

I am a senior citizen who is not having enough energy to follow every time as the medi assist and national insurance are actually passing the bucks.

Please understand sir, now i go to the medi assist office by spending 110 rs which is further disturbing my financial condition.

Dear sir, with reference to above subject i kanaksingh parmar holds a group mediclaim policy through my corporate pnb metlife insurance company ltd. My individual policy no is 222900/28/18/p1/02650932 & my parental policy number is 222900/28/18/p1/02652775. I have raised a reimbursement claim for the amount of 74828/- on 16th jan 2019 through tpa mediassist claim number is 18792814. My claims all investigation & all procedure was completed successfully by your tpa on 7th february 2019 and i have informed the investigation officer how the hospitalization incident occured and was verified by investigation officer. My mother has wrongly/unintentionally taken a poisonous medicine which was used for my pet's cure inspite of her regular syrup which she takes regularly for her cough/congestion. It was misunderstood by the shreeji hospital & mlc was filled which unknowingly signed by my father mangalsingh parmaras he was completely disturbed at the time of hospitalization as he was busy with my mother khemalben parmar treatment. At the time of treatment which was going on at hopsital even police officers also visited hopsital as mlc was filled and police also recorded the statement of my mother & also asked the relatives about the incident happening. After the completing primary treatment we shifted my mother to bhailal amin general hospital where further treatment was carried on bhailal amin hospital also carried on the treatment on the basis of documents received from shreeji hospitals. I request you to kindly consider the case & proceed further asap.

Hi,

I am raghavendra pise ex-employee of wipro limited.

Last year during october month, i have raised below two claims for united india insurance through mediassist.

Policy numbers :[protected]

The claim was approved on nov 2018 and sent for credit note but amount is not yet credited to my account.

I have been doing a follow up with mediassist customer care but they giving other reason.

Medi assist customer care saying due to change in payment process its delaying. This reason doesn't seems to correct because last 4 months they are same reason which is not believable.

Could you please help here to resolve this issue.

With reference to above mentioned claim no you have written account no [protected] where as the account no given to you is [protected]
kindly send the amount at the proper account no. my claim no 18232924 is already settled as you have sent the amount in punjab national bank it went back to you as i inquired from the bank, my Employ id is PNB-ORI-ROY-[protected] AND MY MEDI ASSIST ID IS [protected], INSURER CLAIM NO IS 272900/48/2019/005528.You have deposited rs 261993 vide claim no 18232924
regards dr vijay khariwal

Hi mediassist,
Regarding claim no 1871825, for new born baby claims, submitted the documents on 20november and today is 15feb still the status remain amount approved with insurer. I do not know of every thing is approved why the dispatching of amount taking so much time. I have mail proof also that wrong information has been shared that transaction has been done. That's very annoying that u guys are just dragging without any reasons. Kindly settle the claim.

My claim no 97626815 of maid no [protected] name sudha babu of claim amount 40708 was not fully approved and the reason for non approval was hertraz.in my past and later claims the bills containing the same medicine was passed. Then why rejection in this claim. It's the same medicine used for cancer and it's the same medicine used before and after this claim. Only claim no 97626815 gets rejected.

Mediassist has played fraud. by denying 22 thousand rupees.
The claim was submitted on 30th jan 2019, which is well within the date.
The claim was submitted for my new born baby with expenses of Rs 23849

Mediclaim automatically created a new record of its own with my spouse name on 8th Feb(which is outside the date)
attached are the screenshots

CCN# 18948238 under policy# 900001/12001/2017/A[protected]

Patient Name Swati Chandra
Policy Holder IBM India Pvt Ltd - Emp
Primary Beneficiary Praveen Raja
Medi Assist ID [protected]
Policy No. 900001/12001/2017/A[protected]
Relationship with Primary Beneficiary Spouse
Employee ID 04528N
Procedure / Treatment Planned Medical management
Insurer Claim No
Insurer Member ID [protected]

Summary of Approval

Processed Amount (INR) 1152

I have submitted the above claim for my treatment of diabetics, htn, dislipidemia, thyroidism, uric acid and frozen shoulder due to my accident and operation in right hand. I had submitted all bills vide above claim no. 18191648 on 24/09/2018 which was acknowledged by you on 29/09/2018. An information was sought on 20/10/2018 for submission of physiotherapy advise from orthopaedician and date wise physio therapy chart. On 7th dec'18 information awaited advice generated and on 8th dec'18 the subject claim was closed at your end.in this connection, i would like to say that i have already submitted all the bills/vouchers etc from the treating doctor and physio therapist but for the want of date wise physio chart, my claim was not sanctioned and the same was closed. I have taken up the matter with your office located in our canara bank office, ranchi for the sanction of the same several times but no solution was given and my genuine claim was denied. Kindly let me know whether physio therapist is a valid doctor or not? If your office did not want to approve the physio therapy bill, then why the bills of my medicines and doctor's fee was also not sanctioned? I feel that you have not ensured due diligence and your positive attitude towards my case. I request you to kindly consider my request and reopen the claim and sanction the same at the earliest please. An early action in this regard will be highly appreciated.
With regards,
Manikant sharma
Staff no.67699
Canara bank
Telco colony
Jamshedpur
Mbl [protected]

Emp name : soorya s s
Ccn: # 97363993 under policy# 602200/46/18/[protected]

Based on the previous complaint regarding my denied claim, i have already registered one complaint here. Based on that claim was reopened by medi assist.

But after that they requested for -"advice require from insurer" but this is not updated by them.

After few days they cancelled my claim again. By mentioning waiting for -"• advice require from insurer. Miscallenous bill"

My claim was closed in last month (28-jan-2019). After that i didn’t received any update on this.
Last week also i tried to call, unfortunately call is not taken.

So i am requesting you sir, please process my claim as soon as possible.

From bank of baroda my employee number is[protected]we have reembesment clain on[protected] we have submitted all the oroginal documents via courior and then awaited documents they nees i also post it on 29-jan-2019 and i also send documents via medibuddy application also so yet the claim is not passed and not any update given by this company.wen i call to coustemer care they onece say we received else people say we didn’t receive documents .Please check the same to avoid unnecessary delay and consider the claim.
As a supporting document, i had attached copy of the 4 reports from my diffrent 2 claims which were sent in original to tpa end in email...
Below i also attach the proof that they have receive the courior and the sign and stamp of employees of mediassist and stamp
My awb of traking num is [protected]

Claim id[protected] for emp id 21484 corporate-bank of baroda. All original diagnostic report issued by 'dna labs' were already sent in the courier received at tpa end on 12th january. They will be able to retrieve the documents in the initial courier itself hence making the query redundant. After i had written email, they were able to track 3 reports in the courier itself, whereas i had sent 6 original reports. Please check the same to avoid unnecessary delay and consider the claim.
As a supporting document, i had attached copy of the 6 reports which were sent in original to tpa end in email to [protected]@mediassistindia.com. I am afraid they have either misplaced the documents or are not checking the couriered docs properly hence causing avoidable mental agony to patient and family. This is to request you to track the complaint in order to prevent further escalation of matter to regulatory authorities.
Regards
Vatsala paul

For reference request[protected]
• discrepancy in hospital duration stay

As per discussion with the doctor hospital stay for my mother will be for minimum 7 days.

You have estimated for only 2 day hospital stay. Your estimated date of discharge is absolutely wrong.

Please revise your initial authorized amount subject to minimum 7 day hospital stay. You have wrongly calculated initial approval amount based on 2 day hospital stay.

• please provide justification for not providing initial approval of 100% of the amount.
• please send your policy documents based on which you will decide final approval amount at the time of discharge.
• please send your term & condition for “medicines consume during patient hospital stay”.
• please send your term & condition for “medical tests performed during patient hospital stay”.

Our claim no is 18918390 is pending for approval and is pending at medi assist insurance toa pvt ltd and theiry office is asking queries in bits and pieces. We are regularly replying their queries but after receiving reply they put another query. We came here for the treatment how it's possible for us to comply every query in regular intervals. We are continuing mediclaim policy since 2011 and policy no was 332100/48/2011/1578. They have asked for the no of old policy and documents also is this is not the harassment can a person going for treatment keeps all policy document and no with them the details which they are asking can get directly from the oriental insurance. Kindly expedite.
Thanks,
Your,
Dilip kumar jalan

I am an emoloyee of bank of baroda. One of employee mr. Hariom tiwary, employee no. Ma9362 have came to our branch telling that medi assist is arranging a health checkup with tie up hospitals and booked a appointment thereby deducting the charge of rs.3999.96/- on medibuddy on[protected] telling that you will receive an appointment details from medi assist in 2-3 hours or by evening and after not receiving and doing follow up with him daily i asked him to cancel the appointment which thereafter also
Not received the amount back. Kindly refund the amount. Of rs.3999.96.

This is in regards to the subject matter details ; it is my request to please process reimbursement for the claim submitted on 23rd nov 2018.

The status is showing still in a process tab, its more than a month for the settlement pending. I have called many times to the toll free numbers and the reply remains the same as "it is in process".

I am unable to find out the reason for delay in processing my claim even after 2 months. We have paid hospital bills by taking some financial support from relatives with a polite commitment of returning in 15- 20 days. Now my situation is worst to explain it in writing to you,

I am a senior citizen who is not having enough energy to follow up even after 1.5 months of claim submission. Every week i go to the medi assist office by spending 110 rs which is further disturbing my condition.

Hope you politely understand my situation.

Need your prompt resolution and quick credit my account as early as possible.


Name of patient : - bharatbhai v savalia
Mobile no - [protected]
Claim number : 18369028
Date of claim submitted : 23rd nov 2018.

Awaiting for your early response and credit account.

Medi Assist is one of the most shameful TPA company that operates around in the country. They blatantly violates all the SLAs they tell to the customer. I have a private insurance (non-corporate) so Medi Assist understands I have the least leverage with them. I opened up two tickets 5556189 and 5721439 with them and never received any response for their resolution even after multiple follow ups and calls with customer care for more than a month. They might reply in response to this review that we will address the issue but finally they never do it.

It is a company which is trying to maintain social media reputation by providing false responses. The real aim of the company is to reduce the claim approval to as minimum as possible so that they can make maximum commission from their respective insurance company clients. My suggestion to all private insurers and corporate HR teams is to never select Medi Assist as TPA agent. Reject such insurance company offers.

I have submitted my claim documents from last 3 month back. All verification has been done. Two time submitted some another required documents but still my claim not process. After putting reminder 5, i have received revert that your claim is under discussion with our senior.
Its fraud company and if am not getting my claim i will go by legal way.

Claim no = # 18352727
Claim id = tp[protected]

From
Ravi kumar
Manager airtel
[protected]

I have submitted all my documents to mediassist on 11th jan 2019 that includes medical reports bills discharge summary. Till now i haven't got any update regarding my claim. My claim number is 18737531. And whenver i tried to call on your helpline number when option comes that press 2 to know your claim status thereafter just phone rings for around 1 minutes and then phone call gets cut from your side. It happens daily. Around 3 pm i used to call. Kindly give me update regarding my claim status.

My claim number is 18618123 and i have received a message on 27th dec, 2018 saying that they have received all my documents. As per the policy they have been constantly saying that it requires 21 days for the settlement.
Though my claim amount of 52913 is approved. But still its not settled.
Please try to reimburse the amount asap it has already extended beyond 21 days policy.

I had submitted my post operation bills for reimbursement on November 25 2018 and followed up more than 10 times in Medi Assist, but they did not move further step for my claim reimbursement, when ever call to them, they are saying same story like will settle with 10 working days, but till now it did not settle down the claim reimbursement.

This is vert worst company
My claim No: 18197500