Medi Assist India Complaints & Reviews

This is to highlight that even after requesting a number of times to provide for a written reason for denial of cashless facility. We have not received it twice in call i was promised that they will be sending in 5 min, but nothing has been sent.
Now we are struggling to pay. If any clarification was needed it should have been asked for before denying the claim.

Current problem is for the first time yet based on past history (Which is not related to current problem and was asked for) they have denied it, doctor and hospital is ready to send the clarification if medi assist ask for it, but medi assist is not sending email to the hospital.

Patient is 66 year old and is being harassed he is concerned more with the money than to look for treatment, what's the point of having mediclaim with cashless facility if we can't use it. Really disappointed with the approach, if this is not address now, i am going to escalate it to irda and ministry.

Regards
Sanjeev

I have submitted my claim on 21-11-18 and then till now i have uploaded all the relevant documents but still team is blind and asking for the same documents again and again. I wrote to senior staff but they didn’t responded yet. I called on helpline but system says my claim number is wrong. I called via other help options executive said to contact via email. All together very worst service and improper communication.

Dear sir,

I am arvind bhikaji kale. I will issue two claims.

Claim detailed are as follows :-

1] arvind bhikaji kale, maid id no. [protected]
Claim amount rs.1060/-

2] subodhini arvind kale. Maid id no. [protected]
Claim amount of rs.917/-

So, please this two claim was settle early as possible.

And transfer to bank account.

Thanks & regards

Arvind bhikaji kale
Mobile no. [protected] / [protected]

Dear Sir/Madam,
This complaint is regarding my reimbursement claim filed with ‘MediAssist TPA Pvt. Limited’ (TPA for Oriental Insurance Company Limited) for Rs. 13, 790 which is withheld unethically by the TPA even after approval without citing any valid reason.
I had a Mediclaim Insurance Policy bearing policy number 272500/48/2018/4611 issued as a policy for PNB Customer covering my family of 3 including my son Nehit Sukhija (aged 2 years now). This policy was in continuation since November 2013 and without any claim.
My son was hospitalised on 24/09/2018 in a non paneled hospital for which I intimated about this admission on 25/09/2017 with intimation id 10671831. All the bills, reports, prescriptions and discharge summery alongwith reimbursement forms and NEFT information was sent to the TPA after getting the form signed by the hospital. Amount claimed being Rs. 13, 790 The claim ID issued by the TPA was 18127868.
After receiving and processing the claim as approved for total amount 13, 790 MediAssist asked me to submit the cancelled cheque mentioning it as missing whereas it was already submitted. I received the message for the same on 23 Oct. On 24 Oct, I replied them about the cheque through mail mentioning that they had received my cancelled cheque and even that is uploaded by them in their app as documents received for claim. I even attached the soft copy of cancelled cheque again in this mail. I was issued a ticked no. 4985216 for this mail. I got no reply for this mail.
After few days I again received a reminder for missing document and was asked to submit it by 8 November. I now sent a new cancelled cheque again through courier (waybill no. [protected]) which was received by them on 6th November 2018 as per records of courier company.
I received no communication from the TPA in this regards. On 8th November my claim was put on hold and I was sent a msg by TPA that it is being reviewed and an update will be received soon.
After waiting for some more days as there was no communication I started to contact at their helpline, which is quite pathetic. After trying it for several days it got connected on 26/11/18 to the executive named Mansur, who was unable to provide any reason for this delay in processing. After forcing him to register my complaint he noted it down and unwillingly provided me with a complaint no. 5670950 and replied that I’ll get the resolution of this case by a week’s time.
Today on 4th December 2018, even after a week I have received no communication in this regard.
One more information, which may be the possible reason of this unethical business practice or behavior shown by the TPA or Insurance company, I would like to tell you and won’t be informed by the TPA that seeing this kind of service I discontinued with the insurance company and got my policy ported to another Insurer wef. 07/11/2018. So, as now I am not their customer now, they have held my payment and no communication is being replied even.
The policy was in force and was duly paid for last 6 years without any claim. After submission of documents, the claim was approved. First they intimated a cheque as missing without realizing that is even uploaded by them as received. Then when it was sent to them twice, no acknowledgement was given.
A real example of Pathetic service being in the service industry which is related to Emergency situations sometimes. Even their executive accepted that their phone lines are poor to connect or handle the queries.
You are requested to kindly look into the matter and help me in realizing this claim from TPA or Insurance Company which is withheld by them without any legal reason.
Thanks and regards.
Amit Sukhija.
#[protected]
[protected]@rediffmail.com

My name is janina merlyn george, working in vijaya bank, member id [protected]. I have sent claim form of my daughter eva elizabeth jibin for admission period 11/09/2018-15/09/2018. I have received the status of the claim as approved on 30/10/2018. But till date i haven't received the amount.
Claim no. 18092184
Regards,
Janina merlyn george
Staff code 31355
Vijaya bank

From,
Shankarbhai m shah.
E-25, prachi park,
Near vitthal nagar society,
Waghodia road – vadodara

To,
Medi assist india tpa pvt ltd.
Vadodara,

Sub: claim status not updated under the claim no.17876297

This is inform you that, i am already submitted the query document dated 25th october 2018. Under the claim no.17876297

But the still very long time claim status not updated, so please updated the status and release the payment at the earliest.

My name is pavan madhukarrao mokashi i am work with canara bank. I subbmited claim for my daughter on 29 september but till date it's was not approved. My claim number is 18097571 all required document are already submitted so why that much time required for approved claim. My claim amount is only 7559 rs. If this amount claim take this time then what we should expect from mediassist. Please help me for settled amount as soon as possible.

Hope you are well.

This is regarding submitted claim[protected] on 6th nov 2018 by meddiassist processing team because they have mistakenly cancelled my original claim 18184755 due to amount mismatch which is changed by meddiassist only.

I have checked status on meddiassist portal for my claim and can see the current status is 'claim processed-physical documents awaited'; however i have submitted the hard copy...

I rahul is working in bank of baroda with employee no 91061. I was covered under corporate health insurance where in tpa was dhs dedicated healthcare services tpa india private limited wherein the app is medibuddy. I have claimed health insurance with claim no 18128848 for master takshay (My son) which is pending since 22 oct 2018. I have called customer care at [protected] and also mailed as [protected]@mediassistindia.com but didnt not get any response. My insurer claim id is [protected]c[protected] and insurer member id is [protected]p[protected]. Please do the needful. I will be thankful to you. I am attatching the screenshots of medibuddy app of my claim. They have also mentioned that procedure charges are not payable which i have highlited in the attatchment.

I mohammad imran khan have a claim in my spouse's name mrs nishad khan having claim number 17985120 this claim was processed in 13/10/2018 by meddy assist but the insurer has not made the processed amount yet.

Please help me get the processed/settled amount as soon as possible.

Thanks
Mohammad imran khan
Bank of india
Gotegaon branch...

I am suppose to be discharged on 23/11/2018, still haven't received approval on my discharge bill submitted. Medi assist i'd: [protected], i am in the hospital from last 2 days waiting for nothing this is really frustrating when i have already suffered a lot, when i call u guys don't pick up, or reply with exact time of processing, really disappointed with your servies

I have medical official medical limit 2.5 lac for family. My wife was not feeling well in her pregnancy. As per doctor it was special case so they put her under observation and she suffered also. She was in hospital for 27 days. Before this two time she was admitted for same reason. I got mediclaim for that. Last bill was more than 1.5 lac which is still my under mediclaim limit. But mediassist did not approved. Given reason that, the limit for maternity benefit are 50000/- for both normal & cesarean delivery. But its dont come under this case.

Can help me. I have all detail documents and email communication.

Thanks,
Anand vastrad
[protected]
Email id: anandkumar. [protected]@gmail.com

Dear sir,

Name : soorya s. S
Employe id :1013269
Company : quest global engineering services pvt ltd
Quest towers, technopark campus, trivandrum
Pin: 695581

Documents of insurance claim number[protected] 4693210
Registers ticket ids: 4693210, 5085486, 5237868

After rejecting this claim, i requested them to return my original documents by registering one ticket on 26 sep at 2:43 pm. But still now i didn’t get any documents. I have sending reminder mails and call every week.

Mail contents:
Hi,

Regarding the insurance claim number[protected] 4693210
I didn't get those documents till now.
So please share as soon as possible.

Regards,
Soorya s. S

From: quest [mailto:quest. [protected]@mediassistindia.com]
Sent: saturday, september 29, 2018 6:30 pm
To: soorya s s
Subject: re: insurance claim number[protected] 4693210

Dear soorya s s,

Thank you for writing to medi assist.


We will share you the document asap.


Regards,
Medi assist support team

Web | social | blog | app
_
Carry your world of healthcare on-the-go with the medibuddy app. Cashless hospitalisation | health checks |
Medicines | claims tracking and much more. Call[protected] or click here to get your app now.
_

On thu, 27 sep at 10:44 am, soorya s s wrote:
Hi,

Please find my contact details.

Soorya s s
Emp id : 1013269

Quest global engineering service pvt. Ltd.
Quest towers
Technopark campus
Trivandram – 695581

Mobile no: [protected]

Regards,
Soorya s. S

From: quest [mailto:quest. [protected]@mediassistindia.com]
Sent: thursday, september 27, 2018 10:40 am
To: soorya s s
Subject: re: insurance claim number[protected] 4693210

Dear soorya s s,

Thank you for writing to medi assist.

Request you to share the contact details.

Regards,
Medi assist support team

Web | social | blog | app
_
Carry your world of healthcare on-the-go with the medibuddy app. Cashless hospitalisation | health checks |
Medicines | claims tracking and much more. Call[protected] or click here to get your app now.
_


On wed, 26 sep at 2:43 pm, soorya s s wrote:
Hi,

Could you please process this ticket as soon as possible?

Regards,
Sooryas. S

From: quest [mailto:quest. [protected]@mediassistindia.com]
Sent: wednesday, september 19, 2018 4:48 pm
To: soorya s s
Subject: we’re working on your ticket number:[protected] insurance claim number[protected]

Dear soorya s s,

Thank you for reaching out to us. Our support team is working on your ticket number 4693210 and you will receive an update from us within the next working day.

In the meanwhile, do try giving medibuddy an opportunity to help you instantly get the information you need – claim status, policy conditions, enrolment status and e-cards, network hospital list, reimbursement claim document submission and more. Need help signing in? Here are some tips.

You can also consider browsing through our blog - we have a range of posts around frequently asked questions on health benefits that you might find relevant.

Thanks again,
Team medi assist

Ps: have you given us all the information we need to resolve your query? Send us your policy number and claim number, quoting this ticket number, to help us process your request faster.


Carry your world of health insurance with you on your smartphone. Cashless hospitalization | health checks | medicines | real-time claim tracking and much more.
Get the medibuddy app now! Call[protected] or click https://goo.gl/LYTdFR

4693210:206014
— disclaimer — this e-mail contains privileged and confidential information intended solely for the use of the addressee (S). If you are not the intended recipient, please notify the sender by e-mail and delete the original message. Opinions, conclusions and other information in this transmission that do not relate to the official business of quest global and/or its subsidiaries, shall be understood as neither given nor endorsed by it. Any statements made herein that are tantamount to contractual obligations, promises, claims or commitments shall not be binding on the company unless followed by written confirmation by an authorized signatory of the company. —
4693210:206014
— disclaimer — this e-mail contains privileged and confidential information intended solely for the use of the addressee (S). If you are not the intended recipient, please notify the sender by e-mail and delete the original message. Opinions, conclusions and other information in this transmission that do not relate to the official business of quest global and/or its subsidiaries, shall be understood as neither given nor endorsed by it. Any statements made herein that are tantamount to contractual obligations, promises, claims or commitments shall not be binding on the company unless followed by written confirmation by an authorized signatory of the company. —
4693210:206014

Dear sir,
My claim no is 16576746
It's going to be one year approx but till now there is no progress in reimbursement of mediclaim. Even though i have submitted each and every documents relevant to this, but not yet processed. People have faith on your company if you are not going to help us on time then who will take your policy and why we will rely on health insurance company.
Kindly do needful as soon as possible and request you to act immediately.

Thanks and regards
16576746

I have submitted my 2nd claim on 3rd november 2018 and have received confirmation via sms and email stating documents received. However till date website shows no claim on file. Inspite of multiple follow-up there is no response. They are just passing my email internally to each other to respond my email. Pathetic service. Its a corporate plan. Waste.

My patient was admitted in mata roop rani hospital on 29 th on november 2017 and was dischared on 5 th november 2017 .And i have followed all the process for the claim as per the rule, but after a long periond of time i have not recived my claim amount after his death also and i am deeply hopless with this company . i want my money to be reimbursed with the company my reference number is CCN# 15699841 under policy# 272900/48/2017/30500 (Emp Name -Mohanlal Jain ), This company is totally harased the people of reimbursement claims.

Hi Team,

This is regarding the Claims for Maternal expenses, as given in the below mail chain, I have submitted all the required details in July’18 for the overall amount of 79200 INR and have submitted all the relevant documents with the bills even after 4 months of my request, it hasn’t moved a step ahead also.

Please find the details below on the Claim request & Medi Assist membership:

Claim No : 17514157
Media Assist Member Id : [protected]

Here, Medi Assist person who came to verify the details in the hospital has incorrectly updated the records of Mother & Doctor name as given in the below email chain. Because of which I am unable to get the Claims till date.
Many times I have requested the Medi Assist team to approach the hospital again and get the verification done properly and update the records in correct way, so that I can request for the claim, but nothing is moving ahead, instead they are rudely behaving and confirming that, no one can help for further movement of the case ahead. As given below Kavitha holding mobile number (+91 [protected]) & Mani holding mobile number (+91 [protected]), Vijay Kumar (+91 [protected])
have been contacted numerous times, but they are not considering my request and are not of any help in moving the request ahead and they are saying to raise compliant with anyone and of no use, which is definitely wrong way of responding.

As given in the records your names published as the escalation point of contacts, that’s the reason, would like to request you to take stringent action on the Medi Assist team to get the records updated properly and move my claim request ahead, as its purely mistake done by Medi Assist team in interchanging the names of Patient and Doctor (which I came to know, when checked with Mani in my first call with him).

Please find below the names of Doctor & Patient:

Doctor Name: N.S.Rani
Patient Name: ASWANI

PFB details:
Claim No : 17514157
Dedicated id : [protected]@Infy
Employee id: 645161
Contact no : +91 [protected]
Infosys, Pocharam,
Hyderabad

Aswani + Baby =64000 (Date[protected] to[protected]
Baby =15200 (date[protected] to[protected]
Total Amount = 79200(INR)

Total amount is 79200(INR).

Can you please update your records as given above and let me know the status on the request as early as possible. It has already been delayed very long and would like to get this resolved at the earliest.

Let me know for any issues.

Regards,
Mahesh,
Infosys,
Pocahram,
Hyderabad,
cell : [protected]

I have sent many email and they replied like will process but still now no actions taken.
Claim no: 17716543

Could you please let me know the status of claim 17716543. I got a message about the claim, it stating “claim has been processed for rs 6102/-” even though i have sent the missing report for rs 1750/- through email and sent the hard copy in mail with other documents which is not considered.
Please find the below email chain for your reference and let me know what is the reason for amount 1750 is not been considered for claim approval.
I have been following up this claim for nearly two weeks and sent all the required documents whatever you expected but finally these thing are not been considered.
If you are not consider the report cast with this claim then please send me the original documents (Bill & report) for the amount 1750. I will raise the new request and claim the amount.

And they replied for the above email on sep 11 2018 as like below

Dear karthi murthy,

Thank you for writing to medi assist.

We sincerely apologize for the inconvenience caused.

Your claim number 17716543 is in approved status. Once this claim gets settled, we will reopen your claim once again and process the remaining amount. Please intimate us once the amount credited to your account.

We look forward to your co-operation and patience in helping us serve you better.

Hi,
Intimation bearing id 10669461
Have corporate policy. Since september 22 claim is not settled. My database like employe name is updated wrongly on your database hence your team is asking blank cheque and other documents which is not possible to give. Last time same thing was happened and you team has updated data. Now again have to struggle. Really very bad experience.

Claim no : 17514157
Media assist member id : [protected]
As per my discussion with mani (+91 [protected]) and kavitha (+91 [protected]) (Medi-assist customer care officer) on finding the reason for claim rejection, came to know that the issue was because the doctor & patient names have got interchanged, because of the mistake by med-assist agent.

Med-assist employees kavitha and mani is not properly responding

Please find below the names of doctor & patient:

Doctor name: n. S. Rani
Patient name: aswani

Pfb details:
Claim no : 17514157
Dedicated id : [protected]@infy
Employee id: 645161
Contact no : +91 [protected]
Infosys, pocharam,
Hyderabad

Aswani + baby =64000 (Date[protected] to[protected]
Baby =15200 (Date[protected] to[protected]
Total amount = 79200 (Inr)

Total amount is 79200 (Inr).

Can you please update your records as given above and let me know the status on the request as early as possible. It has already been delayed very long and would like to get this resolved at the earliest.

Let me know for any issues.

Address:

Media assist,
Ibc knowledge park, tower d, 4th floor, bannerghatta main rd, 4/1, bengaluru, karnataka 560029, india