Medi Assist India Complaints & Reviews

Respected sir,

I would like bring you in your notice that my claim 17962857, submitted to mediassist has been delayed due the mistake of staff. While scanning they have made wrong entry of cheque details and because of that wrong details it has been delayed.

I visited the mediassist ahmadabad office personally and submitted the new cheque again. But even after 10 days i am not getting update.

I would request you to please look into it and do the needful at the earliest

Claim no[protected]
Policy no[protected]

Thanks,
Atul bhavsar

My claim was approved on 27sep2018 and was told that the payment will be made within 10days but it's been one month and I have not received the amount and also not telling why claim amount not send on my account. I have reached out to mediassist customer care multiple times but it is still pending. Can you please look into it and update me.
My claim no[protected]
Regards,
Parul gaurav
I Am also attached files related to the claim. My meddiassist I'd card and approved claim paper... But not payment the amount yet and one month passed after proceed the claim. Please Check it and solve the problem.

Dear medi assist team,

I have submitted documents on 5th oct, 2018. But, still i didn't receive any sms or claim no. And my claim is still not processed as it is already 18 days over.

I am calling to branch since last 10 days and talking with mrs. Ronny, she is always telling me that it will be done by tomorrow.

Iam not getting response from customer care also.

Please give me status and do needful as soon as possible.

Ploicy holder name : dhiraj sahu
Patient name : dhiraj sahu
Place : ahmedabad

Pfa,

Regards,
Dhiraj sahu
[protected]

My claim no: 17737199
My wife v. Beulah was admitted in venkateshwara hospital. Bill amt of rs. 2, 56, 603. Oriental insurance paid an amt of rs. 1, 65, 843 and remaining amt of 90k was paid by me. So, i applied for a reimbursement of the diff amt thro another tpa (Md india pvt ltd). Mdi asked for few docs, medi assit needs to provide this doc. I have sent couple of emails and haven't recd the doc.

Last 1 months my claim is pending. All details i sending to your concern team. Why it is too delay..? When i called to customer care no. Its totally hold the line for 15-20 min. And afterwords discunect.
St document disptach to your team as on befor 1 month & now again the want clrification, i alrready sent to your team as on 20th oct 2018.

Why it is too dealy..?
They are not given proper answer to me.
Kindly look at matter priority basis.

Claim submitted for reimbursement of hospitalisation expenses to medi assist insurance tpa pvt ltd. On scrutiny of the claim documents, they observe that the claim is not admissible.

I have provided every documents and doctors otp report.. My mother who is 68 years old and was in an unbearable pain and went through the diagnosis as suggested by doctor. Doctor asked to admit in the hospital and epidurals were given as a part of treatment. All the documents and requested reports have been provided.
Please check the claim number and related documents. As doctor suggested we have taken the course of action and we can once again check with the expert and open the case. Ill wish to submit this case to grievance cell in your regional office or head office for redressal.

Regards,
Vinit ware

I sent all necesary documents (Reimbursement claim form, investigation report, discharge ticket, bill, aadhar card, ultrasound report) which provide by hospital but now demended indoor case paper. As in the claim formate not mention to submit indoor case paper so the hospital not provide indoor case paper. Now distance from my place to hospital is 630 km, so it was not possible to collect indoor case paper from hospital. So kindly humble request to consider the claim paper and approved my mediclaim reimbursement

Name of insurer - asha devi
Claim amount rs 10001
Date of claim 04.08.18
Reimbursement claim id 17824316
Insurer member id - [protected]p[protected]
Insurer claim id - [protected]c[protected]
Hrms id 0013878

Regards
Binay kr singh choudhary
Dena bank

Dear sir/madam,
Myself ghodke tushar, and my father ghodke pralhad sunderrao who is medi assist policy holder. Our policy number is [protected]p[protected]
On 12-oct-2018 my father was admitted to asian noble hospital at ahmednagar, maharashtra for chest pain treatment as per doctor's suggestion from beed. My father complained about sudden chest pain on 11-oct-18 at beed where he stays. So rush to doctor at beed on 11-oct-18, and doctor admitted my father, and detected a heart attack and treated initially in chintamani hospital in beed. And suggested to admit my father in asian noble hospital at ahmednagar for further treatment. So we admitted my father pralhad ghodke in asian noble hospital at ahmednagar on 12-oct-18, and treatment started at noble hospital.
I discussed and verified with account department of noble hospital for cashless claim. Account persons from noble hospital, told me that we can continue treatment with our cashless claim and there should not be issues from hospital side for cashless claim, as noble hospital is listed hospital in medi assist hospital network. So completed all formalities for cashless claim, and we were eligible for cashless claim as per medi assist's terms and conditions. I also personally informed to medi assist customer re-preventative about cashless claim with required detail. Customer
Re-preventative did not indicate any issue for our cashless claim 18073632 as per our documentations initially. And my father had a angiography and angioplasty surgery at noble hospital on 13-oct-18 as per doctor's recommendations. And we continued our treatment in noble hospital. Since i was not being informed anything from medi assist side about chances of denying our claim till last day of our discharge.
After completing all the formalities from our side for cashless claim 18073632, on day of discharge on 16-oct-18 medi assist just denied our claim giving single line reason "beneficiary covered from 21/06/2017". But as per my understanding there wasn't any clause in medi assist terms and condition for about period of holding policy should be prior to covered from 21/06/2017. My father had renewed policy on time and during the date of hospitalization our policy was not expired. We had paid all the premiums from 21/06/2017 to till date well in time.
Because of denying our cashless claim on last day of discharge, myself and my family had lot of mental stress and harassment to arrange huge bill of around rs 267000/- (Two lakh sixty seven thousand) at last moment.
So tried to registered for reimbursement claim through medi assist online website and mobile app.
But there is no way on medi assist online web and app, to register claim for reimbursement, since hospitalization date (12-oct) was beyond their intimation time period.
So we are really helpless to get our reimbursement or cashless claim from medi assist even if we are eligible for cashless claim or reimbursement.

I kindly request you to look into this complaint and help us to get our medical claim/reimbursement amount from medi assist.

I have company health insurance with mediassist with 60000rs meternity limit for normal delivery and my hospital where my wife admitted has a package limit of 55000rs.
Final bill was 67000 but mediassist denied to approve the applicable 55000rs and simply says hospital package limit is only 40000. But i have actually shared the document which says hospital package limit is 55000 for my case - instrumental delivery and ac private room.

Thanks
Venu

SBI is providing medical insurance with medi assist and my father in law is ex SBI employee.

My mother in law was operated on 21 august in Dr ram manohar lohia hospital Lucknow for angioplasty. We had submitted all documents on 5th September 2018. Despite all original documents medi assist have been asking for original discharge summary. We have submitted all original documents to SBI Zonal office Lucknow and they sent scanned copy to medi assist and scan copy is uploaded on their medi assist app portal. We can see scan copy of original discharge summary on page no. 47 and 48 yet they are not approving the claim.
Now they are asking to provide the hard copy of original discharge summary but as I had already submitted it earlier how can I provide it again. I have photo copy of it which I have mailed to medi assist as well.
Still I don't have approval of my claim.
Please help me as a big amount is stuck and my in laws are senior citizen and being harassed by medi assist.

Dear sir,

Claim id [protected]c[protected]
Member id [protected]p[protected]

The history of my claim is appeared in the portal as below;-
1. Claim was received by iba care on 23.08.2018
2. Claim was approved on 28.08.2018 for rs.30, 127/-
3. Payment initiated on 04.09.2018
4. Payment failed on 06.09.2018
(Though the latest account details alongwith physical cancelled cheque sent with claim they forget to update the same please note)
5. Account details updated on 20.09.2018 by iba care.
They informed me the amount will be credited at the earliest but till date not done.

I request you to initiate steps for credit the same at the earliest. I have already sent 15 mails regarding this.
A. Chandran 40331
Canara bank
Show quoted text
Dear sir,

Above my claim is approved and settlement is pending more than two months. Please take steps with insurer for payment.
A. Chandran
Show quoted text
Dear sir,

Till date the subject claim is not settled. Please do the needful.

A. Chandran

I have submitted the physical documents to the mediassist team on 4th of september i have the reference no# which i got from them stating we have received the docs. I submitted the docs to the andheri branch directly to the medi assist office as the address was given by one of the tcs mediassist helpline desk.

After 10 days i got to know that the docs have received to the wrong team it should be given to his team of tcs. The supervisor of the mediassist helpline said his team have have already sent an email to the mediassist team they are forwarding the docs to the t s mediassist team his. This was said to me before 12 days.

I tried calling them daily for follow up, today i called them again and now the supervisor is saying the his team has not yet received the docs we are still chasing for it.

I dont understand what should i say bcz i have written 100's of email and i calls i m notgetting proer response from the tcs his team.

Regards,
Hariharan. R
[protected]

I have operated on 19.10.2018 i have submitted my claims papers. When my clain no. Is 17886962 & maid no. Is [protected]. When i track my claim on your site, information awaited is shown. I also send a application which was receive by you & i asked what kind of information your want, plz give me information in written. But no proper response from meddiassist. Plz give the details. My mail id is [protected]@gmail.com & my phone no. Is [protected].

Claim tracking no : claim no : claim registered on

H[protected] [protected].09.2018
H[protected] [protected].09.2018
H[protected] [protected].09.2018
H[protected] [protected].09.2018

The company has denied the above claims for reimbursing the lupride injection bought for my father who needs to take it for his hormone therapy which as advised by tata medical centre in kolkata as the treatment required for his prostrate cancer post his radiotherapy treatment for the same disease.

These injections are given as part of a day care schedule at the hospital every 3 months.

While the radiotherapy component of the treatment has been covered by the insurance company they initially stated that that the hormone therapy component is not covered as per the policy.

When i questioned why the hormone therapy which is part of the treatment for prostrate cancer not covered and to specify the exact policy wording which prevent it from being covered i was told that it is unconventional mode of treatment.

This claim of treating the hormone therapy as unconventional treatment is completely disagreed by the doctors at the tata medical centre kolkata and have stated that its a standard form of treatment.

I would like to submit this complaint in order to ensure that the company get their facts right and reimburse my just claims.

If i have to submit any written confirmation from the doctors about this being the standard form of treatment for prostrate cancer please advise what exactly is required and i can request the doctors to provide the same.

Name of the Complainant: Durga Sankar Joardar
Reference Claim No.17670883
Claim Acknowledgement Letter No. 4469103
Date of Submission of Claim Form duly filled: August 17, 2018
Date of Receipt of Claim Acknowledgement Letter by Complainant: August 29, 2018.

Additional Document required by this letter no. 4469103 dated August 29, 2018 as follows:

A). All past history, duration and treatment sheet related to this hospitalization.
B). Doctor Advice for admission to hospital.

The above mentioned documents were submitted in your Kolkata office on September 15, 2018. The history sheet from the hospital mentioning the duration of T2DM and HTN duly authorized by the Physician were submitted. All the treatment sheets were already submitted on August 17, 2018.

I received the following e-mail 8 times from you office up to October 01, 2018 as follows:

Kindly provide duration of T2DM, HTN, PROSTATOMEGALY from the treating doctor

But the same was already submitted to your office on September 15, 2018. It is clearly implies that your office staff did not understand hospital documents duly authorized by the Physician.
Then I sent an e-mail on September 27, 2018 as follows:

Quote:

Dear Sirs:

This refers to mail dated September 27, 2018.

The required documents duly authorized by the Physician were submitted at Kolkata office on September 15, 2018. The stamped receipt is available with me.
I cannot understand why you are asking the said document which was already submitted to your office.

I would request you to go through the 'History Sheet' of the hospital and you will find the same. As per this sheet:

A. Duration of HTN: For last six months
B. Duration of T2DM: For last seven months.
The diagnosis of Prostatomegaly was first time done after the admission in the hospital. That is the reason there is no past history.

I do hope that you are now satisfied related to your enquary.

Please do the needful at the earliest.

Regards,

Durga Sankar Joardar

Unquote:

After this mail, the request for missing documents from your office has been stopped.

Today is October 10, 2018. Still my claim settlement has not been completed.

In view of this situation, I would request you doing the needful at the earliest.
I am a senior citizen of 71 years old having no other income like pension.

Regards,

Durga sankar Joardar
E mail ID: [protected]@gmail.com
Contact No. (+91) [protected]

My claim was approved on 24th of aug and was told that the payment will be made within 10 days but its been 1.5 months and i have not received the amount. I have reached out to mediassist customer care multiple times but it is still pending. Can you please look into it and update me on this?
Claim number 17693017

Regards,
Abhishek kumar jha
[protected]

Claim ID[protected] Reimbursement claim still pending for approval since 1 month. Customer Care not responding properly and even the coordinating branch Indore is unable to give proper response or solution. Submitted all Documents in best possible manner spending almost 300 rs in courier for query redressal daak/correspondence so faar. Money spent in cash by Son for father who was hospitalized, all bills, clarification is submitted. Document coordinating branch is Indore Madhya pradesh, sent to Mr Bhoopendra Chaturvedi. Verbal Queries are being generated every now and then and not in writing or in the status portal. Every time new UNREALISTIC /NON PRACTICALLY VIABLE query is raised that too verbally. I think the Team is unable to understand what exact is the requirement. Earlier also due to this misunderstanding they initially approved but then rejected after 20 days for the same claim, and when i re submitted the documents from Testing center regarding clarity on charges, claim we are admitted but stand unaddressed yet. Current Status is 'Information Awaited' now its 1 month. We would be forced to approach to Insurance Ombudsman in case still unresolved.

Hello sir

I have oriental medi claim insurance policy since march 2015. I was admitted to fortis noida on 30th sep 2018 and discharged on 3rd oct 2018. Medi assist rejected my claim with out any satisfactory reason. This was the first time in my life i was admitted to a hospital for any issue.
I have been paying premium from last four years for nothing.

Claim number 17924794
This is a partial claim. We have provided signed claim form, attested hard copies of other tpa, original receipt of excess amount paid. Yet claim is put on hold for second time asking me to provide itemwise breakup. This was provided on 29th sep, yet again claim put on hold, again asking to provide itemwise breakup and hard copies. All this is provided. I called call centre and it was hell. I was harrased to a point where i felt it's better to die than ask for claim
Tkt # 4830957 gives all details of my experience with call centre.
Tkt # 433979 gives details of how irresponsible execs and claim team is.
Btw none of my tkts are attended and still open.
I have lost hope and almost in depression as i will be loosing my hard earned money.
Hope there is one soul listening.

Hi Kavtha,

As per my discussion with Mani (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.

Please find below the names of Doctor & Patient:

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