Medi Assist India Complaints & Reviews

Cashless claim (Claim #[protected] for meena ganatraatra was submitted on[protected] at 17:22. For insurer claim ref# 144000/48/2018/006520
An amount of 10000 will be paid to sterling ramkrishna speciality hospital and wasapproved. But still the amounts are not paid. All the documents were submitted by hospital. Even we have sent the mail id and tried to contact cistomer care on toll free number they said it will be settled but still...

I had undergone an surgery tah for which pre auth was rs 83 000/=.
However post operation there was additional medical expense of 10998, which is not reimbursed to me. Since last 45 days im writing to the mediassist team for our corporate employee group, but no valid response.
They are mentioning reason for disapproval as excess of gipsa package.
Request break up of gipsa package 9 to verify if hospital has overcharged us)
N also copy of policy to prove that claim / reimbursement is limited to gipsa package.

Around 5-6 mails and follow ups and no valid response from the company

This is Bhanu Prasad S/o Narasinga Rao who is an LIC agent having corporate insurance policy and the TPA is Mediassist. Mr. Narasinga Rao had undergone two surgeries one is TURBT and the other is Radical Cysectomy due to the attack of Bladder Cancer.

We applied for the reimbursement of pre hospitalisation expenses for the above two surgeries and the details are

Mediassis Id: [protected]

1) TURBT...

Sub claim no : 17514157 : requesting for reverification of the medical bills.[protected]

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

Pfb details:

Dedicated id : [protected]@infy
Employee id: 645161


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.

Could you please help me madam regarding claim.


Regards,
Mahesh,
#[protected]

S highly intolerable that i didn’t get any reply from you for the past 3 days. I need information on the following:

I would like to know about the list of ayurvedic/ siddha hospitals to treat heart related ailments using cashless mode. I have already raised a request on medi assist portal with ticket number 4726664. I need prompt actions as the sla is breached for that ticket. It is an emergency situation and so please consider this as priority. Would like to contact the medi assist representative to discuss on this.

Last two months onwards i have send 20 mails and 30 calls but nobody properly responded.

Please let me know reason.

I have enquired with the medi-assist customer care team for the reason of denying our medical bills related to my wife’s pregnancy expenses along with kid’s medical expenses.
Medi-assist team suggested to get the re-verification done for the expenses claimed once again with srujana hospital as there is some discrepancies.
But, when i checked with srujana hospital management team, they are confirming on the correct submission of the medical expenses to the medi-assist team.
I am really not sure, where and what kind of discrepancies happened, when going through the details given in the portal for denying the claims.

Requesting medi-assist team to once again re-verify the claim documents and highlight for any issues. Please let me know on the status asap.

Please revert me in case of any further details are required in this context.

Pfb details:

Dedicated id : [protected]@infy
Employee id: 645161


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

Total amount is 79200 (Inr).

Kindly recheck once.

My wife name is [censored]al Sharad Parteki. My wife is pregnant please add the name

Dear Sir/Madam,

I have Submitted all documents for the claim settlement to wards Mediassist but they are not going to pass the claim and intentionally demanding new requirement of documents and doing delay for the process.

As per required documents below original hard copy was submitted to words Mediassist.

1.Employee claim from with all details
2. Hospital Information & registration number with all doctor details
3. Discharge card (original)
4. Investigation report (Spouse pregnancy sonograpy with baby scan image, Baby foot print and hospital delivery report with seal and stamp )
5. All blood report
6. All original medicine bills, Main hospital bill break up, Hospital receipt with sign stamp )
7. Adhar Card & pan card
8. Doctor precipitations

All original documents submitted then also demanding investigation report (Is pregnancy sonograpy is not investigation report ?).

After sending same scan copy then agreed for the same but before that hard copy was submitted which means that cratered unwanted delay.

Again next new additional demanding, they asking for submission of original fee receipt that also i was submitted with stamp and hospital seal and same confirmation was taken from Medi Assist representative, he said ok.

Now next feedback received from medi assist, receipt number is required printed instead of hand written which is intentionally making delay and claim is not going to process.

As per regulation & compliance all things are covered in receipt as an amount receiving proof.

Please find the attached documents for your reference.

Kindly lookout for issue & Help for claim settlement.

Please click on below Link for submission of documents towards Medi-Assist.

https://www.dropbox.com/s/1yt0rgbxy71lw46/medi%20claims%20sakshi%20pawar%20form%...⇄

Mediassist Adders Details:

Himanshu Kukreja,
Medi Assist Insurance TPA Pvt. Ltd.8
B, Second Floor, Tej Building,
Bahadur Shah Zafar Marg, ITO,
Near The Times of India Building
Pin Code-110002, New Delhi

Medi-Assist Contact No.
Manjunath TR-[protected]

Insurer Details:
Emp No: 211056
Emp Name : Ashish Pawar
Policy Holder : Jones Lang Lasalle Property Consultans India Pvt Ltd
MAID : [protected]
Insurer Claim No : TP[protected]
Insurer Member Id : MEMBER13154

My police no. 171600/48/2019/8275 PNB ORIENTAL ( MDI ASSIST)
its writen letter me dr. kanu bhai parmar "

this is to certfy that mansukhbhai b vankar pt is admitted under my care from[protected] to[protected] during admiision pt`s one of diagnosis is accolarated HT` .this is to say that this hypertention is first time detected and PT`s had no such past history"

this is wreetin letter give me to dr kanu bhai parmar " janvi narsing home" gurukul char rasta waghodia road vadodara. so plz sir my claim amt paased early as possible 31, 079/-

Below is the e-mail chain that i have initiated from my end to your team with absolutely no response.
[protected][protected][protected][protected]------
adilla vivek
5:58 PM (8 minutes ago)
to corporateresponse, shivananda.mahadeviah

Hi Team,

Please have the courtesy to at least acknowledge the e-mail that i have been sending.

Thanks,
Vivek Adilla

On Sat, Aug 4, 2018 at 2:54 PM adilla vivek wrote:
Hi,

My name is Vivek, I hold a individual policy numbered [protected]P[protected].

I raised a reimbursement claim numbered 16776850 on 9/4/2018 for Rs 177559 thru the Medi assist office Begumpet, Hyderabad.

Subsequently I was told to submit policy copy and medical reports on 2/5/2018 for which I submitted the documents on 8/5/2018.

I received another mail to submit
Require discharge summaries with investigations pertaining to pulmonary thromboembolism treated 2 yrs prior along with treatment given for COPD.
Require all previous consultation papers.
On 20/6/2018 for which I submitted the documents on 25/6/2018. In this mail sent on 20/6/2018 it was mentioned that the claim will be closed in 10 days if documents are not submitted, but I submitted the documents on 25/6/2018 well before the 10 day deadline.

Then I receive a message on my mobile on 22/6/2018 that the claim has been closed due to non submission of documents just 2 days after the mail was sent from your end.

I enquired with the team in Hyderabad as to how the claim can be closed before the 10 day window expires and they told me that the status is just a temporary and will be reopened as I had submitted the required documents. I was told that it will take 20 days for the claim to be processed, which I took it at face value.

I checked the status of the claim in the first week of July and found that the claim status was still closed, so I visited your Begumpet, Hyderabad office to know what is going on. An associate after going thru the details assured me that the claim will be processed and it will take another 20 days which I unfortunately agreed to.

I checked the status today i.e 4/8/2018 and the status was still closed. I visited your Hyderabad office again and now I am being told to contact the customer care and Bangalore office as this claim is closed. I was told to drop an e-mail to one shivananda mahadeviah to reopen the claim, this is unacceptable. Why should I go around pillar and post to get the claim reopened when the problem is from your end.

Consider this e-mail as a official complaint and take necessary action with regards to the claim.

If the claim cannot be reopened or processed then I would require an official communication in writing as to the reasons for the same, with which I can proceed with other alternative forums for redressal.

Thanks,
Vivek Adilla
[protected]

I Jagdish Chander Bansal Claim no. -. 96687821 not received claim on the basis o[censored]nlogical ground.
I send all documents three times but they still show requirements.
Two months passed to my accident but still I waiting for claim.
Very bad service is provided by customer care officials.
Very bad service by Medi assist India.
Medi ID - [protected]

In an emergency situation i was put in narayan hrudalaya hospital, bangalore. The cashless claim was submitted from hospital after couple of days of my hospitalization date. Mediassist and hospital keep exchanging notes even after the discharge date which put mysef (When i was treated in icu) big trouble. The hospital in their records updated me as released hence no bed, no food, no medicational treatment was provissioned after the discharge time, where as medi assist never paid them hence they did not discharged me practically either. After discussion with company hr, i had to pay the full amount to come out of such troublesome situation. Now mediassist is asking for some papers named icp which supposed to provide by the hospital. By the way hospital is one of their networked hospital. As hospital has not provided me the paper, mediassist declining even to consider the claim as that paper is mandatory. My question to mediassist how patient will get a paper which network hospital supposed to provide. When i tried to reach out to mediassist management, on every occasion i was put on hold and mediassist call center team ensured the call to be terminated after few minute wait.

This is regarding maid # [protected] and claim no.: 17563501 and tracking # h[protected] for my father s k jain.

Please note claim is in in progress status for last 45 days and inspite of all documents received. I have calledn mediassist many time and always told it will be approved in short time. I have also sent emails (Tracking #4647143) there is no response after acknowledge of email inspiste of multiple reminders.

Esclating issue as a next step to you.

Rohit jain
Contact numer: [protected]

Medi assist id 17389366.
My wife had undergone a surgery in a multispeciality hospital in kerala in last june. After which i submitted the relevant documents and bills duly signed by the chief medical officer of the hospital. But they have sanctioned only 50% of my claim amount that i came to know from the meddy buddy mobile application yesterday, with certain lame excuses.
At the time discharge we paid the entire bill to the hospital in which all the break ups are mentioned. But the company asks for separate bills for anesthesia signed by that doctor, nursing charge, lab charge etc... But a team of doctors when a surgery is performed, it is ridiculous to ask this.
I had sent a complaint mail to retailsupport @mediassist india.com, but no reply yet.
Anesthesia charge, nursing charge, ot charge, medicines etc in the bill if the company does not provide to the insurance policy holder, then it is what type of insurance you are providing?

I have submitted a parental insurance claim on 27th july but still i am not getting a proper response from wipro medi assist helpdesk.
I have tried to call the toll free number[protected], but all the lines were engaged always.

Claim no : 96618148
Policy no : [protected]p[protected]

I have enrolled in this policy when i was working with wipro, but now i have been moved out from there, so i can not directly upload the documents in the wipro portal. Hence, i have sent all my documents to bangalore jp nagar office & got the acknowledgement receipt.in that receipt itself all the documents are present & i told them 3 times via mail, but still they are asking for that again and again and not processing the claim. Even i have sent all the details again via mail as well.

My father is suffering for kidney issue... I have raised claim since - march 2018... All the documents they require i have submitted but till today no response... Tpa have no responsibility. Doesnt get feedback. I have submitted may month claim till date i have not get any information on their portal... Poor service. No customer service... I have already escalate this to everyone... If. Any body having tpa like this it will never get benefit of customer service...

Hi Team,

This is regarding a hospitalisation claim which I have submitted in march 2018, but since then they are misguiding me by asking for extra documents and when I have provided them the documents from the hospital they started ignoring my mails and calls .
It's more than 5 months but they never gave me any satisfactory response .
Even when I called on their helpline number multiple times they didn't transferred my calls to the senior persons .
I do have all the mails and recordings in which I asked them to transfer my call but they never did.
Initially they asked for some extra documents which I get on constant follow ups from the hospital and when I have submitted those documents they didn't replied on my mails for several days and later on they come to me with an excuse that we can't process this claim as this belongs to last financial year .
I asked them that it's your fault, you were delaying the process by ignoring my mails and call, I am not responsible for this .
Please look into this .
It's very much unprofessional and intolerable.
I didn't expect this from Medi assist, I never recommend Medi assist and new India assurance to any one .

Dear sir,
as i have taken medical policy from you, i have renewalled my policy before the due date, still now i didnt get my new policy letter from you, sir i am sending old plicy letter & bank pass book in which you can see the amount credited to you that is in the month off march 2018, sir i kindly request you sir to consider our issue and solve the problem

regards
soma premnath goud( advacate )
mahabubnagar
telangana
cell No :[protected]

Please refer to my claim tracking no. Coc00073810 and medi assist id [protected]. As per the india govt postal speed tracking my claim application is received at your kochi office on 0.24.09.2018, but i have been intimated from your office through sms as 07.09.2018. Whenever i had contacted your kochi office through phone [protected], the staff is seen reluctant to give me the status of the processing and even disconnecting the telephone without ready to hear me. I repeatedly asked that lady to give the contact details of manager or any senior officer in charge of claims she had talked very negatively every time. I have of a feel that the behaviour and approach from your office staff is clearly a denial of natural justice to a customer like me who have been took the health insurance policy for a continuous period of 12 years. So it is requested to bestow your personal attention into claim matter and such staffs without any manners may be posted to any other posts having no direct contact with the public, since it will surely affect the reputation of your company.

Thanking you,

Sarath kumar. R
[protected]

My claim number16073413. L request you humbly to give my money. I truly believe in you. L need it very urgent for my loans. I tried it so much but it is not working. I requested it 9 month but you are simply say reasons. I have sent all my details and much more. Please send my money back to me. Say do you have of giving money back to us or not. I hope you reply for my answer