Medi Assist India Complaints & Reviews

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

Claim settlement of claim no17477603 date of discharge : 07/07/2018

I have a national insurance company name : chandubhai savajibhai malaviya, i taken a treatment in smt. R. B. Shah mahavir super sp. Hospital, surat. I have submitted necessary documents.

Please consider the above matter and settle the claim as earlier as possible

Contact no.[protected]

I have made a reimbursement claim and submitted all the original bills and other documents provided by hospital. They asked for few other additional documents which i have submitted. Now again they have asked me to submit twb - original invoice or sticker. Tbw means tension band wiring and it is a procedure name and not the name of implant. So, how can i get the original invoice and sticker for it.. The wire that is used for my surgery is just a 93 rupees stainless steel wire and no invoice or sticker exists for it. It's clearly mentioned in the discharge summary that tbw is the procedure and there is no other implant cost mentioned in the pharmacy bills. I am telling this to the customer care service people from past one week and the response i get is that it is a mandatory document.. It is completely senseless to ask for something which doesn't exist. Mediassist doesn't go through the documents and just sends the unnecessary requirements list.

Iam j siva sankar my claim no 18126963
After 10000 free approval after treatment given doctor total amount applied after my clim denied that details i will sumit

(This is approval messege medi assist india pvt ltd)

{claim no 18126963 for j siva sankar of inr 10000 for policy issued by united india insurance co. Ltd is authorized for cashless on 21 oct 2018 16:43:47 the total authorization as on date is inr 10000 for hospitalization between oct 21, 2018 and oct 22, 2018 at aashritha hospital, hyderabad. Use link https://mbudy.in/uhlsx6c to track your claim details. Sign into medibuddy https://mbudy.in/emdtf7t for complete access to your health benefits.}

This is after teratment total bill applied
After message

{enhancement request of inr 54049 has been denied. However, your cashless claim 18126963 stands authorized for inr 0. Use link https://mbudy.in/uhlsx6c to track your claim and reasons for denial. Download the medibuddy app https://mbudy.in/emdtf7t to know more about your policy. Please do proceed with hospitalization as advised by your medical team.}

Starting mediassit approval not given means doctor treatment not given. When i have money that time i will join hospital

My wife smt. Shibani sen was admitted to mittal hospial for the operation of overian cancer by dr. Mau roy on 11th july 2018. But she had to transfer to mmi narayana hospital on 12h july as she was collapsed after giving anesthesia before doing the operation. Tpa at mittal hospital refused the claim and i had to pay the hospital charges by cash. Then i applied for the reimbursement of hospitalisation at medi assist indore. My claim was rs. 43, 068.00. Medi assist indore sanctioned only rs. 16, 104. Saying that the remaining amount could not be paid as the amount in the policy exhausted. Now my policy no. 191200/48/2018/1475 expired on 23rd july 2018, and the new policy no.191200/48/2019/1440 started from 24th july 2018, so there is no gap in between the two policies. So, i would request you to kindly pay the retaintion amount of rs. 24, 948.00 in this policy no.191200/48/2019/1440 as both the policies are in continuation and oblige. My claim id and claim no. Are as above.

My reimbursement claim i'd 96980223
Insurer name - mohini pillai
Insurer claim i'd - tp[protected]
Claimed amount was rs 64752
Approved amount was rs 35000

Rs 1702 was deducted towards non payable drugs
Rs 28050 is deducted towards excess of defined / aliment limit
Brief reason - as per ppn tarriff package / 10% deduction for non utilisation of cashless/ inclusing 10% sterilisation

This is ridiculous and makes unhappy. How do a common man would know hospital tarriff and deduction on sterilisation.

We dont cheat insurance company however this type of deductions makes the customer dissatisfied. I need my funds to be reimbursed otherwise would file a case on consumer forum.

My phone no. [protected]
Email id - [protected]@gmail.com
Office id - mohini. [protected]@tcs.com

My mother had been treated with a laparoscopy operation for removal of lymph on her liver in jehangir hospital pune and the same was covered through mediassist which was the tpa. There was a claim i had made of rs. 11, 500 which was paid to jehangir for conducting an opinion on the lymph that was removed and was done after my mother had been discharged from the hospital and which was thus not covered under the cashless. So i had raised it under post hospitalization claim which was allowed as per their policy. I had received numerous queries from them relating to the claims for which i had provided all the relevant documents and bills in hardcopy to them. After 3 months of continuous follow ups the company rejected the claim on the grounds that details of the expense are not available. I have written a mail to the company on the same and they are not providing any response on the same.

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.