Medi Assist India Complaints & Reviews

This is incidence of reimbursement of my spouse maternity claim.

I have submitted my spouse maternity claim documents towards medi assist for reimbursement as par said in mail by medi assit representative. Below documents i have submitted hard copy by courier towards media assist.

For investigation doc. - original pregnancy sonography report with scan image, hospital delivery report, baby physical birth details...

Sir, i have submitted a claim of rs. 6, 137/ on 18.06.2018 vide claim i. D no. 17222344, of my daughter pre/post hospitalization expenses but till date amount has not been credit in to my account.
It come to notice that claim is with insurance company.

Pl look into and credit the amount at the earliest.

Thanks

Neelam punhani
M/o shivali punhani

I n having membership id [protected] from axis bank employee i'd 152663 in the name kanchan lalwani having group insurance policy holder is axis bank having self policy in the name (Kanchan lalwani) and also request you to provide mmid number. Kindly do the needful as soon as possible...
As i want cashless treatment.
Thanks regards
Mob [protected]

As per the status on mediassist portal, it seems that the claim h[protected]c001 has been denied.

However, i strongly believe and suggest that the claim was very much valid as per the enrolled policy and it has been incorrectly denied.

It was a critical medical condition, where there was a serious forehead injury of my 2 year old son which resulted into a huge blood clot in the affected area (Hematoma in medical terms).
Post that he was advised by the doctors for immediate admission along with suggested ct scan etc.

The ct scan report as well suggested internal skull injury as well.

In such a grave situation, how can mediassist deny this all genuine claim.
Does mediclaim suggest against doctor's advise to keep patient at home and suggest hospitalization in such critical medical conditions as invalid.

When there is an obvious case of serious injury and probability of after effects, how can this be treated as a mere 'day care' condition only.

I have a family floater insurance plan form your company. My wife was. The tpa said that only 1% of sum assured is available for room rent and nursing charges. And tpa deducted all amount of actual expenses (Including operation theater charge) as a proportionate deduction. But as per the policy these expensese are only limited to sum assured.
So i request you to make necessary action to settle my claim
Cashless claim reference number:[protected]
Policy no 442600/48/2018/2051
— oriental insurance thodupuzha

Dear sir/mam,

My claim no[protected] approved on 26/07/2018 but payment was not satled
I well send the mail so many times but not responding tickets number given and also called the customer care he well taling that 10 working day's this was go to 10*3 working day's (In the men's 30 day's) today also called 10 working day's this taling very discussing.. Plz satied amt imaditetly very urgent need for me..

Thanking you,

Harish kunder

Dear team,

I am anil kumar vc and claim id 17703823 submitted through mediassist india pvt limited company which i acquired through corporate company.

I have been diagnosed with eye problem and doctor advised me for an ayurvedic treatment for 15 days. I initially contacted mediassist and they told ayurveda treatment will be covered under insurance. Since the hospital which i took the treatment does not provide cashless facility, i opted for reimbursement. I stay in bangalore and the hospital where the treatment is provided is in kerala. I went to kerala and got hospitalized on 27th july 2018 and got discharged on 10th aug 2018. I had to pay a bill of 42, 275 rupees.

When i returned to bangalore, i submitted my original medical bills and reports. I tracked the claim id through medibuddy and found the claim got rejected mentioning advice require from insurer. I connected with mediassist team and i was shocked to hear that my treatment was a day care treatment and does not require hospitalization. I spoke to the mediassist team supervisor roshna and explained my concerns who offered a call back within 24 hours after getting connected with the concerned team. Roshna did not even mention who would be concerned team and also the department name who she contacts when i asked for (I don’t know why so much to hide). It’s been 5 days now and nobody from mediassist called me. I called the mediassist toll free number[protected] multiple time but in vain. The toll free number is pathethic. It hardly gets connected.

The doctors strictly advised that i should be hospitalized since complete rest to be taken and shouldn’t go outside and avoid dust and sunlight while undergoing treatment. Paying so much of hard earned preminum amount to the insurance company and when there is no benefit does not make any sense. My family is insured with the same insurance company and how do i trust this insurance company. I need to get this sorted out. Please let me know if any details required

Claim id 17703823
Insurer claim no :[protected]c[protected]

Insurer member id :[protected]p[protected]

Regards,
Anil

I have submitted one reimbursement claim through corporate level in mediassist india pvt limited company which is pending to process since 4 months. The claim was submitted on june-2018.
Please refer the following details of my claim no:
Maid Id- [protected]
Claim no[protected]
Insurer claim no- [protected]C[protected]
Insurer member Id- [protected]P[protected]
Incident details:
My Father was admitted to Vivekananda hospital in Lucknow and during diagnosis he was found having CKD and first time DM-II ilness. The patient get released on 11th May 2018. I have applied for reimbursement claim on the month of june 2018. During the processing mediassist company asked for some additional documents which we provided within some time and few days after again they requested to provide doctors clarifications on CKD and DM-II illness since when this started.I had submitted that document also and sent one mail where they requested to submit that. Since then whenever we tried to communicate with the mediassist company regarding the status of the claim, they are very reluctant to give us the reply. They told that we will get the update within 1 week or 2 but we didn't receive any mail communication regarding the claim. I called many times and asked escalation matrix but noone provided and told this will process within 5 days.Today again I received one mail from processing team to submit two more documents now but I had already provided doctors clarifications on that as per their mail .If this document was really reeded then why they not asked earlier.
One more thing I wanted to add that my total claimed amount is around 59k and for that I have already waisted around 20k to go Lucknow from Delhi to arrange documents.Please it's my request to process my claim as soon as possible.

For further reference, some photo evidence are attached.

Hi,

I have submitted 2 claims from a corporate policy which got rejected citing some reasons. And since then i have been requesting to get the original documents back to an address. The claimwas raised on 26th june and the request for documents was raised on 27th july, with ticket number-4282052.
Even after daily followups for 3 months, i have not recieved any response from the team. It was a personal emergency and got no reply despite every call with the customer care numbers and the personal email ids.

Dear team,

Insurance claim denied by medi assist insurance company
Reason: on the perusal of submitted documents claim is for opd bills of holter monitoring. The claim stands denied as per 4.10. Hence we regret for our inability to process the claim.

But as per got policy mail not mention this criteria to denied insurance claim as above reason and also talk with our staff person nikita desai and toll free number and they told condition for claim patient admitted hospital 24 hours and after you will claim and we follow condition but denied..
Request to please help to getting my claim amt due to employee suffering.
Kindly conform for the same.
Claim id[protected].
Emp id -127724 himanshu soni
Hospitalization on date 02/08/2018
Mob no-[protected]

I have submitted one reimbursement claim through corporate level in mediassist india pvt limited company which is pending to process since 4 months. The claim was submitted on june-2018.
Please refer the following details of my claim no:
Maid Id- [protected]
Claim no[protected]
Insurer claim no- [protected]C[protected]
Insurer member Id- [protected]P[protected]
Incident details:
My Father was admitted to Vivekananda hospital in Lucknow and during diagnosis he was found having CKD and first time DM-II ilness. The patient get released on 11th May 2018. I have applied for reimbursement claim on the month of june 2018. During the processing mediassist company asked for some additional documents which we provided within some time and few days after again they requested to provide doctors clarifications on CKD and DM-II illness since when this started.I had submitted that document also and sent one mail where they requested to submit that. Since then whenever we tried to communicate with the mediassist company regarding the status of the claim, they are very reluctant to give us the reply. They told that we will get the update within 1 week or 2 but we didn't receive any mail communication regarding the claim. I called many times and asked escalation matrix but noone provided and told this will process within 5 days.Today again I received one mail from processing team to submit two more documents now but I had already provided doctors clarifications on that as per their mail .If this document was really reeded then why they not asked earlier.
One more thing I wanted to add that my total claimed amount is around 59k and for that I have already waisted around 20k to go Lucknow from Delhi to arrange documents.Please it's my request to process my claim as soon as possible.

My email Id: [protected]@gmail.com

For further reference, some photo evidence are attached.

I have submitted one reimbursement claim through corporate level in mediassist india pvt limited company which was pending for approval for almost 2months 15 days. The claim was submitted on 20-june-2018 in kolkata.

Please refer the following details of my claim no:
Insurer claim id: tp[protected]
Insurer member id: member704256
Total amount claimed: rs.183415

Incident details:
My mother is an artharitis patient and we went to cmcvellore for her treatment. During diagnosis many other problems came up due to which we have to admit her in the hospital. The patient get released on 24th may 2018 from cmc vellore. I have applied for reimbursement claim on the month of june 2018. During the processing mediassist company asked for some additional documents which we provided within one week. Since then whenever we tried to communicate with the mediassist company regarding the status of the claim, they are very reluctant to give us the reply. They told that we will get the update within 1 week or 2 but we didn't receive any mail communication regarding the claim till now. As per the last communication made with the agent of mediassist team, he said that my claim has been forwarded to head office for further opinion.

Desirable solution:
We belong to middle class family and now we are very financially crunched. Please it's my request to approve my claim as soon as possible.

For further reference, some photo evidence are attached.

Team,
I am a tcs employer.
My claim #96626606, has been closed, with an amount total rs. 20000/- not approved mentioning documents not submitted.
Due to emergency was not able to upload docs.
Now the claim is closed.

I do have the necessary documents, and the medibuddy app does not give any option to reopen the claim.

Please help.

Sangeeta mahobia
[protected]

My father mr. P balasubramanian, a senior citizen of 77 years ib being harassed and made to run pillar to post for settlement of his claim raised in march 2018 vide claim o 17392845.

No proper resolutio us being given but the calls res disconnected stating that the claim in settled. We are not even informed regarding the amount of settlement and are asjed to check with our bank.
The statements clearly showing non receipt of the credit have been forwarded but thers is no uodate on the same yet.

Need immediate status update and the reason for the delay and harasssment

Ma id [protected], name : saraswati padhy, odisha. My mother has been hospitalised in Kokila Ben hospital in Mumbai on 31.8.18. The hospital authority has already sent their related papers of treatment to your office. but till date no response has been received from your office for which operation is being delayed. An early response to this case is requested.

My daughter 'Akshata Yadav' admitted and all original documents regarding to it I had given to the Mediassist I followed up many time on mail and finally I got mail regarding to claim has been settled but amount is not received yet.
This is very Pathetic since around two year I am chasing the genuine claim but amount is not received yet.
Please do the needful and Pay the claim amount.

Hi I have Corporate Mediclaim Policy Under Mediassist Policy : 072400/28/17/P1/13199548
Priti Minal
MAID : [protected]
Claim No :17556379

Initially, I went for cashless treatment, and it got Approved by TPA later they denied and asked to do Reimbursement.
All Original Bill and every documents are accurate and submitted to Mediassist.
As i go through company policy Laparoscopy is covered under Mediclaim .
But now they are giving excuse of nature of procedure.
if its due to nature then by they approved in initial cashless and denied and asked to do reimbursement.

Always Health insurance providers intention is to deny claim always.
Even they did'nt asked any query simply send rejection email it really pathetic.

Thanks
Priti Minal

From
St. Thomas hospital
St. Thomas mount
Chennai - 600016
Email: [protected]@gmail.com

Dear sir,
Sub: short settlement of payment in respect of the claim made for
Krishnamurthy, maid no. [protected]
D. O. A: 17.02.2017 d. O. D: 01.03.2017
Claim no. 93662897 – regarding

Ref: 1) our reminder letter dt. 18.11.2017, 13.12.2017, 26.12.2017,
19.01.2018, 17.02.2018, 14.03.2018 & 25.04.2018

Greetings from st. Thomas hospital!

I am writing this letter under great pressure due to the short settlement of the bill related to mr. Krishnamurthy, maid no.[protected] which was claimed as per our letter dt.07.03.2017 for a sum of rs.1, 50, 000/-. But we received rs.1, 04, 679 (Including tds) only. I have spoken to all the concerned office of medi assist about this several times. So far no settlement has been received. Every time i contact the chennai office, i am given to understand that the matter is under active consideration.
A separate letter was also sent to mr. Gandhi – branch manager, chennai.
Till date the short payment has not been settled by the insurance company.
I request you to kindly take step to settle the long pending case and i would appreciate a reply from you in this regards.

Sir,
Your company has sent a mail today regarding submission of documents which we have already submitted. The mails and messages are repeatitive in nature as i have received the same mail thrice already on different dates in 1.5 months. The documents were submitted as soon as we received the first message. The patient is 70+ in age and even after his surgery is going through physical and mental torture by your company.
As per documents required by your company repeatedly i have submitted application stating that original receipts we're not provided to me by the hospital. Only the final bill was given at the time of discharge. The second point mentions original receipt of rs 29000/ - which is a refund by the hospital to us for which the account statements have already been submitted. We also visited ito office on 13th august where it was assured the things are through but again same things are beings asked.
Contact details [protected] ashish puri

Hi,

Am yet to get reimbursement for the approved claim number 17521783. The claim has been approved on 07th august 2018, and payment not released to my bank account. All my followup to your help line does not yield any progress.

Am only getting standard reply from your help desk, that the issue has been escalated to concern team, but progress in status.

Please check and help me to get my reimbursement.

Regards,
Jayashankar
Standard chartered gbs