Medi Assist India Complaints & Reviews

This is with reference with Claim number[protected] of Vijay Kumar Duggal submitted to Medi Assist by Ruby Hall, Wanowrie, Pune.

Initially the amount of Rs. 72294 was authorized by Medi Assist which was worked out based on my Mediclaim policy authorization of room rent and the cost of Procedure.

Since I took a private room the final bill amount was Rs. 103638.

I should have paid the difference between the initial authorization of Rs. 72294 and total amount of Rs. 103638 with a small variation.

However, I was shocked to find out during the final settlement that the authorized amount was reduced by a whooping Rs. 21562.

I am a 66 year old policy holder who submitted the very first claim in 15 years and I am totally disappointed in the way this claim has been handled.

Myself swapnil r. Bhatulkar employee of bank of india. I have submitted my new born baby medical claim in the month of mar;2018 though our vidarbha zonal office to medibuddy which is delivered to medibuddy on 19th mar;2018 (Claim id:[protected] after 1month i. E. On 30 apr;2018 i received mail from medibuddy that your claim has been cancelled because of your dependent name not updated in their system. I have already added dependent name in our boi hrms in the month apr;2018 and pdc send many times from the month may;2018. I sent mail many times regarding claims approval but always got a answer that your dependent name not added in our system plz contact your ho hrms, i have contacted our ho hrms regarding this issue but they told me that your details are already send to insurance company and this cycle rotates from last 4 months now i am very disappointed & frustated by your service which is given to me from last 4months. (I have mailed many times from 15may;2018 but till date claim is not sanctioned and issue is same) god knows when it will be done. I am psu employee but also get this treatment what is the situation of normal customer of your company. I am requesting you to look into this matter and provide a valid solution. I have lot of hopes from your side.

Myself swapnil r. Bhatulkar employee of bank of india. I have submitted my new born baby medical claim in the month of mar;2018 though our vidarbha zonal office to medibuddy which is delivered to medibuddy on 19th mar;2018 (Claim id:[protected] after 1month i. E. On 30 apr;2018 i received mail from medibuddy that your claim has been cancelled because of your dependent name not updated in their system. I have already added dependent name in our boi hrms in the month apr;2018 and pdc send many times from the month may;2018. I sent mail many times regarding claims approval but always got a answer that your dependent name not added in our system plz contact your ho hrms, i have contacted our ho hrms regarding this issue but they told me that your details are already send to insurance company and this cycle rotates from last 4 months now i am very disappointed & frustated by your service which is given to me from last 4months. (I have mailed many times from 15may;2018 but till date claim is not sanctioned and issue is same) god knows when it will be done. I am psu employee but also get this treatment what is the situation of normal customer of your company. I am requesting you to look into this matter and provide a valid solution. I have lot of hopes from your side.

Hi,

I have applied for reimbursement of my fathers hospital bill, on[protected].
Policy # 421100/48/2019-183
Insurance company - the oriental insurance co. Ltd.
Insurer claim id 421100/48/2019/004456
Claim # 17226946.
Patient name - ravasab jayagoud.

The claim not yet settled, its keep on postponing, from june -2018 onward,
They are not responding, keep on saying the same reason (Technical issue) from long time, they keep on postponing the commit date.

Please find the attached snapshot of the progress report and the communication i've done with insurer.

Applied for cashless claim and was rejected saying that cellulitis doest not lie under the critical condition so it is under one year waiting period.

As my father was admitted in emergency and was admitted in emergency for 4 hrs before shifted to wards. His condition was so critical that he his infection was growing high with severe pain and was told to be treated in emergency other wise it need to surgery of left leg and mediassist declined this claim saying non critical.

I think critical case would be the patient who died during claim...

This is purely cheat and will fight for it using consumer court.

Claim no 96558645

I have submitted claim of rs.12940 in respect of domicillary treatment of my wife suffering from arthites. However a sum of rs.1500 not approved towards physiotherapy whereas a have duly submitted bill and receipt of physiotherapist in this regard.
I therefore request you to recheck the bill and arrange to settle the same for full claim amount of rs.12940.
Devendra garg ec no.45077
Asstt. General manager
Bank of baroda
Patna main br
[protected]
[protected]


Complaint status
[aug 01, 2018]
Medi assist india customer support has been notified about the posted complaint.
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Ref:Policy no. 144000/48/2018/32876
PORTAL REF: DEAID/E/2018/01808
Mediassist Claim Id: 17022791

Dear Sir,
This is with reference to the above mentioned claim.
Checking with Medi Assist I was made to understand that the case has gone for investigation on 31st July 2018. I would like to highlight some of the Facts.

1. Claim was filed on 18th May 2018. On 25th May 2018 it went for investigation. After continous follow up on 11th July 2018 they raised 2 point query.The same were submitted on 11th july 2018. Receipt attached.
2, Again on 19th They raised 11 querry. Out of 11 query 2 were already the same as were raised on 11 th july and others related to the policy were answered on 23rd july.Receipt attached.

Medi assist for the past 2 months are coming with same ans as its under process.
I fail to understand that when the case was for investigation for 2 month again why has the same gone again.Its already 3 months now and it should be settled or denied for further action from our end.

I am 74 years of age and have been asked by Medi asssist to submit claim form twice with hospital signature in orignal. I at this age cannot run around for this. When all the documents required by the authorities are submitted they should come up with a answer of aprroval/denial for further actions from my end.

I request you to please look into the matter urgently.

Regards

Kirit C Shah
[protected]

Intimation id: 10632496
Treatment for: rupali kailas kute
Medi assist id: [protected]
Ailment description: maleria fever
Date of admission:[protected]
Hospital details: jeevanjyot hospital, satpur, nashik - trambak road, nashik, nashik, maharashtra
Contact details: [protected]. Nearly two months are going out but still they not given any pendings or not giving claim amount.

I have submitted claim of rs.12940 in respect of domicillary treatment of my wife suffering from arthites. However a sum of rs.1500 not approved towards physiotherapy whereas a have duly submitted bill and receipt of physiotherapist in this regard.
I therefore request you to recheck the bill and arrange to settle the same for full claim amount of rs.12940.
Devendra garg ec no.45077
Asstt. General manager
Bank of baroda
Patna main br
[protected]
[protected]

I have policy issued through my company. My claim was rejected during nov 2017.
Later called several times from company and personally asking to return the bills. But repeated calls and emails nothing worked and not it is aug 2018 and still not the bills are not received by me. Every phone call will take to 8-10 mins to get them to talk. I was never allowed to talk to the manager and every time it was addressed as a new complaint.

Tpa rejected my claim[protected] without any any reason. I submitted all the originals to the company, and tpa received on 06/07/2018. Ma id no. [protected] /[protected]. Also i sent a letter from jubilee mission hospital, trichur, conforming that i have not utilized any cash less facility during hospitalization.
Iam a legitimate policy holder and have to know the reason why the claim is rejected.

Dear sir my son treatment already ok then why my son not discharge tuday. Your confirmation discharge message give mi tomorrow. Please give me a confirmation message just. Please. Paisant name. Shreyas satish kale claims no claim no 96485806 for kale shreyash satish. For inr 10000 is authorized for cashless. The total authorization as on date is inr 10000 for hospitalization between jul 25, 2018 and jul 29, 2018 at shree hospital, baramati. Use link https://mbudy.in/tegfhn0 to track your claim details. Sign into medibuddy https://mbudy.in/emdtf7t for complete
Access to your health benefits.

I was working with cipla ltd and had mediclaim policy with new india assurance (Tpa - mediassist india). My mother had gone cataract operation and i have claimed for reimbursement for the same.. Since, jan 2018 i've mailed several times but only i get revert as we are working on it and no major action has been taken.. This is highly outrageous as mr. Khalid from mediassist is not responding and receiving my phone calls.

It is noticed that an amount of rs.23, 479/- has been deducted from total bill, indicating prorata basis and i had paid the same to hospital at the time of discharge.
I do not understand the reason for such deduction. Such huge deduction put me in an embarrassing position and in such cases the purpose of mediclaim policy is defeated.
My email id: padmanabhan. [protected]@adityabirla.com

With above reference, i (Mr. Maya dutt joshi) pf no. Mj178844 has a reimbursement claim of my daughter miss aahana joshi of amount rs 41, 825/- which had been approved on[protected] and the amount is pending and not credited into my account. It had already taken 4 month from the approval date. And the following details as given below

Client name : bank of india
Policy number : [protected]p[protected]
Employee number : 178844
Employee department : roorkee
Employee name : mayadutt joshi
Patient name : ahaana joshi
Dhs id : da[protected]
Claim no : dhs17y008782

Please do needful as soon as possible

Raised a claim 96197007 and then mediassist asked several documents. I provided all the documents that includes a doctor letter stating the root cause of the infection. Doctor clearly mentioned that "root cause? Local infection".
After 2 months of investigation mediassist rejecting claim stating that diabetic foot and giving wrong statement like "patient taking treatment since 2014 and submit original documents". They did not mention that where did they find this information and how can i submit those papers?

Persons:
Padmavathi. [protected]@medibuddy.in
Anurag. [protected]@medibuddy.in

I h ave submitted my claim document on 5th of june, i am getting tracking no on 8th june as - mum00168..., but still my claim no is not generated. Its almost 2 month, i called so many times to customer care they told me we will escalate this with escalation no 4775922, 20 days ago, but still no one giving me response. Every time they tell me give us 3 days claim no will be generated. But actually its not happens. Let me know where i can escalate...

Maid no [protected]

We have submitted our papers for claims on 11th june 2018, after continue follow up for claim of one month have not got any resolution yet..
We are calling on medi asssist number also.. But no one is bothered over there on call... The service is so pathetic..
Need the claim money as soon as possible..
Policy we brought form kvo seva samaj sanjeevani.

My claim ID is 16653730, bill is pending since feb 2018(screenshot is attached)
Only due to a reciept of Rs. 8500/- which was not issued by the hospital because we didnot deposited any money in advance, but full payment was made at the time of discharge, and hospital issued BILL for the payment.

What is the mistake from our side, if we don't had the reciept. Please do the needful.

I am Alakesh Chakravarty, working in TechM, Bangalore (Member Id.- 25522). Let me elaborate this situation and I request you to treat this a Highest level of Escalation.

14.05.2018 - Visited FORTIS Hospitals, Bannerghatta Road. My wife was advised to undergo surgery for “Laparascopic Bi Lateral Hernia Repair” immediately.
14.05.2018 - Received the estimation Sheet for approx. 2 lakh for the surgery plus other charges of 38K.
15.05.2018 - Contacted my colleagues/friends and decided not to choose Fortis for the surgery.
15.05.2018 - Written to Medi Assist team sitting in TechM premise, asking for the Insurance limit of Hernia surgery but none responded to my mail. They have created a ticket number : 3783719 but no action was taken as if a generated ticket will resolve their issues. Pathetic!!
17.05.2018 (06:30 a.m.) - Admitted my wife in Q-Medical Center, Dickenson Road, Bangalore-560042 for the surgery and surgery was done by Dr. Shabeer Ahmed M.S., F.R.C.S., MMAS.

Final Diagnosis : BI LATERAL HERNIA (Bilateral TEP)
Description : LAPARASCOPIC BI LATERAL HERNIA REPAIR
Chief Complaints : Lump on both groins for the duration of one month.

18.05.2018 - My wife was discharged on this day.

Payment through cheque -
Rs. 90, 000/- was paid for the surgery of Bi lateral Hernia Repair.
Rs. 25, 000/- was paid for Laparascopic Tubectomy.

14.06.2018 - Submitted ALL ORIGINAL documents to Mr. Prem. from Medi Assist sitting in TechM premise in E-City. All old recoreds of my wife, all documents related to Surgery from Q Medical center, all Pre-Hospitalization Bills, Hospitalization Bills, Post-Hospitalization Bills. I was given a Claim Reference No. 17198467.

09.07.2018 - I was asked for few more documents, whereas I was looking for the settlement amount to be paid to me. Received those documents from Q Medical center on 15.07.2018 to Mr. Prem from medi Assist sitting in TechM E-City.

18.07.2018 - Received the SURPRISED mail from Medi Assist with Subject: Approval for Claim Reference:CCN# 17198467 under policy# 021700/28/17/P1/19045393.
Approved Amount : Rs 60000 from Amount Claimed : Rs 134431.

This is something I never expected. Your team said there is a fixed rate for Hernia operation which is Rs. 60K in my case. WHY? WHO fixed this rate in Medi Assist? Is this rate fixed by a Doctor or by a Clerk? Why I was not informed by the Medi Assist guys when I enquired them about the Hernia surgery coverage? I have chosen to go for Q Medical center because Fortis was quoting me much higher. I was not given the Pre-Hospitalization and Post-Hospitalization Medical bills saying my slab was already reached 60K.

Would you send back all the ORIGINAL Medical bills, Medical reports of my wife which were not been considered for the claim immediately to me? If Pre and Post medical expenses are not payable, then WHY did you guys collect all the medical bills/medical reports from me?

Representatives from Medi Assist sitting in TechM premise here in B’lore E-City was not aware of your 60K limit for Hernia surgery? In that case, only surgery report would have sufficed for this 60K.

Terrible experience with Medi Assist. I would surely like to get your “rule book” to see your policies when it comes to Settling the Payment to the Policy Holders.

You can ask your Medi Assist team sitting in TechM premises for the mails I had been sending to them after receiving the settlement letter.

I understand that this Escalating to Medi Assist about their poor payment settlement...! Also, I know What would be the outcome of my escalation...

Thanks - Alakesh/Tech Mahindra