Medi Assist India Complaints & Reviews

I am writing to inform you that i have been waiting for more than 3 months to get my claim for inr 10640 approved.
My claim number is 15698815 which was raised on 8th november 2017 but to my utter surprise even after 3 months it is still in limbo.

I have called the help desk umpteen number of times but every time i get the same response that things are being looked into.

Please get it approved asap.

Regards,
Madho

My claim id is 95181566 emp i'd (824072)
I had hospitalised my father on 1st nov 2017 and i submitted all original bills in time to madiassist office. Till date my claim is not processed. Every 2nd or 3 rd day i call representative and ask to process claim but they kept pending saying original bills are not there. Representative every time confirm that original bills are there and says today i will process but till date not processed.

My tracking number:h[protected] & claim no: 15886277. I have submitted my claim on 24th november 2017 for 32, 949 (Inr) for my father. They approved for only rs.21, 057 and remaining rs.9053 will be reprocessed based on break up bills for medicine. After that i have submitted my father medicine bill hard copy on 11th january 2018 and yet there is no response from medi assist end. I have called customer care number for this claim process alone more than 10 times. Most of the times they wont pick the call or say it will be processed. Also i have sent email more than 15 times with hard copy and with query. But no response for this medicine bill amount. Such a worst insurance process.

Hi team,

I am a dboi employee with id 8386364.

I am waiting at billing section in imax hospital, wagholi, pune to get the claim bill for discharge.

This claim is against my dependent - son

Claim no[protected]

Let me know current status. I was told 1:30 hrs before that the approval will be done in next two hours.

Please let me know the status and the reason of the delay in approval.

Let me know the escalation point contact number

Claim no. 95509121
Issue - claim was raised for my dad's stroke when he was admitted to the apollo hospitals chennai on 3rd feb'18 at 9:22 pm.
Claim raised on monday 5th feb'18 through apollo mediclaim deptt.
Medi assist insisted to be provided details of actine line of treatment, medication, running bill which was provided by mediclaim deptt. Of apoloo hospitals greams raod, chennai on 5th feb'18.
Medi assist hasn't provided any approval stating such cases cannot be approved. I (Anirban talukdar - wipro employee) spoke to them 5 times on 6th feb'18 and twice on 7th feb'18 begging them to consider the case and put me through their management or doctor assessing this case. I spoke to the consulting neurologist dr. Dhanaraj m and he said that he is happy to speak to anyone from medi assist. He also said that he has done the required test and given the medication as after a stroke next 72 hours is critical and hospitalisation is must for case and monitoring.

I am failing to understand why i pay so 50k inr premium every year when such pathetic service is provided. This is not the first time that i have experienced this as it possibly is the 3rd time in last 3 years.

Need medi assist to take ownership and i am happy to file a case in court if i donot get a proper resolution.

We refer to your hospitalisation claim vide our ref # 16243550 please find attached claim approval advice for the hospitalization at dhirubhai aoh and family welfare centre for the date of admission: 10-jan-2018 with claimed amount of rs.8004.

At the time of submitting the claim insurance person told x ray film will show when ask. It is available with me. I will hand over and show if you need. Now they deducted rs. 390 from approved bill which is not acceptable.

Jeevan Hospital is empanelled with Mediassist for cashless services. Even after getting the preauth and approval they are yet to release the due amount for the past one & half year. Our repeated complaints have gone in vain. Our calls to the claims Department personel Viz Arpitha & Mahadevi are being cut repeatedly. Whom to contact now. We posted a mail which gave us a ticket No 30774258 and claimed that we would get a response within 1 working day. It has been 10 days now no reply or response. Our hospital has tied up with companies like Religare and Star Health. Nowhere we have had such a horrible experience.

I am wipro employee and i have submitted the claim documents to mediassist and received the claim number on 31st jan 2018. But have not received any communication regarding claim number so far. I am unable to track the status since i have not yet been provided with claim number. Even after sending couple of mails to mediassist they are not responding to any single mail.

Claim no. 15970073
Vijaya bank telgaon branch.
Insured name : ashok bhanudas lolge
Employee name : ganesh ashok lolge
Employee code : 25553

I have submitted claim 43days before. After he required another document, i had also provide this document via medibuddy app & mail and hard copy sent to nandan courier consignment no[protected]. He received courier at jan 10 2018 2:54pm.
Then telephonic conversation he told claim will be settle within 10days.
So till date claim will not be approved.

My wife medi assist id is [protected].
My employer has covered insurance for my family.
Claim no is 15931176.

Though the hospital who treated my wife for multiple sclerosis through ayurveda says that hospitalization is required, mediassit says below
"on perusal of the claim documents submitted, this claim pertains to admission of mrs. Aruna varadharajan to arya vaidya sala, admitted with a complaints of pain, heaviness and generalised weakness, treated with khizhi, pizhichil, dhara procedures (Ayurveda treatment). The procedure under gone is a op day care procedure and does not warrant inpatient admission. This procedure is also not a listed day care procedure. Hence, we regret to inform you that this claim stands denied"

And is denying claim and no there is no response from them to the claim submitted on dec 7th.

As a customer i feel not convinced on the denial and the policy from the insurer says that ayurveda claim is covered

My claim is show settled in your system on 6th jan but the amount is not credited in my bank. You also confirm that it issue of nic its happen on 12th jan but still i'm waiting for my claim amount. I drop the many emails and also call much time on customer care but not received any satisfying answer till the time plz let me know that how much time you have need for settled my claim because i'm waiting for last 3 month.

Claim id: 15841116

Claim id: 15841116
Claim amount: rs.73344/-
Approved amount: rs.73344/-
Admission date: 07-nov-2017
Claim received to date: 02-dec-2017
Claim denied date: -
Claim type: reimbursement
Pre-authorized amount: 73344/-
Claim status: payment settled
Discharge date: 15-nov-2017
Claim approved to date: 09-dec-2017
Hospital name: dharmdeep hospital


Best regards,

Punit patel
[protected]

As i fill this form, i am still struggling with my husband’s claim no. 15974632.

To start with, mediassist miserably fails at reverting to its customers. No one picks up phone at their call center (You are permanently on call wait). My personal record on hold with them is 1 hour 52 min. Number of emails i have sent to their email addresses goes unanswered 99 out of 100 times. That one time out of 100 if they feel like reverting, they only reiterate their point, instead of answering my query.

On 22 dec 2017, i sent them a pack full of documents pertaining to this claim 15974632. As i had a previous experience with them on a past claim, i sent them every single piece of document i could possibly produce at my end or from the hospital. Same day, they sent me a sms claiming that they have received the papers.

List of documents sent to them on 22 dec 2017:

-claim form
-indoor case papers - integrated care plan sheet, nursing sheet, fact sheet
-etiology of the ailment – doctor’s prescription suggesting the surgery, admission & discharge summary all clearly stating the cause, set of causes or manner of causation of my husband’s condition
-all x-rays (Pre & post)
-all bills in original
-complete medical report & medicine bills
-photocopy of mediassist policy

However, on 18 jan 2018, they came back to me asking for:

-indoor case papers : already submitted on 22 dec 17

-etiology of the ailment : already submitted on 22 dec 17

-valid reason for delay in submission : emailed them my son’s wedding card. This wedding was already planned since 1 year & i was the only one to do everything as husband was bedridden.

-all previous consultation papers & investigation reports : here they are referring to my old approved & paid claim no. 15230604. Every single shred of paper for that claim was submitted to them in original. Is it not the reason that they had approved it? Then, how do they expect me to produce the same papers again.

-condonation letter from the insurance company : i have googled this word and asked everyone i possible could but i do not really understand it. All i know is that mediassist is my insurance company. So, they should know what condonation letter they are talking about.

Their phone numbers [protected], [protected] are permanently on wait. On their email addresses - [protected]@mediassistindia.com, [protected]@mediassistindia.com, [protected]@mediassistindia.com, kanika. [protected]@mediassistindia.com either no one ever reverts. And if in one odd case, when someone did, they only kept repeating what they wanted, instead of acknowledging and reading what i am trying to say.

They also have an office in ito new delhi, which is 45km from my home and i am a 61 years old woman with a bedridden husband of 65 years. Still i managed to go to them in person. When i visited that so called office, their representative kanika claimed that they are sitting there only and only to receive and forward documents sent from clients to mediassist or vice versa. Therefore, all she could do was provide me with her email address to which she doesn’t answer, no phone number and no help!!!

I have provided them with all i had. What else should i do, i don’t understand. This harassment is never ending & taxing me and my husband our health, our peace of mind, our money and our comfort.

I had submitted my reimbursement claim papers in the new india assurance co. Ltd, 's pune d o iv office on 24/12/2017. I got claim intimation no 202042 on 26/12/2017 & confirmation of receipt of papers on email vide tracking id pun00023977 on 04/01/2018. But afterwards i am not in receipt of any further communication regarding approval / dis approval or any further information required by you till date. Kindly let me know my status of claim as early as possible on my emial id [protected]@gmail.com

We have claim id 16001929. Name - mansukh shivchand shah. As per requirement of medi assist office at ahmedabad, gujarat regarding our claim, we have already submitted our documents viz. Bank passbook copy and blank cheque by mail on 3.1.2018.
We have also talked about receipt of the same with mr. Vijay parmar. He has told that your records will be updated within a week.
But again on 13th jan 2018, we have received a message that the documents is pending to submit. Again we have sent the documents through madhur courier on 15.01.2018 and confirmed about receipt of the documents which they have received on 16.1.2018.
But still our status found that information awaited. So even we have submitted our documents on 3.1.2018 and confirmed with them about its receipt, till 23.1.2018, they have not forwarded the file.
Also answer of mr. Mihir bhatt also not satisfactory.

Hello team

It is more than 2 months i am not getting status for my claim. Can you please prioritize my claim process

All verification has been done but still i am struggling for my money.

Claim number

Claim of : monika monika
Date of admission : oct 29, 2017
Claim ref no : 16132858
Insurer claim no :
Insurer member id : [protected]
Claimed amount : rs. 33216
Hospital name : care and cure hospital

Claim no. 95303556
Corporate policy
Tpa id : [protected]

Worst experience with mediassist. Think before enrollment
They have denied my mothers hospitalization claim saying illness is pre-existing (They dont do any pre-medical tests before enrollment) and enrollment is within 1 yr (Apr 2017). Ive informed them multiple times that treatment was for obstruction which cannot be pre-existing this was confirmed by doctor who operated my mother.
Now they are saying as per their policy only critical illness are covered for new enrollments.
Ive called helpdesk on admission day and representative didnt asked for any details just told me to submit the documents after discharge within 90 days.
Ive paid 1 lakh 50 thousands for treatment in mediassist network hospital, which is not easy to recover.

Hi,

I am trying for the past 15days via mail/calls/customer care and so on. but no use/update.

When i login to my mediassist account in mediassist website, I don't see my renewed current year policy.

Current year policy : National Insurance - Baroda Health Plan
Policy Number :[protected]

We request you to please review the same and provide the timely help.


Thanks.

I have had medical insurance since 2016 but have not been provided with the cards. I had submitted mine and my wife's photographs last year but have not been issued with the cards till date.
Would request early action and issue cards at the earliest. Kindly advise if there is another site i have to register my complaint. Please advise i need to provide any other information.

Patient was admitted in max hospital noida and hospital raised the cashless but cashless was not approved then attendant paid self. After 3 hours of discharging, got the approval. Patient raised the reimbursement. Reimbursement was stuck due to previous claim. Max hospital already sent the cancellation letter for that claim but mediassist didn't cancel. I already call 100 times regarding the same they always said it would cancel within 30...

Dear team,
For the above claim id, i have submitted all the necessary details which ever i had and possible by me.

Background: my father met with a road accident 17th april 2017 and expired on 18th april 2017, i have given the explanatory note along with the bills, death report and other documents we had.

During the chaos situation we lost the original bill from the hospital. But we got a duplicate copy and submitted the same.

But still this claim is kept open asking for more documents like explanatory from the hospital, accident record from the hospital and so on, which is not required and is not possible to get.

I have claimed for the amount for which we have paid. I did not produce any false claim.

I have claimed with what ever documents. I had given details of hospital and what has happened.

It is your responsible to cross verify with hospital and clear the claim.

Blindly depending for a document is don't going to help anyone.

Anyone can make colorful documents as you required and submit to please you, for false claims. But as an insurance company justification is needed.

It is not the matter of money alone. Their should be some reasonable and sensible approach as well.