Medi Assist India Complaints & Reviews

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.

Hi,

I have raised a claim in for reimbursement in october 10th. It took more than 2 months to respond back on this claim from mediassit. Post that i was chasing them though calls and mails to know the status of the claim.

But the customer care representatives are dont have basis understanding of english. They are very poor in understanding the customer problem statement. Some times they cut the call and they are very rude in giving the reply to the customer as if they are doing a favor to us.

After 3 months i got a mail saying to give the justification for delay in processing / submitting the claim. I was wonder on why should i give the justification if the delay is from their end. Ispite i give the true reason explaining the whole scenario.

After few days they closed the claim saying there is a delay in submitting the claim.

1) baby was discharged on 28th june 2017.
2) i was waiting for hr approval to get the baby details to be updated in the system.
3) on 10th october, i submitted the claim after baby details been updated in the system here in biocon.
4) on 12th october i submitted the hard copies to mediassit representative in biocon campus and asked for any other additional documetns. He said mediaast will come back if any documents required further.
5) i was following up with mediassit till 20th november to get it processed and also explained the issue through mails and calls on why it is not yet processed. (As i got an update from mediassit stating, some technical issues in processing the claim.). Please refer the attached mail for your reference.
6) on 24th november i received the mail stating mediassit processing the claim.
7) 0n 30th november i received a mail to submit few more additional documents, which i have submitted within 10 days post i received the mail.
8) on 12th i received a mail again stating to clarify why the submission got delayed. Please refer the above steps the reason why the claim documents submitting got delayed.
9) till date am following up for the update. But no proper response from the mediasst.
10) on 16th jan 2018, i got a communication saying they closed the claim due to delay in submitting. But there is no delay from my end. Delay was from mediassit side.

Requesting you to take the necessary action on mediassit on this issue.

Claim number:15873403

Best regards,

My father admitted in arvind eye hospital for glaucoma on 8/1/18 and yag laser done on 9/1/18 then vitrectomy done on 11/1/18. Mail sent from hospital for 20000 but claimed for 10000 only. I paid the balance amount n discharged on 12/1/18. When i called customer care they said partial amount being sent, i didn't receive message like this n insurance people in hospital also didn't mention like this. Kindly do the needful at earliest to claim my amount.

Hi, claim id 14557121 cash less claim for cataract operation done in the month of may 2017 but till date payment not settled.
Kindly raise an issue on priority.
Since last seven months i am in follow up with company but no use they are not able to provide payment details.
Claim raised by hospital was rs.33000 but they have approved only 16170 what about the remaining funds.
Hospital is in continuous follow-up for the payment and asking me to pay the bill in cash.

I have undergo the reason of denial. But i am completely dissatisfied with the denial reason. I need to know the following

1. Why 'leukoplakia excision' is not being considered as treatment? 'leukoplakia' can increase risk of oral cancer if it is left unattended. If it's not a disease as per the policy then let me know why and send the list of diseases which are covered under my current policy.

2. Before i admitted for surgery, i have approval for cashless claim[protected] for inr (30000). After approval only the admission and surgery happened. At the time of discharge i come to know that cashless claim has been denied. If 'leukoplakia excision' is not covered then how come it got pre-approved first time?

Please help to understand the points asap.

Hi sir/mam,

We have admitted our baby in rainbow hospital and opted for mediassist cashless claim. At the time of claim approval, mou discount was not given for the claim no#[protected]B/o asha, baby boy) as per irdai regulation. We have waited for 3 long days to get the discount from mediassist with no luck.

Benefit of discount should be passed on to the patient as per irdai regulations.

Please do the needful asap.

Claim no -
16006808, query of late submission although lt is not too late and reason of late submission also inform to tpa through mail. And seeking of orginal documents - i have been submitted all orginal documents except discharge certificate as it is vital for our future.in that case attested copy also submitted even i have been submitted declaration for submission of attested copy of discharge certificate instead of orginal. Lots mail alreay send to mediassist but no improvement showing in my claim status.

15563028 it is my claim i'd what ever documents you asked i provided by 18/12/2017 through bluedart courier pod no [protected]. Again you are asking for some all most same set of documents how can i approach the doctor these many times my claim was for the month of august 2017. I provided the all set of required documents please help in rembersment of the bill amount19037 rupees