Medi Assist India Complaints & Reviews

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

We have filed mediclaim as on 13/06/2017 which has been settled down without considerations of our pharmacy bills as well as laboratory bills. On raising up the issue with them, advised to send set of xerox copies to re-considered the same.
As on 20/07/2017, we have submitted & received at medi assist india (Ahmedabad office) through maruti currier vide docet no.[protected].

I have followed up on their help line no. [protected] as per below details (I have recorded calls for it)

As on 15/07/2017, 21/10/2017 with ms. Sneha
As on 25/10/2017 with mr. Abhishek,
As on 31/10/2017 with mr. Joshi,
As on 28/11/2017 with mr. Abhishek,
As on 09/12/2017 with mr. Shaiyad & ms. Suguna,
As on 25/12/2017 with mr. Sagar &
As on 29/12/2017 with mr. Sandeep

Even demanded for their higher ups but did not allowed.

Insurance policy ref: 310300/48/16/[protected]
Insurance company: national insurance company limited
3rd floor, dr. Indumati patel trust building, opp. Aradhana cinema, vadodara, gujarat, 390001
[protected], 2426774
Ins. Claim ref.: 14678947
Request for updation of correct data: 1749129

Tpa: medi assist india tpa pvt. Ltd.
403, silverline complex, opp. Bbc tower, sayajiganj, vadodara 390005, gujarat

Hi,
My father expired in hospital itself, so they issued discharge summary which i had to submit original in burning ghat to release the body. Then burning ghat issues me a certificate which i had to submit municipal corporation to get my father's death certificate. While claiming in mediassist, i had sbmitted xerox copies of discharge certificate and death certificate but they are expecting me to provide original discharge summary which i do not have now. I went to hospital and they clearly clarified me that this is the cerificate we wil issue which all mediclaim company should accept as a xerox copy.
As a widow, my mother needs money to survive her rest of life without her husband. She does not have any pension.
Can you please help me on this? I need money for my widow mother..

I applied reimbursement claim no 15950362 of amount rs 52118/ on dated 19/12/17. As per link given by sms for check status of my claim i check then i came to know that in my claim rs 6777 total amount is not approved and remaining amount of rs 45341 is under process. So i want to know why and for what reason amount of rs 6777 is not approved. Pl mention clause of conditions of policy for not approved so i will put my side in consumer protection forum

I have submitted my father claim in mediassist. Claim number is 15886277. Though we provided all the original documents and final bills and medicine bills, again and again they are asking for original final bill and medicine bills. They are not checking the whatever documents the customer provided. Just to extend time requesting for another original bills. When i called customer care executive past 4 times they didn't share this information. But in the 5th call they are telling that original final bill is required. But i have already submitted that one. Such a worst experience with mediassist.

Dear all,

I have applied for claim processing before 3 months ago but still amount not credited. One of worst thing is claim already processed and approved before 2 month ago still not credited.
I want to know why my claim not credited with valid reason and want compensation for delay.
Kindly check and revert on top priority.
My name: sagar jain
Corporate name : rbl bank ltd (The ratnakar bank ltd)
Em i'd : 10231
Member i'd : [protected]

Expecting prompt revert...
Regards
Sagar jain
[protected]

Sent from yahoo mail for ipad

I am employee of wipro tech. Total rs.12763 was not paid/settled for below items. Its really understandable that all these items are basic; were consumed for surgery still the amount is not getting settled.

Kindly, look into it and process the remaining non-payable amount for below items

1. Non taxable pharmacy & medicine
Charges

Cotton rs 315. Sheet rs 198. Urometer rs
266. Adhesive bandage rs 450. Swab rs
480. Ecglead rs 90. Mask rs 36. Softswab rs
146. Gloves rs 45.;

2. Miscellaneous charges
Regn rs 155. Administration rs 10582.

Hi, this is ranjit nale
I submitted my claim no: 14656134 on 9th jun 2017 and it was approved my claim. But still till the date i did not get my money refund back. Now i am worried abt my claim. If i will not get my money it will very difficult to live. I took personal loan for that but you can't understand the insurer condition. This is very bad experience which is i m facing. So i requesting please refund me asap.

I forgot my password. So i clicked the forgot password option and entered the user id and dob details. But it is showing a message "password reset link is been sent to registered mobile num and to mail id '[protected]@canarabank.co"'. But i have not received the link to registered mobile num and my actual email id is been mentioned as alternate email id. The registered email id is company's mail id. Its not possible for me to access that id....

My husband had jaundice in the year 2015 as it was detected late his liver was damaged and he was diagnosed liver cirrhosis was admitted to hospital several times. Claim id 12055846, 12117709, was settled. But claim id 12264561 was denied as the doctor chatni mentioned it was alcoholic liver disease but it was due to jaundice doctor chatni everybody drinks my husband is not addicted to drinking. When he asked whether he drinks or smokes. I replied that he never smokes but he drinks occasionally. Claim 12117709, 12264561 and 1400556 was denied.in oct 2016 he was admitted twice due to vomitting and loose motions and fever and doctor has given full information we sent also and still the claims 13901306 and 13645974 are pending. Sir you can get the information from dr. Kabade. Doctors have told us there is no need for liver transplantation as he is fine now, now again due to back pain diagnosed as slip disc again i have submitted claim for rs.27921/- fate?. Our bank used to settle all the claims within 20 days. All employees of the bank are frustrated with the banks decision of giving this medical insurance to mediassist india. Please look into the matter

Dear sir

This is to inform you that as per medi assist tpa an amount of rs. 58, 248/- was released against claim no. 15362435 for the treatment of ms. Neha battash, against bank utr no. Cheque no: [protected], but we confirm that till date we have not recd,. The above amount and we are regularly writing mails to medi assist tpa officials (Delhi office) but till date neither we recd. The said neft amount nor we recd. Any satisfactory reply from them. On their request we have already submitted our bank book, just to satisfy them, but till date case is pending. Secondly an unjustified deduction of rs. 95618/- was done for the treatment of mrs. Sumiti bala, vide claim no. 91269561, against bank utr no.4440u[protected].

We request you to kindly instruct delhi office to release the above two payments to enable us to settle our bill accordingly

Thanking you and awaiting an early reply

Ramesh puri
Rockland hospitals - qutab unit

M - [protected]

Mail address :- ramesh. [protected]@vpsrocklandhospitals.com

I am having a mediclaim policy of national insurance co. I had lodged a reimbursement claim for my mediclaim policy. The claim number is 15800215. The claim was for rs. 8593/-. To my surprise, i have received only rs. 6203/-. Almost 30% amount has been deducted. I am very disappointed with this. You are requested to elaborate the amount. Pls do the needful and approve the balance amount as well.

Dear sir

My claim no is 15163313 that is approved by medi assist india on dated 25th september 2017 but till date i have not received the approved amount in my account. I have already contact many time on toll free number and also send more than five times mail to iba care but there is no any need ful action taken by him.

I aslo send mail to provide me reason for delay more than three time but no reply by iba care they only say we communicate shortly.

What i do in this event.

Kindly suggest me.

Akhilesh kumar
E mail [protected]@gmail.com
Canara bank

Hi my name is Rajit Ram employee ID D0501043 I am working in MTNl I have a claim as my spouse is in hospital max hospital and today is the discharge date, claim no 15841411 Medi Assist send the approval to me final approved amount is INR 65218 and proportionate deduction 47738 Non medical deduction INR- 4002/

Note:- In the max hospital I have taken the general Room as hospital don't have lower than general Ward so why proportionate deduction is applicable for me.

Also most important when I received the pre approval in the letter they haven't mentioned my room limit in approval letter as in the preauth form send by hospital room taken by me is mentionemed so it's Tpa duty to inform me very first time.

Also Medi assist Tpa call center number not contactable ever time after 10 to 15 min on IVR call got disconnected.

Once i got connected with mediassist Tpa call center they are not assisting properly when I asked send the approval letter to my email I'd she said we have already sent the same collect with hospital and she transfer the call to floor supervisor i informed to him about Room which I opted he is saying we can't do any thing.

When I requested to him please send me the policy details where it's mentioned my Room limit is INR 1500/ he is denying me I asked for manager he disconnected my call.

I tried to calling Mediassist but line is so busy not Abe to contact I am not getting any proper Answer.

I need non medical deduction list also

Kindly resolve this issue on high priority.

Otherwise I will send email to IRDA directly it's not a way to dealing with customer.

Rajit Ram
[protected]

Employee ID D0501043
Mediassist I'd [protected]
Claim no 15841411