Medi Assist India Complaints & Reviews

This is jenson michael holding ma-id [protected] admitted to renai medicity hospital cochin on 4.12.2017 and undergone a surgery on my left hand fractured finger.
Eventhough i was discharged on 5.12.2017 at 1:30 p. M. And submitted all documents for cashless claim it was approved by medi assist only by 8:00 pm. Also the approved amount was only 11, 157 r. S.

Is all your claims under cashless only 50%.?
This is not the customer service we customers expect?

Urgently look into this matter, before we seek legal side.

Totally worst service. No reply given by your ppl even after thousand reminders.

Total details

Ccn# 14840672 under policy# [protected]p[protected]Emp no -110014;emp name - shankaranand)
Cont [protected].

Please look into the matter and solve it.. Even after providing every asked document to u.
After so much follow in application you are showing clim closed status, how on earth thats possible. This is is too bad.

Dear sir
I would like to inform you that my policy number is [protected]p[protected], i have submitted the claim of my dependent (Brother) ronak b mirani on 7/10/2017 & 2/11/2017 ma id [protected], but still claim not paid. Claim is pending for too long.

So kindly request you to look into the matter at your end and try to settle the claim at an earliest.

Looking for your kind cooperation in the matter.

Thanks & regards
Vaishali mirani
E. C. No. 78166
[protected]@yahoo.com

Refer with mail trail my documents have already received on 22/11/2017, but still do not any processing by company. Kindly process my claim and revert

Dear team,

The name of my baby is included in the list of dependants with my employer i. E. Idbi bank ltd. And data pertaining to it may be checked / retrieved from my employer. Kindly refer the details mentioned in mail trail along with the prerequisite of addition of dependant which stands complied now thus kindly process my pending bill of inr 15, 438 - (Fifteen thousand and four hundred thirty eight only) pertaining to the natal care expense. This bill was sent across to you people along with the delivery / maternity expenses bill, refer the copy attached for reference.

Regards

Manish jindal

+91 [protected]

Idbi bank ltd

Sangrur-148001

Punjab

From: idbibank. Mediclaimbenefits [mailto:idbibank. [protected]@mediassistindia.com]
Sent: monday, october 09, 2017 4:12 pm
To: manish jindal
Subject: re: clarify about child bill attached with maternity bill

Dear sir,

As discussed we have not yet received your baby endorsement once we received addition details from insurance company after that we will process your baby claim.

Thanks & regards,

Vedanti kale
Medi assist insurance tpa pvt ltd.
Mumbai : 400072
Cell : [protected]

From: manish jindal

Sent: monday, october 09, 2017 1:04 pm

To: 'idbibank. Mediclaimbenefits'

Subject: re: clarify about child bill attached with maternity bill

Kindly revert

Regards

Manish

From: manish jindal [mailto:jindal. [protected]@idbi.co.in]
Sent: friday, october 06, 2017 2:39 pm
To: 'idbibank. Mediclaimbenefits'
Subject: clarify about child bill attached with maternity bill

Dear mam/sir,

Kindly read my previous mail and clarify me about my child bill that i had attached with materity bill.

Regards

Manish kumar jindal

Ein-127620

E code - 511242

Sangrur

Punjab

Idbi bank ltd

From: idbibank. Mediclaimbenefits [mailto:idbibank. [protected]@mediassistindia.com]
Sent: friday, october 06, 2017 2:12 pm
To: manish jindal
Subject: re:

Dear sir,

With regards to below mail, your wife claim is approved for rs.46, 178/-

Payment will done shortly.

Thanks & regards,

Vedanti kale
Medi assist insurance tpa pvt ltd.
Mumbai : 400072
Cell : [protected]

From: manish jindal

Sent: friday, october 06, 2017 1:21 pm

To: idbibank. [protected]@mediassistindia.com

Dear team,

With reference to claim no. 15335089, i would like to intimate you that i had also attached child bill of rs15000 attached with maternity bill, till now i am receiving only information of maternity bill named meenakshi rani w/o manish kumar jindal.

Kindly clarify about the child bill (Original) attached with maternity bill, processed or not or rejected by company side at first stage.

Regards

Manish kumar jindal

Ein-127620

E code - 511242

Sangrur

Punjab

Dear sir/madam,
Please provide the reason for inability to extend cashless facility for claim no.15810708. After providing all relevant documents why cashless facility was denied for this particular case. The case was dragged for three consecutive days which put the patient at the hospital in considerable inconvenience. My father is a senior citizen and he is having cardiac related issues for which the doctors at the hospital has recommended him to get the necessary treatment done immediately. The hospital has provided all the relevant documents and any other documents pertaining to the same will be provided once clear communication is given to the hospital.
Please look into d matter and provide us cashless facility for the same.

Very bad company and service, my claim approved on 19-9 2017 but til date not credited my amount and no one officer resolves my issue and help me, in call center any time all costumer care is coming busy no one times received my call, it is a very very very very very very very very very bad company and poor poor poor poor poor poor poor services.

My suggestion for all never approach this company.

Its been escalating long time but i dont know whats happening with medi assist.
I requested reimbursement for partial payment of my parent - in law claim.
I replied to them regarding there queries and submitted the original documents required, finally they asked to to provide all attested documents from the concerned tpa as it is partial claim, and original settlement letter.

When i checked the tps for attested documents they said they dont have any documents as such but they provided the original settlement letter and i submitted the original document now the claim is closed and i dont know why it is closed. After escalating and discussed with one of supervisor she told she will reopen the ticket and work on this claim.

After all doing all follow ups till now i didnt get proper response, and am getting mail that i have provide the documents.

Please do needful what i have to do its not small amount close to 1.3lk.

Hi

The mediassist has lost the additional documents (Lab reports and bills) i had submitted to them for claim number (Insurance claim status of wipro emp no 210040 ccn :[protected].

Hospital has rejected the request to give the documents again. Mediassist are not ready to accept this loss of docs.

I dont know how to go ahead with this.

Thanks
Anand

We, runwal accident clinic, jalna, are empanalled with medi assist insurance tpa pvt. Ltd. Since almost 2 years. All the documents relevant to empanallment including our ecs details and cancelled cheque were forwarded to mediassist before empanallment.
Now this was the first incidence since empanallment, that a cashless admission was done on 06/10/17 and discharged on 11/10/17. All the formalities pertaining to cashless admission, like preautourisation approval, final bill and discharge summary, etc, were done.
Mediassist had given final approval of the bill settlement on 2/11/17.
This was with tds deduction of 10%. Tds was also deducted for the expenses (Non taxable items also). Complain regards to this was made to mediassist on 02/11/17. They told tds will be deducted on complete total.
This i didn't understand.
Also it was expected to get the amount transferred in our hospital within 7 days, but it was not done. On repeated communication with mediassist, i was forwarded payment details on 15/11/17 and to my surprise, the payment was done to other hospital - lifeline medicare hospitals pvt ltd.
I again made them of the error made by them and requested to rectify it. They replied on 17/11/17, that they will recover amount from other hospital and then only will transfer it to our hospital account.
On 21/11/17 again i got reply from them showing payment details, and this was again same - to lifeline medicare hospitals pvt ltd.
Hence after repeated complaining to mediassist regarding the same, there is no fruitful result, so i'm lodging this complaint.
Mediassist mail id : hospital. [protected]@mediassistindia.com, vidhya. [protected]@mediassistindia.com, vidhya. [protected]@medibuddy.com, digvijay. [protected]@mediassitindia.com

Dear sir / mam,

The claim amount mentioned at the time of registration is incorrect. Could you please check the documents provided and update the same? The details are given below

Claim number : [removed]
Employment number : [removed]
Date of admission : 31/10/2017
Reference number : [removed]

Required claim amount : [removed]

Hi team,

This claim has been settled but rs 332 is not credit in my account. Please check and confirm for the same.

Please find bank statement in which no rs 332 credit details are present.

As per confirmation, this claim has been reimbursement on 03 nov 2017 while no transaction details has been done in my bank account. Please check do the needful.

Medi assist insurance tpa pvt ltd
Claim settlement advice
Claim no:
95013397
Claim type :
Domiciliary
Settlement date:
09-nov-2017
Employee name :
Lalit mohan[protected]
Beneficiary name:
Lakshita gupta
Maid:
[protected]
Relationship:
First child
Age:
0
Policy no:
920000/34/17/04/00000001
Period of insurance
From:01-apr-2017 to:31-mar-2018
Date of admission:
25-aug-02017
Date of discharge:
30-aug-2017
Hospital name & city:,
Amount claimed:
Rs 332
Amount settled:
Rs 332
Category break up
Charge type bill
Amount
Payable
Amount
Non pay
Amount
Non payable reason
Non taxable pharmacy &
Medicine charges
212 212 0
Miscellaneous charges 50 50 0
Consultant charges 70 70 0
Total 332 332 0
The claim has been settled for rs 332 against the claimed amount of rs 332 after making the above deductions. However, if
You are not satisfied with our settlement, you may approach the grievance cell of the insurer at their underwriting office or
Controlling offices. If you are not satisfied with the resolution of the grievance cell, you may approach the jurisdictional
Insurance ombudsman, address of which are available in website of the insurer.
If you are not satisfied with the settlement, then you may approach the grievance redressal cell of the the new india
Assurance co. Ltd. Issuing office, mumbai. (http://www.newindia.co.in/)
You may also approach the jurisdictional insurance ombudsmen, if you are not satisfied with the decision of the grievance
Cell of the insurer. Ombudsmen is located across 12 cities - http://www.policyholder.gov.in/Addresses_of_Ombudsmen.aspx)
And established by the central government for the redressal of grievances of policyholders.

Hdfc bank statement

Savings account no.: [protected], noida sector i

Closing balance: inr 24, 361.39
Date narration cheque/ref. No. Value date withdrawal deposit closing
Balance
09 nov 2017 neft dr-alla0210133-ruchi gupta-netbank,
Mum-n[protected]
N[protected] 09 nov 2017 4, 000.00 24, 361.39
06 nov 2017 atw-416021xxxxxx6676-p1enpu47-pune 8090 06 nov 2017 1, 000.00 28, 361.39
06 nov 2017 neft cr-citi0100000-the new india assurance
Co ltd-mr lalit mohan-citin[protected]
Citin[protected] 06 nov 2017 1, 706.00 29, 361.39
06 nov 2017 neft cr-citi0100000-the new india assurance
Co ltd-mr lalit mohan-citin[protected]
Citin[protected] 06 nov 2017 584.00 27, 655.39
06 nov 2017 neft cr-citi0100000-the new india assurance
Co ltd-mr lalit mohan-citin[protected]
Citin[protected] 06 nov 2017 1, 260.00 27, 071.39
06 nov 2017 [protected]-irctc_new[protected] nov 2017 11.80 25, 811.39
06 nov 2017 [protected]-irctc_new[protected] nov 2017 2, 880.00 25, 823.19
06 nov 2017 neft dr-icic0001070-lalit mohan icici-netbank,
Mum-n[protected]
N[protected] 06 nov 2017 4, 000.00 28, 703.19
01 nov 2017 neft dr-icic0001070-lalit mohan-netbank,
Mum-n[protected]
N[protected] 01 nov 2017 6, 000.00 32, 703.19
01 nov 2017 neft dr-barb0aligar-lalit mohan-netbank,
Mum-n[protected]
N[protected] 01 nov 2017 15, 000.00 38, 703.19
31 oct 2017 salx10x2017x01232443xxxxxxxxxxxxxxxxxxxx[protected] oct 2017 51, 503.00 53, 703.19
28 oct 2017 ib billpay dr-hdfcve-489377xxxxxx5819 ib[protected] 28 oct 2017 6, 433.00 2, 200.19
27 oct 2017 imps[protected]lalit mohan-icicxxxxxxxx4639-
Gift
[protected] oct 2017 3, 500.00 8, 633.19
25 oct 2017 neft dr-icic0001070-lalit mohan-netbank,
Mum-n[protected]
N[protected] 25 oct 2017 2, 000.00 12, 133.19
23 oct 2017 debit card cash back 23 oct 2017 55.00 14, 133.19
23 oct 2017 nwd-416021xxxxxx6676-mb005201-pune[protected] oct 2017 2, 000.00 14, 078.19
23 oct 2017
Neft dr-indb0000018-lalit mohan-sandoz -
Mum-n[protected]-net banking si - card
Payment
N[protected] 23 oct 2017 399.00 16, 078.19
19 oct 2017 atw-416021xxxxxx6676-p1enpu47-pune 2958 19 oct 2017 1, 000.00 16, 477.19

I am raising a complaint against mediassist tpa as they are playing games for 3 months now and manipulating the data by rejecting formal claim and raising another one which was already rejected before.

Can i know why opt claim#[protected]For 16800) was changed to hospital reimbursement (For 43624) knowing that it cannot be reimbursed under hospitalization?

I have mediclaim policy since last 4 years from "national insurance company limited"for whom "medi assist insurance tpa pvt. Ltd." is working as tpa.

Insured person : rasikbhai patel & niranjanaben patel

Mrs niranjanaben patel is hospitalised in network hospital and cashless claim accepted by tpa. However of the total medical store bills of around 18, 500 only around 10, 500 bills has been passed and remaining is considered as non-medical expense. However we haven't purchased any single rupee item for our personal use & all the items purchased from medical store is used in hospital treatment only.

How can such a practice of not passing bills of medical store is justifiable?

It's not about how much money we needs to bore but it's all about practice of doing this fraudulent activity continuously.

My policy details is as below:

Policy holder name : rasikbhai chunilal patel
Contact details : +91-[protected], [protected]@gmail.com
Policy number : 310300/48/16/[protected]
Period of hospitalisation : 01-nov-2017 to 07-nov-2017
Tpa : medi assist insurance tpa pvt. Ltd.
Ma-id : [protected]
Claim number : 15620702
Total claim amount : 35, 453
Claim not passed : rs. 7, 816

Sir/mam
My claim is pending from last 1 years above. My original discharge already submitted and also submit verification letter from hospital. I also submit all required document and self declaration form.
Policy number-272900/48/2016/17734
Maid-[protected]
Claim id 13419911
Claim amt-1, 70, 108/-
Claim receiving 18 may 2016
Sir/mam i submit all document related to my claim please do the needful...
[protected] mob number

I have submitted my reimbursement claim on 19/06/2017. The claim id is 14717451. Four and half months already passed but no response. I have made so many mail on info. Mediassist. No positive reply received yet. Hope you will take necessary action. My phone details and e mail is available. With claim details.
I was admitted in muljibhi urological hospital, nadiad on 5/06/2017 for the operation of prostate. Robotic surgery was done. Total bill was rs.584089/ of which rs.400000/ paid by united india insurance under cash less facility. So rest of rs. 184089/ i have claimed with my another policy with oriental insurance co.
Four and half month is already passed and no response from medi assist.

Request you to take up the matter and advise me the position.
Yours faithfully,

Bharat joshi

Dear sir,
This is prem lata khandelwal. My medi assist id is - [protected]. I claimed at 27/06/2017 and 28/07/2017. My claim no. Are 15338771 and 15610697 respectively.
But i don't receive the claim amount till yet. But claim approved at 20/09/2017 and 1/11/2017. But still i don't receive the claim amount.
Kindly look into the matter and do needful action as soon as possible.

Thanking you
Yours faithfully
Prem lata khandelwal
W/o mohan lal khandelwal
Pf no. 1977105

Sir/mam
My claim is pending from last 6 month. My original discharge already submitted and also submit verification letter from hospital. I also submit all required document and self declaration form.
Claim id 94307914/94307748
Claim amt-55000/- & 13110/-
Claim receiving date-16-june-2017
Sir/mam i submit all document related to my claim please do the needful...

We have raised query for the denial of my claim on the grounds of delay of submission of documents for which we have mentioned the clauses mentioned in the policy terms and condition which are mentioned below.

Policy terms and conditions:-

Non intimation of claim should not lead to rejection of case by tpa / insurance company. Tpa would be authorised to review the case and accordingly call can be taken in
Conjunction with axis bank.
Employees to submit documents for reimbursement of claim amount within 30 days from the date of discharge. However, no repudiation of claims to happen on basis of late submission of the documents

Cliam refernece no.[protected]
Patient name - mr ramesh chandra gupta

On the basis of policy term and conditions its unfair practice and fraud with the customer

Hello mediassit team,

With really disappointment, as under claim number 15141466 mr bhadresh dholakia valuing rs 3147but even after submitting the scan copy of doctor original note for admission to mail is [protected]@mediassistindia.com on 10.09.17 still we have not received our due amount as it is almost 2 months.
Kindly process at earliest.

As per the policy i have already submitted the documents but the claim is not getting passed and i am not getting proper justification of the same. Mails are not getting answered and also the customer care is not able to answer on the same. I have already mailed the pending documents but the response is not received from your end. The documents are still showing as pending.