Medi Assist India Complaints & Reviews

I have made an otp claim of my mother it was around 2000 rupees in august and havent recieved a single info about it where it is how to track it if rejected then why it has been rejected...
The so called customer care never ever picks up the phone do change its name to "i dont care helples line". Firstly the claim intimation process is so lengthy that a person who is a it unaware or less educated needs a person to fill all those forms and procedures... Aleast senior citizens should have a different door...
I dont think u guys have such a large customer base that u cant attend the call.. This is something very sad and disheartening for an organisation related to health sector where people need immediate attention.
Very irresponsible behaviourfrom the companies side...
Worst tpa ever... If otp claim is not given then why they have made it available there on the webites and the scheemes my claim has been rejected twice... I wonder how they settle hospitalisation claims... Regretti
Ng to be a part of it...

W. R. T cashless claim no.[protected] complaint of sujay urological hospital, vadodara. The hospital has cheated medi assist insured by misrepresentation & excess billing. Please provide us approved rates of this hospital charges by medi assist. Medi assist should review their network hospitals, here question comes that who is the beneficiary, insured or network hospital?

Medicines during hospitalisation and post hosp period for the illness for which had been hospitalised are said to be processed under opd basis for which there is a small annual limit. Whereas the terms clearly state that during those days the medicinal expenses should be under pre-hosp, hospilatisation and post hosp expenses and not the opd basis.in spite of repeatedly telling the personnel at mediiassist they claim that they will not agree. E. G. Levipil is a medicine for epilepsy for which was admitted. Tegaderm is a bandage that is allowed (Subject to conditions) for day care procedure. How suddenly they put it into opd whereas they earlier used to process the same under main insurance amount.

And they never reply to mails, deduct wrong amounts, misplace original ecg graphs (We cant reproduce them) and then deduct the amounts. Arrogant behaviour. Delay of 2-3 months even after regular followup.

Where to seek justice!!!

Its rediculous to see company keeps asking for documents though submitted everything. I regret to have insurance with mediassit or united india whatever

There is no logic behind asking for scan copy of x rays files. Interestingly when you have lost it.

Sending reminder to escalation matrix is good for nothing as we get only auto generated emails.

The documents were handed over to oriental insurance (My insurer) 3 months back and insurer has confirmed that these documents have been forwarded to medi assist way back before.
This has been duly confirmed by medi assist customer support officer (Mr ankit) yesterday.

I need to know by when would both the claims be finalised and what is holding the claims to be finalised?

Claim details (Claim number[protected]:

Claim amount of inr 2 lacs plus.
Claim amount of inr 13k plus

Ideally, it takes 15 working days to process the claim and 7 working days after that for payment but this has been more than required timeframe.

Regards,
Ss bamrah

We have submitted all the original claim documents on 04 sep 2017. Afterwords on 12 sep 2017 we received message "we regret the delay in processing of your claim no: 15244322. This is being reviewed and you will have an update shortly", however we have neither received the reason why delaying nor claim amount. We are not able to understand why so much of time required to disburse the same. Current status is showing as "under process" i don't know why this claim is stuck in the system. Please look into the issue and do the needful.

After escalating multiple times with mediassist, i fail to understand what is the claim amount disbursal tat & why so much of time required to disburse the same whereas, all documentation done & claims has been on approved. My claim was approved on 31st july 2017 but payment has not been done till now by medi assist also i marked a mail to grievance officer keeping [protected]@irda.gov.in in loop but no positive revert on the same however they are testing my patience, i mailed them initially on 20th sept, 2017 after the escalation next i replied on 25th sept, 2017 since no action was taken but they still checking within team since it's been 5 working days but no amount been credited in my account. As per knowledge money transfer by neft/ rtgs takes 24-48 hrs to transfer the fund in the account still medi assist fail to do it. Please look in to this matter & resolve the same.

Dear sir / madam,

I have submitted the claim # 94588341 with medi assist india 2 months back and replied to all the queries raised and provided all the required documents that were additionally requested by mr. Balaji - balaji. [protected]@mediassistindia.com.

I haven't received any further notification nor my claim is proceed further.
I am really unhappy with the service i received from medi assist india.

Please look into the issue urgently and do the needful.

Thanks & regards,
Mouneel

Issue with mediassist in settling claim reference 15036503

Claim documents were received by mediassist on 4th august, and the customer service reps have been extremely unhelpful. They advised me to provide multiple documents on different dates and when these had been provided, they asked for still more
Details on other documents. The point currently under discussion for the last 3 weeks was on 1 particular document where they needed further breakup on a package treatment of varicose veins. I spoke to a csr by the name of mr. More last week and he advised that this was not required and they would begin processing of this claim at the earliest. Yesterday, i received another reminder to submit the same set of documents. I have tried calling up multiple times and even emailing them, but no one has been responding to my query.

Also, regarding the claim, post their response, they were supposed to followup with the concerned hospital and they followed up once. When i chased them today, they said they were unable to followup with the hospital and instead asked me to follow up. This is after 2 months of submitting the required claim documents

Dear team,

My claim is not process till now while i have submitted all the physical documents on dated 6 aug 2017.
And i didn't got any call from the executive, and i have send many mails but get any positive response. This is a measure concern.

Name-prateek kumar
Mobile number -[protected]
Claim[protected]
Company name-oriental medi assist tpa

Im working in corporation bank we applied for the medical reimbursement claim on 22-07-17 with claim id :15050680. But it is still not processed till date. We submitted all the original hospitalization bill through proper channel. Even though we submitted all the documents still we are receiving so many sms remainders regarding submission of original discharge summary.
Please help us to get the refund.

Dear sir/ madam,
I have claimed for the hospitalization bill of my mother c vasanthi on january 2017 for sleep apnea. But the same was rejected at the cashless facility and have informed us to taken up for reimbursement after a week of reporting the cashless facility at hospitals. While taking up the same for reimbursement and for the cost of cpap machine which is instructed by the doctor to continue for life time, both the reimbursements were rejected at medi assist, while both is covered under the policy.
While taking up the same, there is no reponse from jan 2017 to till date, even after continous e mails, telephonic calls to customer care.
Being so lathergic towards the customer e mail and reimbursements and declining the cashless facility at the end moment without any proper intimation has given disappointment and stress and depression to arrange money at the neck moment.
After waiting so long from the mediassist insurance company, to my last hope forwarding you this email for immediate action.
The details of policy and requested reimbursement cliams are detailed below:
Insurance company
United india insurance co. Ltd

Policy number
500100/28/16/p1/09923078

Validity period
[protected] to[protected]

Claim no: 13892934 dated[protected]

Patient name : c vasanthi

Ailment summary : obstructive sleep apnea, hypothyroidism, dmii

Claim form of cpap machine is attached herewith for your reference.

I have submitted reimbursement claim. And all required medical reports. Despite that they told that they haven't received my documents and closed the claim. When i call customer care everytime they will give some wrong reason. Also they have asked my sugar reports after 4 months i have raised claim. Its worst insurance i have ever seen with worst service.
There is no proper response. Even their sms service is worst. They have asked us to send sms to[protected]. Even now my claim status is showing as work in progress when even i will send sms to this number.
I used to call helpdesk very frequently. Despite that they are not specific about the reports they want. I have already submitted all my blood reports, but they reported that they have not received my documents. I have the courier number which shows that my documents have been delivered to helpdesk on time. But when we call helpdesk they reported that they have not received courier and my documents.

This is the worst insurance with worst customer service.

They are very ridiculous to process our claim and worst tpa.

Hi,
My claim number is 94536086
I am working with tcs, pune.
I have submitted claim documents 2 months back for hurnia endoscopic surgery.
For such surgery mediassist expect implementation stickers or original invoice. But normally hospital purchase it and use it during surgery hence hospital gave me detailed bill with implantation amount.
I have talked to customer care executive and explained him the problem so he gave me a solution that to get one written letter from hospital on their letter head and submit this will be sufficient to proceed with my claim. Even today morning i got confirmation from mediassist customer care that no additional documents required and i will get my claim amount in 2 weeks of time. But again i got the same query to submit original stickers or invoice :- (
I don't understand when two executives gave me the solution then why again mediassist is expecting the same.
Looks like mediassist is trying to ignore my case to reimburse the money.
I have escalated to my hr and waiting for action from mediassist and my company.
Mediassist customer care doesn't respond some time and i used be on long wait to talk to them.
It is really irritating.

I underwent a acl reconstruction surgery on 31st august n applied for reimbursement claim on 3rd september till now i hv not received any revert claim amt s 163995/- i called up the customer care in 13th sep that time customer care executive said nothing s pending i then later i m getting a mail for additional docs requirement why you ppl always require a reminder. I can medical non medical bifurcation too but still it is under process. Im not getting any proper response also. I hv to repay my card bills on 23rd i n telling them be on my shoes and understand my issues still mediassist ppl are irresponsible n not understanding the problem. Claim status s in progress for the past 15 days. Please address my query immediately.

We applied for the medical reimbursement claim in may month but it is still not processed till date. We emailed the medi assist but no revert is received. My claim no. Is 14417322.
Please help us to get the refund.

The last email converstaion is below

Hi team,

I think their is some misunderstanding. My mother has gone under operation in columbia asia hospital on 5th of april 2017 and get dicharge from hosiptal on 09th of april 2017. Our first claim for cash less and reimbursememnt of expenses during hospitalisation has already been passed and we have received the refund for those expenses too.

Now we have filled the second claim by claim no. 14417322 and by this claim we are claiming the expenses which are done before the patient has admiitted in the hospital i. E. Before 05th of april 2017. These expenses are done in other clinics and hospitals for the tests whihc were necessary before the hospitalisation. These may be done in the hospital in which the patient has undergone operation or in other hospital and clinics.

So the reason for deny of claim that the patient has not undergone hospitalisation is not correct and i request you to please look again in this claim and refund the amount of claim that i applied.

Please let me know if i need to submit any thing else.

Pol no[protected]p[protected] due 31.10.17 for 4lac.
Claim no15248999 rs4084 rejected on 8.9.17 reason'atalentalia' dosease not covered.
Claim is for disgonstic;path and consultation of wife including ultra sound;spear test&ecg rs3600 (Approx)
+medicines rs460 (Approx) total 4084
Is it atalentalia.?
Matter refered to irda also.
Kindly take suitable steps

Hi,

My claim no is 14871281 which has been approved 2 months back i.e on 17th July 2017 but still amount is not yet refunded.

We have called more than 8 times to call center people and it takes almost 45 mins to reach them they just say it is in processing and you will receive the amount within a week and we are escalating to upper management.

As well they dont have their escalation matrix. Literally calling them everyday and reaching them is just a big task and irritating. They dont have a proper management.

Kindly let me know their escalation matrix.

I don't know why my organization choose to go with mediassist, but the trouble started on that very day. I realized it when i put a claim to process. First of all, many hospitals out rightly declines to process cashless with mediassist and your trouble starts. Do the payment to the hospitals and start swimming in the ocean of mediassist. Submit the original docs and get ready to answer repeated emails asking for originals again and again from different guys/depts of mediassist. You will received all acknowledgement mails/sms which will commit to complete the process within 5wds and keep patience to follow-up them regarding the claims status for another 2-3 months.
So i suggest, better to start all un-parliamentary words in the email from the very first day because anyway you will end-up using them after few months, doesn't matter how gentleman are you.
My claim id : 15001721 and second one is tracking # p[protected] for amount: rs. 27411

My name is mohd mustaq shaikh
My medi assist id no-[protected]
Addmision date of hospital[protected]
Discharge date[protected]
Amount-52006
There is evidence of fracture seen at the shaft of right 4th & 5th metacarpal with seperation and displacement of fractureseen through x-ray and still i cant work with my right hand
I have subimited all my original document as per policy
Im not getting any reply from medi assist
Please help me wtih the issue
Mob-[protected]
& also i want buy new policy