Medi Assist India Complaints & Reviews

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

I am working in corporation bank.
My userid is [protected]@ibacob
I forgot my password. I opt for forgot password it shows retrieve password
Hasbeen sent to your mail id. But i am not received retieve password.
I have to give intimation about my father's eye operation. Kindly sent retrieve
Password to my mobile no [protected] and mail id [protected]@gmail.com. Thank you

My claim id 15120657
I have submitted the hospital bill amount rs 23035.
But you have to reimbursement the total only rs. 13000
Why you deducted the rs 10035
As per your your reason you mention 2 days more stay but as per dr. Reply i am stay in hospital
So it is not my duty and i my doesn't told to dr. You discharge.
So pl rest of my amount reimburesment as early as possible

Parag sonagra
Ahmedabad

Subject: denial of claim 94631277 under 070300/28/16/p1/11511126_silver_sez

We refer to your claim submitted for reimbursement of hospitalisation expenses to medi assist insurance tpa pvt ltd. On scrutiny of the claim documents, we observe that the claim is not admissible in view of the following:

On perusal of the claim documents submitted, it is found that there is no hospitalisation / in - patient treatment. All bills / receipts enclosed are out-patient related. Therefore the claim is not admissible as per the clause mentioned above. Hence, we regret our inability to admit this liability under the present policy conditions.

The denial clause/s with description is/are reproduced below for your ready reference:

Clause description.
2.32 opd treatment:opd treatment is one in which the insured visits a clinic/hospital or associated facility like a consultation room for diagnosis and treatment based on the advice of medical a practitioner. The insured is not admitted as a day care or in-patient.

Since the claim does not fall within the purview of the policy terms conditions, we regret our inability to admit the claim. If you have any other information or documents to substantiate admissibility of the claim, please provide the same within 15 days of receipt of this letter.

Hi team, my ecard is valid upto 31 oct 2017. I need to use this card in nov 2017 for my maternity purpose. How can i renew my card? Or will it be auto renewed? Please clarify and find my details below,

Medi assist id:- [protected]
Full name:- keerthi shree kamaladi
Emp id:- 302005
Organisation:- wipro technologies
Mobile: [protected]
Email:- keerthi. [protected]@wipro.com
Insurance company:- united india insurance co. Ltd

Hi,

My wife maid no [protected] went through lscs operation in st john’s hospital, bangalore between aug 15 – aug 24 for which a total amount of rs 75858/- was given by hospital. Mediassist has approved 50000 as a part of my cashless process.

Further i’ve received message also from mediassist saying "enhancement request of inr 75858 for cashless claim no. 15104197 is authorized for inr 10400. The total authorization as on date is inr 50000 for hospitalization between aug 15, 2017 and aug 24, 2017 at st johns medical college hospital, bengaluru".
During the final discharge the hospital asked me to get mail from mediassist saying – “50000 shall be paid to st john without any deduction and patient should pay only the difference amount”
I spoke to your customer care agent ashok on day of discharge aug 24, 2017 who spoke to the hospital insurance cell saying he would send an email regarding the same i should only pay the difference amount. But no one sent any email and later i’ve written many mails to mediassist, even called them (Honeywell number –[protected] and general toll free number[protected] many times but they don’t answer. My wife and new born baby were suffering sitting near verandah due to such false policies. I was having an hard time with the discharge with your so called cashless claim.

Summary of authorization :
Total estimate 75858
Initial authorization 39600
Enhanced amount authorized 10400

Total authorised 50000
I’ve the mail which says mediassist has approved total 50000 but hospital claims they will get only 39000. I’ve paid the rest amount from my pocket i. E 35163/- and 1320/-. Mediassist has deducted this amount from my sum insured. Instead of paying the difference amount of 7585 + 18273 = 25858/-, i ended up paying 36483/- to the hospital. Please refund the difference amount asap.

Thanks & regards,
Sumeet

Dear sir i'm vijay kumar working for corporation bank, i would like to inform you that i have undergone a eye surgery in march 2017 and in april i have submitted the reimbursement claim to my insurance company which is mediassist through courier. But even after 4-5 months they have not yet processed my request.
I had been calling every week and they will promise to solve but nothing has been done, i have called there customer care more than 5 times. Even i have mailed them which is of no use, at last i'm here because i lost hope on there false promises. Please help me
Medi i'd [protected]
Employee no 222319
Mobile [protected]

Lens amount advance paid – rs 76700/- (Applicable for both the claims # 94473841 & #[protected]
In that, icl lens (Left eye and right eye) – rs 38350/- + 38350/-
Breaking bills provided for both. 22000/- @ 17300/-. Concern over authenticiy of 17300/- (Clarified already). I remember clearly i provided original bills only but again and again repitative comments i am getting plz provide the original bill.

Total lens amount has been taken as advance amount – rs 76700/- (Applicable for both the claims ccn# 94473841 and ccn#[protected]
In that, icl lens (Left eye) – rs 38350/- (For the claim ccn#[protected]
Breaking of bills like hospital charge/bed charge – rs 22000/- (For the claim ccn#[protected]
Total claim amount - rs 60350/- (For the claim ccn#[protected]
In a nutshell, you need to consider the amount of rs 38350/- as the remaining bill amount from the advanced amount of rs 76700/- icl lens cost amount (76700/2=38350/- for the claim ccn# 94473841[[protected]=38350]). Same applicabe for ccn# 94473824[[protected]=38350)].

*#[protected] concern was raised for rest of the amount (Total claim amount - 60350) except rs 22000/- which i just clarified here.

*#[protected] rs/- 15650/- extra amount showing deducted (In the medi assist portal) in addition of 10% deducted amount. It is wrong. Only 10% amount is deductable. It was assured. Total claim amout - rs 55650/-