Medi Assist India Complaints & Reviews

Hi,
This is in regards to my mother's angioplasty surgery. The hospital had charged us enhancement request of inr 138474 for cashless claim no 14964614 is authorized for inr 77352. The total authorization as on date is inr 89352.

You have not reimbursed the amount promised as per the company policy stating a 80% or a 90% reminbursement for dependents.

Your claim is that u reimburse only for general ward charges. Why is that the difference from a general ward to semi private is just 500 rs difference. I could have just paid the difference for the room. I have ended up paying 50, 000 extra for just choosing a room which is 500rs extra.

Pathetic service, the lady i spoke to had no remorse. If this the type of policy that you guys are offering than my company should think of changing the insurance company.

Do something about this now!! Or i will go to the media for this.

Regards,
Jennifer.

Dear sir,
Policy no.[protected]
Claim no.94328021

I have rise the reimbursement claim of my son surgery right leg at madhuram hospital rajkot.

Amount claimed rs.102950/- and settle amount rs.81490/- in these claim
Ambulance charge not consider a reason given that bill was handwritten.

I was submitted printed bill which was given by ambulance owner.
(Invoice attached)

Pl. See the matter and take necessary action.

Dear sir, on 3.4.17 i recd. A sms that my claim under clim no. 14246627 is passed for rs. 4220. Oo and shall be credited to my account no. 968 with canara bank. Till date i have not recd. My claim amount credited to my account.

Further i have sent a claim under claim id 14685888 for rs. 168049 after operation for reiumbursement. Lot of letters e mails sent after that but n response recd. When searching for claim status i came to know that final papers recd. For claim on 14.6.17 status shows information awaited i am sorry to inform you that i hve not recd. Any query or being asked any information.

Since claims are pending and i have spent money from my pocket, please credit the amount of claim without further delay to my canara bank account no. 968. My canara bank id is 12475.

Regards,

Rajendra patni

Dear sir/mam,

Reference to the captioned subject this is to inform you that i am not satisfied with the services provided by your company mediassist pvt ltd. I have sent you the claims with claim no's[protected] and 14541376 amounting rs 14241 and rs 15402 respectively file also attached for your reference.
As both claims documents are fully completed by me personally at your mumbai h. O saki naka, andheri (East). And yours dhs h. O churchgate on 5th july 2017 and same has been uploaded by you but till date i have not received the claim amount even one claim has already approved and other is pending with you without any reason. I have called so many times to mr gaurav jain ludhiana ([protected], [protected]) and to your mumbai's no - [protected] and [protected] but no one attending the call even i lodged the complaint to toll free no but no response. Yours company services are pathetic and irresponsible. As per irda guideline company has to settle the claim with in 30 days of completion of documents but you have already crossed. So it is my humble request to you kindly settle the claim at the earl list other wise i have to approach my consumer court.

Regards

Sumit narang
Pf no - 185900
Mb no - [protected]

Dear
I am work with lifstyle retail ltd. I am sumit remibursement form. To meddiassistindia and conformation message recived form. Sent to. Me and my claim no 14707430 are approve ammount are 11292 my claim id 14707430 are approved 03-07/2017 but till date not credit in my account they send me claim. Approval letter 3/07/2017 but till date i have not recived ammount credit in my account please do needful

Regardbr...

Not approving the claim and not coordinating with us
Not coming to hospital for investigation and processing the investigation process pl help us to get our of the problem our patient admitted 01 march and till today not approval
Claim no. 93969119
Patient name. Deviyani

Hospital: - sardar multispecialty hospital

With reference to claim no.93969119 of mrs. Deviyani h patel regarding usg report kindly find enclosed singed and sealed usg report of dr mr. Suresh k patel for any further clarification in this regarding you may contact dr. Anand bhatt no.[protected]

This is for your information and further action

Not approving the clam and not coordinating with us.
Not coming to hospital for investigation and not processing the investigation process
Pls help us to get out of this problem. Our paitent id admitted till 14 july and till today not approving the claim or not coming the member to check or investigate for approving the claim
Claim number :[protected]
Patient name :- harsha
Hospital :- sehgal neo hospital

Dear sir/ madam,
As per the claim stated on subject, the claim amount was ₹41368, the amount sponsored by medi assist was ₹39525 on the day of discharge. But at the time bill settlement the amount sponsored reduces to ₹9114. I mailed to customer care, they said room rent covers ₹500 only you opted higher rent (₹1180). If higher room rent then exclude that amount. Why the sponsored amount reduced from ₹ 39525 to ₹9114. Please clarify this point.
Thank you.
Dr. P. C. Srinivasa rao

Hi sir/madam,

I have submitted my father’s (Ma-id : [protected]) cataract surgery hospital documents to mediassist for reimbursement claim.

Claim id : 14811790

As i came to know that, rs.5000/- has been deducted from claim amount (Rs.24, 724/-) which is paid for hospital treatment rates in advance to order the lense. I want to know why that amount is not payable?

Same was reimbursed earlier (Old claim id:[protected], and why not this time?

Pls let me know is there any specific reason for deduction.

Thanks & regards,
Vanishree k v

I've written many mails to mediassist even called them many times but they dont answer. My wife went through lscs operation in motherhood hospital, sarjapur road, bangalore for which a total amount of rs 76131 was given by hospital. Medi assist has approved 55000 in the beginning as a part of my cashless process.
Next day i've got a mail saying a total of rs 67735 was paid from mediassist to the hospital which you can find in this mail also.
Now i've got a message from hospital that they have got only 55000 as full and final settlement from mediassist. I've attached their settlement receipt from mediassist.
Further i've received message also from mediassist saying "enhancement request of inr 76131 for cashless claim no. 14350790 is authorized for inr 12735. The total authorization as on date is inr 67735 for hospitalization between 19-apr-2017 and 23-apr-2017 at motherhood, bengaluru".
Summary of authorization
Total estimate 76131 previous approved amt if any 55000
Total authorised 67735 current enhancement 12735

I've the mail which says mediassist has approved total 67735 but hospital claims they have got only 55000. I've paid the rest amount from my pocket. Mediassist has deducted this amount from my sum insured.

Have not received the claim after 15 days of approval.

Claim id[protected]

There is no update on by what date I will get the reimbursement. Insurance co is National insurance co and the TPA is Media assist. After submitting all the required documents first they delayed to approve the claim now there is no update on reimbursement. Calling the customer care no but all in vein. Donno how these companies work.

Claim no :14298886
Policy : 520000/48/2017/883 policy period:[protected] to[protected]
Patient name : shalini r policy holder name : flsmidth pvt ltd
Claimed amount : 39384 final diagnosis : benign neoplasm of brain and other parts of central nervous system
Maid : [protected] hospital name/city : guest hospital
Doa : 17 mar 2017

Hello team, i have submitted my insurance claim on march 20 2017. And i have got reply that its been rejected with the folloiwng response.

On scrutiny, it is observed that the claimant mrs. Shalini r, 26year old female admitted in guest hospital, chennai with the diagnosis of pituitary microadenoma with headache 17/03/17 and 18/03/17 and was managed conservatively for the same. On observation, it is found the hospitalization is not warranted and can be done on opd basis. Hence, the claim stands repudiated.

I have reached out to mediassist office in choolaimedu several times and have been there in person as well to submit all the requested documents such as drug charts and ipcp report. Each and every time i was told to bring a different report from the hospitals (Apollo hospital perungudi and guest hospital) and i have furnished the same to them. I was also told that my claim would definitely be processed, however, i have received a rejection after 3 months and i am unable to apply for insurance elsewhere as well. Can you please take a look into this and try to process it again?

I have submitted claim 45 days before. Claim status is not updated from last one month on medibuddy portal website. I have provided all original bills and receipts by hand to medibuddy person and to the new india assurance company.

Medibuddy portal says status as following

Information awaited kindly provide all original claim documents

Could you please provide me updated status as soon as possible or give me contact person details where i can get details of claim..

Claim no[protected]

We have requested for claim on 24th june 2017 for an accident case. But now patient is ready for discharge and bill sent to medi assist from hospital. Patient was asked to discharge from hospital yesterday (26th june) itself but due to delay in approving the claim from medi assist still the patient was in hospital which is really worst.

My name is jegapriyan
[protected]

Planned for my dependent surgery worth Rs.13000. Before planning surgery enquired multiple times regarding amount eligible for surgery. Mediassist call center executive informed 90% of the amount will be paid but during discharge. Rs.54000 was approved on reaching mediassist got only apologise for half info our call center executive is not aware of policy and provided you half information regarding amount eligible for the surgery.

I lost the id cards against my mediclaim policy some time back and had lodged complaint a few days ago with the tpa. So far no response from anyone. Even i tried to reach them through toll free no. (Automated ivr, never attended) and their bangalore office no. (Invalid no. Website not updated) my policy no. With oriental insurance is 455100/48/2017/70,

I was hopitalised for ten days, medi assist was informed within 24 hours. The mail was reciprocated by an automated system and the ticket number: 1669340 was generated. As soon as i was discharged i tried to file my reimbursement claim via the website but nothing worked. I wrote to them informing them of this but did not get a reply. I tried calling the helpline but was on hold for ten minutes and gave up.
I wrote to them a second time, once again i got an automated response and the ticket number: 1729411 was generated but no actual person got back to me to address my problem.
How can i file my claim if there is absolutely no way of contacting the company? The website doesn't work, they can't be reached on the phone and they do not respond to emails. Extremely disappointed with their lack of professionalism!
They were first contacted on the 1st of june 2017 by my father and subsequently on the 12th and 15th june 2017 by me.

I am writing here with ref to the claim ccn# 14527112 duly submitted for peritonitis and hernia surgery.

I have provided all the hospital summary reports and the claim was submitted for 2, 50000 inr however only rs 54000 was approved stating hernia limit, i have sent multiple emails along with follow-ups to revisit the hospital summary report as it is clearly mentioned of peritonitis along with hernia repair which are two different things and to save the money mediassist team is considering it as hernia repair and not approving the claim of rs 2lac.

I have provided them the clarification from doctor manjula who is famous gynec and padmashree, she clearly described it as two separate things and asked for the mediassist team to revisit the documents.

Mediassist team is claiming that they wont consider doctors clarification and simply stating peritonitis comes under hernia repair and are in hurry to close my case. Please check and let us know the update

I am not sure if i have to approach consumer forum to get this settle down.

Thanks,
Syed shahbaz ali
Hyderabad

My mother got hospitalized for 2 days on 30th jan, 2017 because she had nose bleeding.

We submitted all the necessary proof and bills to the company but now they are denying for claim amount. Amount is 12675 only.

Earlier she had minor problem with bp so she used to take medicine sometime but this was not a mojor problem.
But on 30th jan, nose bleeding started suddenly.

Claim passed on 4th april, 2017 against id 14142860
Eventhough my claim was passed on 4th april, the amount was not credited to my account and no on one from helpdesk was able to guide me on the same. Earlier helpdesk said that everything is completed from mediassist side it was pending with insurance company. Last week i. E. 5th june, i came to know that due to death case some details have to be sent to insurance company which was not sent and due to which it was delayed. I sent number of mails to all concerned parties, but no one replied me back. I sent mails to '[protected]@mediassistindia.com';'[protected]@mediassistindia.com', unfortunately no one replied me back. Even some of the helpdesk staffs were rude with exception of mr. Manish who tried to help me out.