Medi Assist India Complaints & Reviews

Claim no:13913821

I am working for Techmahindra and i have submitted a claim for my mother, who is a policy holder with Mediassist, who was hospitalised for 2 days due to VERTIGO GIDDINESS CERVICAL NEURALGIA WITH HTN.

The claim was declined and with no proper justification. stating as "On persual of claim documents submitted the patient got Admitted on 23/1/16 & Discharged on 25/1/2016 at Dr Bhoomi Reddy Hospital, Karimnagar Diagnosed as VERTIGO GIDDINESS CERVICAL NEURALGIA WITH HTN managed medically .ADMISSION ONLY FOR INVESTIGATION PURPOSE .The given treatment and the ailments mentioned do not warrant hospitalisation . Hence, claim is repudiated as per T & C "

i have tried to escalate this to Mediassit through phone, the customer service person says, it can only be escalated through email.

i have emailed asking questions as below.

"This hospital mentioned was one of your network hospitals, and why did they asked for a 3 days hospitalization If it is it just for an investigation purpose and can be managed medically?

Why don’t you ask your member to investigate from hospital end? Since its one of your network hospitals. Is this why we pay for mediclaim policy?

Do you really think the hospital kept the patient for a bed rest just for investigation?

I would like to escalate this further please."

But no response received for the many emails sent since last one month.

I dont know where to go for help as the mediassist is not responding for my emails, i have all the evidences of emails that i have sent from last one month.

Please help me.

Bill rs 2964/- dated14/07/2016 bill rs2600/-dated 09/09/2016both bills has sent after one day to discharge from hopitals .i have sent many reminders but not a singal repply has come till date. so you are requestrd to look into the matter.lshall be highly thankful to you policy no.[protected].p.f.no.2627671.from darshan lal batra sbi retired employee. Kothi no.531 phase03 model town BHATINDA

Hi Sir,

I have claimed for Reimbursement with claim ID: 93811285. and also submitted all the necessary documents. But in claim status I could see "Require pre numbered cash paid receipt for IP bill of Rs.3000/-(Given only for Rs.1600/-)". Please find the attached document in the attachment which already has been submitted. Please let me know the exact status.

Ir,
I attended a call from one assist regarding their insurance plans, I told them I dont want this service but they charged me 1299 for its subscription for one year. I just don't want the subscription and please cancel my subscription for my HDFC credit card ending with 7749.Other wise cancel my credit card, i don't like to spend money on all these things.

My number is [protected]
Mail id is [protected]@gmail.com

I have contacted Wipro team multiple times and medi assist helpdesk multiple times ... no one is responding back .
Could anyone please help ...
any claim should be settled with in 15 days as per your norms .
Now its 6 months almost ... no one is responding ...

claim id : 93211823
complaint lodged num : 2595700
pol no : 070300/28/15/pl/11529814

I am employee of Canara Bank and i have submitted my claim in September 2016. Till Date i have not received my money. Even after numerous mail no one is replying every time when i call to customer care executive no one gives a satisfactory replying every time they are saying your claim will be settled in few days. This is really bad as my family members are questioning my integrity they all feel i have received the claim amount and not informing them.

The company is a total fraud, our claim for hospitalization has been stuck for a month, even after providing all the necessary documents, they have completely forgotten about remitting our money.

I keep emailing their generic ID and they always send back standard responses that we are working on it. All the phone numbers mentioned on the website do not work and they have also provided me with a wrong email ID for their corporate office, seems like they have left us no choice.

This is a plea for help to get our rightful claim and put a stop to these corrupt practices.

Have submitted a mediclaim in Mediassist. There is no proper response from their side in the last three months. I have been trying to contact them in the last three months. But they are saying the same story again and again that they have not received the payments from Insurance company. Today also I have called them but they have disconnected(the customer care person) the while taking and asking for the reason. I am totally upset that they are not even ready to talk to their customer and give proper reply to the customer. They do not know how to give respect to the customer.
Really, I feel very bad to do the claim over there.
Claim ID : 93057760

My Policy No: 570500/48/15/[protected]
Claim No: 13701621
MAID: [protected]

with ref to above claim, I have received similar 3 letters from Medi Assist
asking to provide Investigation Report for Rs. 7500
and letter stating delay for submission.. reg.

I have been paying the Mediclaim premium for last 10 years to Medi Assist.

I have well submitted the report and do not understand why Medi Assist is repeatedly asking the same Question / reminder on the subject..
inspite not getting a proper reply what is the status of the claim..

With much regret I would like to inform you that even after two months, there
is no proper reply received from such a reputed Company like Medi Assist.
Would appreciate your immediate / proper response by return.

Also I have been trying your toll-free customer care number to talk,
which never getting to speak and I receive answer that "Sorry Network is
congested"..

with much regret, I remain.

Dear Sir
My claim number 13748207 is pending with you long back . I had submit email to my head office that reject rs 400 - chest pain report and rs 950 lab bill reject and pass reaming amount.

I had already submitted hospital seal pdf file to my head office

Deal in submitting bill is due not known procedure to me
Regus to you pass my claim immediately effect

Regards
Sunil deshak
Pune
[protected]

Hi Team,
My employee ID is: 10916229 and I have working for Accenture Solution Pvt. Ltd. I have submitted the hospital Documents for Re-Imbursement on 27th Oct'16 the amount Rs.5282 I received a Pending document that pending document also i already there in medi assist but they are not review properly on my document again they asking those document finally I have go and ask hospital they advice me already these bill are available...

My Name is v. sampath am working in Sansera Engineering pvt ltd plant-7 Bangalore, my medi assist ID : [protected] and my Emp id : 9477.This is the complaint ABOUT not updated my wife details in medi assist insurance. I already submitted all details to HR Department but not added...Please do ASAP...
My spouse name : s.priyanga

age : 23

Date of birth : 20.06.1993

Date of Marriage : 16.06.2016...

Dear Consumer complaint,

I have not received payment of my approved medical insurance claim id : 13585263. Pending since 07-Nov-2016.
And I have got a rejection on claim id : 13854912.

Both the claims are related to maternity claim.

Such delay is unanticipated and completely not unaccounted for.

Poor professionalism from Medi Assist India.

Best regards,
Ritesh Agrawal

Hi Team,

My employee ID is: 102719 and I work for Tangoe India Softek Pvt. Ltd. I have submitted the hospital Documents for Re-Imbursement on 9th Jan’17 and I received a confirmation message on 11th Jan with the Reimbursement Claim ID as: 93496394 along with the track URL. But, whenever I track, I am not finding any data. I tried calling to the Toll Free number, where as I got a response telling that even they are not finding this Claim number online.
Hence, Can you please check this and let me know what is the status on this as it’s been more than 20 days now.

Dear Team

My wife is undergone for Laparoscopy and histroscopy due to "A2 with abnormal uterine bleeding". But i have received reply from team that it is related to xxx. i informed them that my wife got 1 normal pregnancy in June 2015 and second time ectopic pregnancy in May 2016 which is mentioned clearly in the Discharge summary. But so far, they are not replying or approving my claim.

Kindly help.

Thanks,
Srinivas

Hi Team,

Claim no :[protected]

Really disappointed after submitting all the relevant documents n sent my entire medical file but nit getting proper respond from the Medi Assist. attached are the some documents which i had sent to Mediassist. Whenever i am calling to customer support of Mediassist advisor doesnt have sense how to speak with customers nor escalation team have sense how to speak, Last Wednesday...

Hi,

My father has been a diabetic patient for the past 8 years. He was admitted for treatment of diabetic odema which is a result of diabetic liver decomposition and not alcoholic liver disease.

Further, my father has never had a alcoholic history. He has quit alcohol 16 years back. Even the discharge summary of Poona hospital does not mention the primary reason of liver decomposition to be alcohol abuse.

This is a clear case of denying the claim for frivolous reason.

I request you please look into this matter immediatly, or else I will have to go to the consumer court and file a complaint for wrongly denying my claim.

Thanks,
Sumeet Chavan
Assistant Operations Manager Legal
JPMC
On 19-Jan-2017 1:00 PM, Team Medimanage wrote:
New reply for the ticket #MM00130984

Hi Sumeet,

We regret to inform you that, your reimbursement claim is processed and denied. Please find the denail reason below for your reference.

On persual of Policy document it has been noted that the claim pertains to a person 65yrs old hospitalised for Anasarca in Decompensated Alcoholic Liver Disease. And as per policy terms and conditions use of intoxicating drugs/alcohol not covered.hence we are unable to consider the case.The claim stands denied.

#MM00130984

Thanks & Regards,
Team Medimanage

Last Contact Reply
From: Query
Date: Wed, Jan 18, 2017 at 08:52 PM

Hi,

I have submitted a reimbursement claim on 22/11/2016 and I have received SMS confirmation that the claim is registered with # 13753064.

This claim is not showing on my active reimbursement claims dashboard, hence I am also not able to check the claim status.

Request you to kindly address this.

According to mediassist policy, claim for cataract is Rs. 30, 000 per eye but at
Dr Shahs Eye And Laser Centre, Ambarnath(Maharashtra) they say that the policy is changed and it's just Rs. 20, 000 per eye and the rest Rs. 10, 000 I have to pay by cash. No such change in policy can be seen in mediassist portal. Please let me know what has to be done.

It is very painful to inform you below service which we have received from you.
My aunt has undergone cataract correction in her right eye In Disha Eye hospital on 7th Jan 2017. Hospital has raised the pre authorization request(Claim #[protected] on 2nd Jan. Nothing was informed to us from that day. On 6th Jan we have got the for first SMS and from that I was continuously following up with you people and hospital multiple times. But till now it has not been resolved.She has gone through the surgery from her own pocket. It is very difficult for such old age people to multiple follow up with you people and hospital and at the end of day if they have to pay their own, then there is no meaning for cashless service. So requesting you from going forward smoothen the process.

I am suffering from tingling and other problem i have sent the approval for insurance to medi assist bangalore. They are not proving my approval so that i can get admitted and start my treatment. Doctor has advised to get admitted and start treatment immediately. My husband is not working from last few months just to take care of my health. As i have got very serial neuro problem. Mediassist is not at all giving any update and not approving my admission in hospital. I am suffering everyday and do not have money to get admitted and do the treatment. My company is paying to mediassist from last 12 years for my insurance. Now when i need help after 12 years medi assist is cheating me not approving my claim. I am frustrated with mediassist now. If anything happens to me only medi assist is responsible for everything. I am the only earning member in my family and if anything happens to me only medi assist is responsible and they only have to take care of my family after me. As they are cheating me in this critical situation. I am attaching all the screen shots where it shows the critical situation of my health problem