Medi Assist India Complaints & Reviews

Dear sir
My claim details attachment

Hi,
Me and my all my family are a policy holder of your company. Now my mother admitted in Aster Medicity Hospital at Cochin, Kerala for heart surgery. Our policy amount is 1lakh rs and have 22500 rs as no claim bonus. Hospital bill is above 3.5lakhs. we submitted the details in your office through Hospital and they approved only 55875 INR. I want clarification about this. Since more than 13 years we are taking insurance from your Co. I need the approval for full amount( INR-122500) Please do the needful ASAP. Patient not discharged, still in CICU. The MA-ID no is [protected] and cash less no is 12997595.

Regards,
Navaneeth.
[protected]

Ref.: Medi Assist ID – [protected]/ Policy No. 120200/28/15/P1/12677548

With reference to above, I am already submitted all original documents regarding above claim to your Noida Office on 10th June 2016 with claim form. But till date no information regarding my claim receives from your side. Please do the needful and revert back.

From last three to four day i am follwing from your executive to send one pdf of claim form, after assurance till time they have not send...

My mail id is [protected]@gmail.com
[protected]

Hi I am Anand Parik and have been waiting for my claim since last 20 days, my claim number is 12841092. Whenever I call them they give me assurance that the amount will be credited to my account in next 2 days; however, I am still waiting for that amount to be credited. I am an employee of the company and will also escalate this. But even escalating this to the mediassit did not help. They do not have a proper answer to this.
One of the worst experience I ever had with such TPA. I would never recommend it to anyone.

I have submitted for reimbursement claim no 12742216. still it's not getting processed and after submitting all documents also, they are sending it back to me as documents required. the 2 documents which they are asking, i have sent it 1 month early only. everytime customer care people are telling documents are getting scanned and it will be processed within 7 days. but after 2 months also still status is same only.

My ma id: [protected] . I need to send claim papers. Whether to send claim papers to your Banglore head office address or any other address. Tell no provided on claim form is working when I have contacted. Please advice me
Regards
Kumaraswamy
Mob [protected]

Today 29 days in my discharge process but yet not refund my 10202/- also today one mail coming he want my contact number
Why?
From: "sandesh r" mon, 11 jul '16 6:04p
To: you
Show full headers
Dear prashanth,

Please share your contact number.

Thanks and regards
_
Sandesh r

Medi assist india tpa pvt ltd.

4th floor ibc, knowledge park, tower d,
No 4/1, bannerghatta road,
Near dairy circle –bangalore 29

Toll free number :[protected] /[protected]
Track your claims : http://track. Medibuddy.In
Download e card : http://ecard. Medibuddy.In
Track through sms : claims and claimno sms to [protected]
Regards,
Prashant

This is very frustrating that no body was there to help us in the night of 09-July-2016, when we were not allowed to take the patient to home by the Medihope hospital stating the reason that, there was a requirement of a mail from you on the approved amount payment confirmation without further deduction. (where non approved amount was Rs.1410/- and hospital people demanded more i.e., Rs.5110/-)

But, you people really let us down and did not help us in either providing the same or saying you would not provide such thing through mail. I had been calling you guys from 5-30pm to 09-30pm, but no body came to help us (eg venkat, radha, chandrakala and others..) and your people did not even show the courtesy to respond to my continuous mails. All you people did that, kept me on hold for 15-20 minutes and then disconnect the call, in spite of explaining about the patients situation and our problems again and again.

Because of you guys, I had to call police for the help and finally I had to pay Rs.5110/- as demanded by hospital in the late night and brought the patient home, who was supposed to be discharged in the after noon itself.

I am admitted in birla hospittual at 8 jun to 13 june but yet madiassist company say they was not received my hospital documents then how to completed my discharge processing that time and witch based discharge me that time i will pay 10202/- know
Mediassist say yet not received my hospital documents but that time hospital sending by mail all document then completed my discharge but working 28 days not received my original documents by hospital to mediassit
How to handel one corporate company not clear one pasint cashless claim 28 day
Regards
Prashant

Dear sir, i having a medicaim policy of oriental insurance and policy no is 242301/48/2015/1848 and in the month of march 2016 my son admitted in fortis hospital jaipur and after discharge with in 5 days on 21 march 2016 and claim i'd is 12492593. i am submitted all the original documents but still today more the 3 and half months passed (110 days) but still they not sattelling my claim and not giving any information.
When i am compliment then at irdai they arise unnecessary documents which already submitted by me.
So kindly help me and sattel my claim as soon as possible.

I am writing with regards to an insurance claim reimbursement which was submitted to medi assist.


The claim was for lasik surgery for both eyes which is quite eligible for reimbursement (confirmed by mediassist on call) as i had a power of -7 and more in both the eyes.
I had a package of 45000 inr with some additional relevant medical bills which totals to 46055 inr for which i had claimed. for which i had submitted...

I have submitted my claim with claim id 12569980 covering hospitalization expenses along with the hospital discharge summary with hospital stamp. I have send all the documents in the month of May 2016 ; tpa has received the same.

But whenever i verified for the status, i am getting the information that it is in progress and i has submit all documents i.e bills, discharge reports, all reports and bank details, but against they are raise quarry for submisstion of reports again and again, .

Now it is nearing a 2 month; no reply for the reminder mails. I tried...

Hi Team,

This is RamBabu Tadiboyina,


Claim No: 12086187 &[protected] same claim)


Subject: Mediassist closed my claim due to previous year claim with un professional way.


Now iam explaining you what i have faced issues by Mediassist.

I have couriered all the docs in the month of October 2015, In November they requested few more additional docs like indoor case sheet and prescriptions and i have submitted those docs in December 2015. Actually in my hospital, doctor not maintained any indoor case papers, the same also doctor stated in his letter pad clearly, and that doc i have sent in December. The same now i attached in this mail as Witness.

After wasting of 2 months time period they requested again indoor case papers i.e in February 2016.

Due to doctor non availability i have submitted docs in May 2016, in meantime i regularly communicated mediassist by customer care and raised queries in mediassist portal. They have given assurance like " no need to worry when ever doctor came, please submit those docs along with statement given by doctor of late reasons " i got these replies from them, still i have proofs of that attached in this mail PFA.

But in May, they closed my claim.


Iam not happy with decision by mediassist, i felt its completely cheating. Before it self they have given assurance after submission of docs they have closed my claim with reason of last year claim. Doctor went to USA in that scenario what should i do?? i informed the same and got assurance but later cheated by mediassist.
If it comes under last year claim reason to cheat candidate then why are you not informed me? if yes please show me proof?

In claim form also every doc mentioned but indoor case papers not mentioned. If doctor not provided what should i do? he given statement why he is not provided case sheet? then why not considered mediassist? and later i have submitted indoor case papers this time why told reason as last year with out processing??

Even i have given doctor contact no also for assistance. why that is not considered??

For investigation also they have taken 3 months time period< in this scenario who wasted time? In investigation report also completely blunder. my hospital is sri krishna hospital, tenali, guntur dist but in report mentioned as sree raja raghavendra nursing home, pulivendula, kadapa dist...Please find this proof i have attached in this mail. Its completely blunder and irresponsible. I requested many times to correct this but still they did not. even investigator provided false information. only once he visited hospital and doctor busy with his work told wait for 30 min . but he went. but investigator provided he visited frequently and doctor not cooperated


Iam not happy with mediassist, i completely felt its a fraud company. i found them as defaulters.

Now iam planning to take action against them either by accenture or IRDA Grievence or Consumer court or legal action. I had each and every proof.


Please find all proofs attached in this mail.

Please resolve ASAP.


Regards,
Rambabu Tadiboyina
[protected]
[protected]

Subject : regarding the payment of mediclaim of mrs. madhurisrivastava, maid-[protected] dated[protected]. of rs.62, 621.00

Refer : your ccn[protected] under policy no. 221504/28/14/p-1/04957877

Dear sir,

I undergone my surgical operation for “total knee joint replacement b/l” done between[protected] to[protected] at primus hospital.

I am also vovered under cghs.
The primus...

I have submitted my claim with claim id 12522673 covering pre and post hospitalization expenses along with the hospital discharge summary with hospital stamp. I have send all the documents i the month of April 2016 ; tpa has received the same.

But whenever i verified for the status, i am getting the information that it is in progress and i has submit all documents i.e bills, discharge reports, all reports and bank details, but against they are raise quarry for submisstion of reports again and again, .

Now it is nearing a 3 month; no reply for the reminder mails. I tried with the help line also; result is the same.

Please be informed that i hold a corporate insurance from medi assist india and its details are as follows:
Name: sitesh kumar padhy
Medi assist id: [protected]
Claim no.: 12609663

I had opted for a non-network hospital of medi assist india as my wife expecting a child on 09.04.2016. As per the procedure i had submitted all the relevant documents for reimbursement claim purpose through our corporate office at kolkata which was received by medi assist india on 30.04.2016. On 16.05.2016 i received a mail from them stating that the discharge summary submitted my me does not include the admission & discharge date of the patient and they asked me to submit a proper one. However i managed to obtain another rectified copy of the same from the hospital and submitted it to medi assist india through our corporate office once again which was collected by one of their officials on 27.05.2016.

Since then i have been regularly following up with them and every time i raise
A query regarding my claim status, they come up with the same reply that i need to submit the proper discharge summary which was in fact already submitted as mention above. I have already written more than 10 mails to them regarding the same and it has been over a month since i have submitted those documents but there is still no progress on this matter yet.

I am pretty much harassed by the way medi assist india is handling this matter as they seem to be totally unprofessional. Now it feels like my words have been falling in deaf ears all this while.

Hence i would request you to kindly intervene in this matter and do the needful so as to arrange to settle my claim at the earliest.

Regards,

Sitesh kumar padhy

CCN# 12698573

I had done my LASIK surgery on 15/04/2016, i had informed them 07 days prior that i am undergoing this surgery.

After 15 days and several follow-ups they sent their CLAIM FORM which needs to be filled online. The whole summary was given to them including the surgery details.

After which I was told to courier the documents to them. I couriered all the originals to them after which i got second email mentioning the query and the letter of explanation for delay.

I sent the hard copy to them after which they told me that the back end team is working on it for more that 20 days.

And they replay saying it is not covered hence the claim has been declined.

Medi assist is the most pathetic tpa i've ever seen!!!


I have summited my claim no.12568962 documents in the month of apr 20th 2016, till the date they are giving me only assurance to sattle this in in next 3 working days, but till date it's not slatted, i will take a legal action against it.. Can you please sattle this matter within week.. Either i will sent you a legal notice on 21st june.

Thanks,
Sunil nayak

I have submitted my claim with claim id 92336593 covering pre and post hospitalization expenses along with the hospital claim. I have send all the documents on 8th may 2016; tpa has received the same on 10th june.
But whenever i verified for the status, i am getting the information that it is in progress.

Now it is nearing a month; no reply for the reminder mails. I tried with the help line also; result is the same.

Being a elderly person, i am coming to the conclusion that thetpa is trying to discourage people for submitting the hospital bills.

In such case the insurer should not recommend the tpa for the settlement of claims.

Further the policy should incorporate the clause, that the claim will be settled as when they like; or will not be settled at all.

I hope that the grievance from a elderly person like me will be taken care.

Further people go to hospital only to get rid of the illness; not for sending the claims.
The health insurer has the responsibility to see that the tpa is doing their work properly; they should wash their hands assuming that tpa
Has been with the task of settling the claims.

Hope that a early action will be highly appreciated.

In spite of this complaint, if there is no action, then the matter will be referred to the ombudsmen for further action.
Thanking you,

Ramdoss