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Medi Assist India Complaints & Reviews

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Updated: Jul 3, 2025
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G
grcmurthy
from Bengaluru, Karnataka
Aug 31, 2010
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Resolved

Hello,

I am working with Wipro Technologies, Hyderabad and have taken parental insurance for my Father through ICICI LOMBARD. Policy details are as follows
Policy Certificate No Cover Period from Cover period to Type of cover
4015/0001657/01//12606 1-May-08 30-Nov-08 Comprehensive
4015/0001014/03/2046 1-Dec-08 30-Nov-09 Standard
4015/0001014/04/0891 1-Dec-09 30-Nov-10 Standard

My father has undergone cataract surgery on 23rd April 2010 and Iraised calim with TPA Medi Assist. This claim is denied, with the following reason "The insurance incepts from 01/05/2008 and the patient was admitted to the Hospital on 21/04/2010 for the treatment of Cataract. As per treating doctor certificate, the patient is suffering from cataract for the last 2 years. Going by the duration of ailment and taking into account the date of inception of Insurance, the ailment is pre-existing. Hence the claim is not admissible under the policy and stand repudiated under the exclusion clause no. 3(i)of the mediclaim policy.".


I believe ,that the statement that cataract is existing for the last 2 years in the Doctors certificate, which is very generic in nature, can not be taken as reason for the denial of the claim. As we all know, though cataract exist for last 2 years, it is the Doctor we decide when this need to be operated. This is not the case, when some one got some accident on a particular day, with evidence available.

I request your guidance in selling this claim.

Regards,
Ramachandra Murthy Gunturi
Aug 13, 2020
Complaint marked as Resolved 
There is a place atleast in Bangalore where you directly file a claim to medi asist . Pls provide me ur email address and we can talk more .
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    suneel2005
    from Hyderabad, Telangana
    Aug 31, 2010
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    Address: Hyderabad, Andhra Pradesh

    Dear Sir,

    My sister was suffering from fever, she was admitted in yashoda malakpet(hyderabad) on 30th aug, 2010, she was to be discharged. She is having a REliance Medi claim(mediassist) we submitted all the documents with the concern in time and she has been waiting in the hospital since 30th aug and today is 31st aug,

    Very bad service very poor response and very very bad company.

    Pls dont go with this policy.

    I am suneel
    My contact no is [protected]


    Thanks
    Aug 13, 2020
    Complaint marked as Resolved 
    Sir,

    I, K . Srinivas, submitte claim for reimbursement in the month of March 2010 to TPA (Medi Assist) office in Bangalore and now I am in Hyderabad. My claim No is 4839263 and Policy no is[protected]. It came for final opinion in July2010 last week and still it is under final opinion. His representative met me here and collected the requsite information 15 days back. I could not understand still how much time required by TPA for completion of final opinion and relesing the claim amount? The Reliance is communicating me the position of June 2010 to me now. That is the updation of Reliance General Health Insurance Company.

    K . Srinivas
    SIR
    MY CLAIM 52855547 IS PENDING FOR LAST TWO MONTH.WHY IT IS TAKING SO LONG.
    NAME PRADEEP VYAS
    MAID [protected]
    ADRESS 31 GUJRAT VIHAR DRLHI
    POLICY IN NAME OF JARDENE CONSUMER SOLUTION
    Sir

    My claim no. 5610099 is pending since 1 month . while i have sent all the document. why it is pendig .
    please confirm


    D.P. GUPTA
    My claim no. 5663108is pending since 5 month . while i have sent all the document. why it is pendig .
    please confirm



    Regards,

    Madhuri
    Hi,

    My claim no. 5663108is pending since 5 month . while i have sent all the document. why it is pendig .
    please confirm


    Madhuri
    [protected]
    mail ID: madhuri.[protected]@yahoo.com
    Hi

    My Claim No.5784243 Is Pending 5 month.while i have sent all tha document.why it is pendig.
    Please confirm



    Rathod Asha
    [protected]
    mail ID:asha.[protected]@gmail.com
    RESPECTED SIR LET ME KNOW THE STATUS OF CLAIM NO.6467953. SUBMIT ON 25/01/2012. FROM AKSHAY PAGDHARE.
    Subject: FW: Claim for the policy number is [protected]
    Dear Sir,

    I had forwarded my claim file on dated 14th of march 2012 to below address via by hand to Medi Asist’s office NOIDA .but till date I have no idea about the status of my claim file. I request you to kindly look in to the matter.


    Regards,

    R.K MATHUR
    My claim No.6656687 is pending 2 months and i have sent all the required documents. Please expidite by N.Gopinatha
    my claim no 7335755 is pending 6months andi have all required documents colse .please expidite by puri deepak
    I Rajnikant S. Kayasth had submitted my claim no. 2902624 one month ago to Medi Asist’s office Vadodara, but till date my claim is not process. I humbly request you to process my claim as early as possible.
    Subject: FW: Claim MAID- [protected]
    Dear Sir,

    I had forwarded my claim file before 15 days .but till date I have no idea no sms about the status of my claim file. I request you to kindly look in to the matter.
    Sir

    My Clm No.:2748659. You have intimated that the form Received On 4/6/2013; Patient Name:Laly Binoy; MAID: [protected];Hospital: PUSHPA MISSION HOSPITAL MATERNITY HOME;DOA: 03/11/13 00:00;DOD: 03/22/13 00:00;Clmd Amt: Rs. 9945

    I have submitted all the documents and cancelled check as per the information last May itself. Still I am not getting any information. please respond. We have invested money and started insurance. If it is for no use in case of emergency, it is waste. please value our comments and respond. I have called the bangalore office and they also are not able to guide properly.
    thanks for responding

    Binoy
    email. [protected]@gmail.com
    [protected]
    My claim ID is 2897333, we have received SMS on[protected], claim status is passed the initial scrutiny and amt Rs. 76341/-, How much time to be taken for payment? . there is any problem ? if, any quiery, please contact to my registered mobile number with you.

    Vikram Rathva
    Sir
    I requesting to you regarding claim
    MAID no. is[protected] and all document allready sent to you
    but no respons ur side let me know about my claim status
    so pls call to me or massage at my registered mobile no.


    thanx & regards

    Claim status - Comment #1951655 - Image #0
    Sir

    My Claim No.:10035525.Policy No.310300/48/13/[protected]

    I have submitted all the documents and cancelled check as per the
    information last May itself on 25/04/2014 at Baroda, Gujarat. After more than 25 days has been passed nothing heard from the company and by inquired so many time about status of my file and payment then they have informed that today evening i.e.21.05.14 you will get the information online about your file and claim. Even approx one month I am expecting payment of my claim in place of that I am getting only online information of my claim only
    Please respond. We have invested money and started insurance. If it is
    for no use in case of emergency, it is waste. please value our comments
    and respond. I have called the bangalore office and they also are not
    able to guide properly.
    Sanjay Chavda
    email. [protected]@yahoo.com
    M-[protected]
    my claim no is 9962208...they had denied my claim...wat r the reasons about dis...can i send again our documents of medical if some document is missing????
    my claim no is 9962208...my claim has beeen denied by medi assist with no particular reasons...??????????? this is not good on part of medi assist...i want immediate reply.. from mediassist(noida)...cani send my documents again????? my nos is [protected]
    Dear ranganath,

    I have met Mr. G.V. Rao., Vijayawada and had a conversation as you told.

    But he is telling that the file is closed and you people can't open again. How is this happening. It looks like i am toy and you guys playing with me. How are you working and giving trouble to the customers. As you said to talk with Mr. G.V.Rao. But he is telling the other story to apply for "ODBUDSMAN"

    Note: Claim No: 9753622-Patient Name: Syed khader Unnisa Begum

    As you guys giving trouble and telling us to complain to ODBUDSMAN. This is not fair. For a genuine case., you guys making it difficult and closing the file. I don't angry with your response.

    Regards,
    Asad Mohammed
    Sir

    Quote our reference no: 10192663. is pending since 1 month . while i have sent all the document. why it is pendig .
    please confirm. Policy Holer: Jayshreeben Pravinbhai Pastakia


    D.P. GUPTA
    Dear Sir,

    We request you to update the status for as I submitted my documents 1 month back their is NO RESPOND on the same.
    Yesterday I have discussed with your Executive reference (Mr.Dixit) his stated that within 7 working days you will come to know status.

    Please do the needful.

    Reference no:[protected] Clim No [protected] # Mrs.Jayaseeli dtd.8th November, 2014 - (DOA) and documents submitted on 11th November, 2014.

    Request you once again to update at the earliest.

    Regards
    Lalitha.S
    Respected sir,
    I have sent all the required necessary original documents to Mediassistmediclaim (andheri office) but they are not giving any reply or about the status of claim.I have sent original documents by professional courier on Jan 4 th 2016 by doket number [protected], and the office received the same on 5 th itself, then also no reply from their side.
    Maid no: [protected]
    Patient name: gopalkrishnan k.s.


    Regards,
    Gopalkrishnan k.s.
    Sir

    My Claim No.27092692 so cliam is aprroved and not payment settld pleace satild
    My claim no 15424805
    I have submitted all the documents
    As per your requirement, but still
    Pending at your end.please look
    Into the matter and settle the claim.

    Ramana Murthy raju p v
    I HAVE undergone a treatment from Yashroop hospital, gurgaon. the claim bill has already been submitted with claim no.17198446. it was received in ur office on 14th june, 2018. but till now it has not been resolved whereas the time frame is of 20 days. you are requested to process it soon .

    pls refer to my earlier mail of 13th july. i am very sorry to see such type of working in mediassit india. the claim no. 17198446 is still under investigation even after one month. the claim was received in ur office on 14th june, 2018 and till date i.e. 20th july, 2018 the claim is under investigation. very disheartening situation this is! even after a week's time, i haven't got he reply of my mail.

    on contacting the toll free no. [protected], the executive provides a mob. no. [protected]. She informs that the claim is under investigation and she can't give the the details as she has no other information. she doesn't have any information reg. e-mails. this is the working system o[censored]r office. the executives don't provide the details of the higher authorities.

    in this age of technology and advancement, your people are befooling the customers. why so much delay? is there any solid reason to give? no reason at all
    "Medi Assist" should change their brand name to something els. They never "Assist" their Policy Holders but never do a fair settlement when it comes to Bills settlement. Very pathetic settlement of payment and policy holders are reimbursed less than half the amount they spend and submit their original proofs. They come back with hundreds and thousands of reasons when you ask them and show their funny "rules book. My recent experience with these guys is very very bad. Better avoid "MEDI ASSIST" and choose some other Insurance. There are hundreds in the market these days.

    These guys are not worth of even one Star, hence I chose "No Rating".
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      prasanna.vs6
      from Bengaluru, Karnataka
      Aug 19, 2010
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      Address: Bangalore, Karnataka

      Hi i enrolled my parents in medi assist health insurance through online without noticing the charges,once i noticed the charges i tried to delete the names but it was locked.So i sent a mail to the medi assist to cancel the same,but they are telling me that its already enrolled and its not possible to cancel till the next year.And the premium amount will be going to deduct from my 2nd month salary onwards in 3 installments.I requesteded them that its just 2days and i have not availed any benifit so that please cancel the enrollments of my dependentd because if the amount is deducted from my account means i will be in trouble & i cant meet my personal committment.So please help in cancelling the dependents enrollment.

      appreciate your help

      regards
      Prasanna.
      Aug 13, 2020
      Complaint marked as Resolved 
      can u please let me also know. i also stuck with same problem
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        A
        ashoktp333
        from Dhamtari, Chhattisgarh
        Jul 17, 2010
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        Address: Karnataka

        medi assist ID No. [protected]. medical reimbursement claim is pending since June 2010. The Jayanagar branch of medi assist in Bangalore is not receiving any calls for the enquiry. the matter couldnot be clarified by the helpline and have expressed their helplessness.
        Aug 13, 2020
        Complaint marked as Resolved 
        dear sir, 28/12/10

        my name is Sunil Uttam Sathe, i have a reliance general insurance health wish police,
        my address is Surat city, i purchase police number is[protected] in
        Agon Religer company. i submit claim document( all document to hospital original) Delhi Meddi -assist branch send to courier number[protected]tracon courier) 08/12/10medi . i call Delhi branch number is[protected], 30913811, 30913813 and[protected], 41624845, i call this number but this is not Riccive my call, and not given my claim detail claim number

        Pl settle my claim i want to detail my claim

        my mobile number is [protected], [protected]

        my email id- [protected]@gmil.com
        pz

        Medi Assist — Reimbursment

        I have claimed for 4 lakh when i have 5 lakh of insurance policy. but they have some clause saying they can pay only 1.3 lakh for a particular disease.
        I want to know whether this is true & where can i get these policy terms & conditions.
        Dear sir,

        Let me know the my reimbursment status (claim)

        Details:
        policy no: 710400/34/10/04/00000001

        policy holder; Nagarjuna oil corporation limited
        MA-ID--[protected]

        Please reply to Madhanraj.[protected]@nagarjunaoil.com
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          lazer
          from Coimbatore, Tamil Nadu
          Jul 17, 2010
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          Address: Chennai, Tamil Nadu

          I have given medi claim on 24 Dec 2009 and my Policy no is -[protected].
          I have handed over my claim in Medi Assist Office, No 1 Lakshmi Ammal Street, Ayyavu Naidu Colony, Aminjikarai, Chennai.

          Where as I haven't got any respose from them till date.

          Regards

          Lazer D
          No 17, Church st,
          Old Pallavaram,
          Chennai-117.
          Aug 13, 2020
          Complaint marked as Resolved 
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            S
            satatkhare
            Jun 18, 2010
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            I had deposit my original medical bills with attested copy of hospital bills (Amount 254000 INR) on dtd 26th Feb'10 at Delhi office, Kailash Plaza . At that time all they had confirm that claim will be cleared with in 2-3 wks.

            Last month they had asked some addtional paper (Document) which i had also diposited in Delhi office.

            But After 3& 1/2 Months has passed and no one of Medi Assist person are giving proper reply nor interested to discuss actual status (Matter).

            Patient Name : SMITA KHARE
            Policy No. :[protected]

            Hope you understand my problem.

            Waiting for your positive response.
            Aug 13, 2020
            Complaint marked as Resolved 
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              megharajrajeev
              from Mumbai, Maharashtra
              May 31, 2010
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              Address: Bangalore, Karnataka

              in the early morning of 25th May 2010 while travelling from the Bangalore International Airport to Bannerghatta road on a easy cab. A concrete mixing lorry rammed onto the cab bearing number KA 01 D 4615. I was critically hurt with a swollen forehead, thru n thru torn upper lip, Bleeding profusely thru the lip and nose, Buldging nerve on the neck and a broken 6th cervical bone. I got admitted to Fortis hospital located on the Bannerghatta Road. Fortis which is short of experienced doctors allowed some very young interns to check me. The interns after an X Ray of the neck discharged me. I developed numbness in my arms the next day. I got myself admitted in Fortis again this time under the guidance of a nuero surgeon, who asked me to get admitted. My trauma started when post a series of test conducted and i was given the discharge summary. I was covered under the medi assist health Insurance. The initial analysis from medi assist said the claim is rejected which was later retracted and partially approved the next day only to be retracted again. Phone calls to medi assist does not heed. So what if one is critical, if you are an medi assist client you need to follow up in vain and to their apathy. If you are a tourist to the city you met with an accident you need get admitted to the hotel not hospital. I V & Operations is a must for re imbursement. yawn yawn...
              Aug 13, 2020
              Complaint marked as Resolved 
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                piyush.singhvi
                from Noida, Uttar Pradesh
                May 27, 2010
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                Unethical Deduction of Insured Amount

                Address: Hyderabad, Andhra Pradesh

                Regarding Serious complain against Medi Assist

                Hi,

                I would like to draw your kind attention towards a strange issue; I faced during my hospitalization and post discharge process on last week end.

                I as a HCL employee covers under Medi Assit insurer with 80% part have to be paid by insurer and 20% by the employee.

                I was admitted to Apollo Hospital Hyderabad for two days to get...
                +1 photos
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                Meghna Sayta
                from Delhi, Delhi
                May 4, 2010
                Resolved
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                Address: Maharashtra

                >> his is my complaint against Mediassist ( TPA) who has failed to process my Medi claim inspite of 10 months of follow up.
                >>
                >> Inspite of several follow ups what we get to hear is an extended timeline to receive a cheque.
                >>
                >> I have been following up with MediAssist staff ( Mumbai) for past few weeks to get my claim processed. Every time i hear an extended timeline to process my Claim. There are times when we were committed a timeline of Saturday for receiving the cheque and the same was nto adhered to.
                >>
                >> My Dhananjay ( Manager Mumbai) and his team ( Sapana S) have also delayed the inquiry on their end. Last week I was being told that the cheque would be issued by Saturday ( i.e 1st May) whereas today Mr Dhananjay calls me and tells me he would 2 more weeks time to get the cheque processed as they have to exchange some clarifications with RBI cell..
                >>
                >> My concerns are
                >>
                >> * The case was closed irrespective of we submitting all the documents ( without any intimation to us)
                >> * Every Follow up done from our end we were told that it is under Final Stage and should be done by Saturday ( till now am hearing
                >> the same reason on inquiring the status of my Claim ID 4557049 )
                >> * We personally visited your Andheri office and were assured that the Mediassist team would personally follow up on our case adn
                >> would get the cheque processed by Saturday ( post that it is three weeks over and we continue to hear the same confirmation without
                >> any action)
                >> * Your team only promises to call back but they do nto turn up
                >> * On asking for managers on call they do not handle the escalation leaving it on the officers to handle the case
                >> * No sensitivity displayed towards customer requirement
                >> * Things which could have been done earlier are being done now ( Why were the clarifications with RBI cell not taken before pro actively.)
                >> * Have given feedbacks also on your Feedback link but no one has attended my case till now ( Feels that they do not care for your
                >> customers at all. Their Mission Statement, Their Vision statement is just a formality to attract business at the cost of policy
                >> holders) *The Medi Assist team is disconnecting my call inspite of helping me get my problem addressed.
                *Have also followed up with the reliance Team and they say that the claim is pending with the TPA. Fail to udnerstadn that who actually is responsible to expedite our case and help us to get quick refund of the claim.Have given feedbacks also on your Feedback link but no one has attended my case till now ( Feels that they do not care for your customers at all. Their Mission Statement, Their Vision statement is just a formality to attract business at the cost of policy holders)

                Would request SOME help to get into the details of the matter and help me get my money at earliest as I am in urgent need of the same.
                Aug 13, 2020
                Complaint marked as Resolved 
                in absence of accountability, it is difficult to make somebody do one's job
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                  syedb97557
                  from Bengaluru, Karnataka
                  May 3, 2010
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                  Incorrect Patient name updated in their record and refusing for cashless hospitalization

                  Address: Chennai, Tamil Nadu

                  Hi,

                  I have a valid insurence with ICICI Lombord (MediAssist is TPA) for my father (i am employee of Wipro and took parental insurence) from 01/12/2009 till 11/30/2010.

                  My father has got heart attack in Jan 2010 and MediAssist re-imbursed the amount after deducting 10% of co-pay.

                  After few check-ups in hospital, doctor suggested to go for Angiogram for my father and i applied for cashless hospitalization...
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                  ramjilal swami
                  from Mumbai, Maharashtra
                  Apr 16, 2010
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                  Address: Jaipur, Rajasthan

                  I have madical policy of your company since 2004 and my policy No. is 120300/48/06/21/70000193 sir since 2007 i am making claim of my medical expencess which were spent by me at SMS Hospital Jaipur and all the document regarding medical claim has been sent to you time and again and also since 2007 i am making my claim or sending you reminder in this regard but till today nothing has been done by you and inspite of so many representation sent by me nothing has been done by you and except a letter dated 09/08/2007 not a single time any correspondence done by you, hence sir by this reminder i am requesting to you to settle my aformentioned claim as soon as possible.
                  Aug 14, 2020
                  Complaint marked as Resolved 
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                    V
                    Vimal Navin Parekh
                    from Mumbai, Maharashtra
                    Feb 23, 2010
                    Resolved
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                    We have medi claim Insurance with New india Insurance & their TPA is MEDI ASSIST INDIA TPA PVT. LTD. our family policy number is 141600/34/09/11/00004063 & claimant name is vimal Navin parekh WITH MEDI ASSIST CLAIM NO. 1549512

                    Our above claim is settled by company with a letter mentioned that company will not do any clerification after 7 days of settlement advice letter date. We have wrote 2 letters to this company within 20 days from their settlement letter received by us to their Indiana house Andheri (e) , Mumbai office. However company is not replying to this letters from last about 1 month nor they have put any online status about our letters on their website
                    www.mediassistindia.com under our alloted online access account. This kind of service approach for a ISO certified company is really not appreciated. Company can not take their stand by specifying in settlement letter that they will not clerify anything about settlement amount after 7 days of this letter date. Generally customer receive letter 1-2 days after letter date & it takes some time for claimant to analyze the same. Even sometime some details may be required from hospital to resubmit it to TPA company & it takes time so 7 days limit is certainly not acceptable. Ideally company must reply to all queries of customer & put the status of all such queries online. I think company's ISO standard also do not agree with such policies.
                    Aug 14, 2020
                    Complaint marked as Resolved 
                    Decency and etiquette demand reply to insured. The insurer must dictate guidelines to TPA and ensure no harassment and mental agony to its customer who has paid premium including service charges of TPA. Whether the 7 days limitation of no reply is as per Insurance Act or Act of Limitation?

                    Both Underwriter and TPA to clarify and improve its services to insuring public. Such bureaucratic approach adds to ever increasing pending cases with Consumer Redressal Forrum and Ombudsman.

                    People have no good opinion for TPAs.
                    To : Medi Assist India TPA Pvt. Ltd.
                    Claim No. 1720688
                    MAID : [protected]

                    Sir / Madam,

                    This is further to the following email and the documents that were faxed to Medi Assist India TPA PVT. LTD., Andheri office fax number for the expenses incurred towards my father LATE Sanjeeva Shetty

                    After several attempts could connect to the andheri office on[protected] which is not on the letterhead and i could manage to get from internet. I was able to take up this matter with Ms. Tabassum in this office. Even the office do not know who has signed the two letters received by me. I too do not find any name of the person who has sent these letters. While the transmission of fax of 4 pages is shown okay at my end i am being told that the fax machine is not working and that i should courier my complaint to their office, which they will reply later.

                    Still now i am not able to understand why the claim is repudiated??? Where is the annexure A as mentioned in the letter???? why the expense cannot be reimbursed??????

                    When i insisted to meet the Incharge of the office, i am being told that Ms. Vijaya Bhandari is the head and she is not available till monday and that too on monday i should first courier the letter and then callup before visiting the office.

                    What impression are you giving about your service to the general public - who have gone for mediclaim with the hope that it will come to their help in hour of need especially when i have lost my father.

                    I am also working on a very responsible position as the head International division for 15years in a pharmaceutical company and i see the attitude of your staff very lax and inhumane.

                    I am going ahead with taking up this matter with the legal department.

                    ASHOK SHETTY
                    Direct Line No. 67739109
                    Cell No. [protected]
                    G.P. Mathur
                    3/474, IInd Floor
                    Dakshin Puri Extension
                    New Delhi-110 062
                    Mob:[protected]
                    Email: [protected]@yahoo.com

                    Date: August 4, 2010
                    Medi Assist India Pvt. Ltd.
                    TPA
                    Indian House
                    A-Wing 6th Floor
                    Marol Naka
                    Off Andheri Kurla Road
                    Behind Star TV Office
                    Andheri East
                    MUMBAI – 400059
                    Phone :[protected] / 01

                    Sub: Unfair trade practice and Gross deficiency in not allowing the claim

                    Ref: Claim No.4990749, Insurance Policy No.9202/[protected]

                    Dear Sir,

                    My wife, Soma Mathur, was firstly admitted in Sawan Nellu Angel’s Nursing Home, Saket, New Delhi for treatment of stone in gallbladder in and around 21/12/2009. She was operated upon. Your Company being TPA for Reliance Health Insurance had given approval for Rs.32, 000/- (approx.) towards treatment of my wife and the said hospital was paid by you. The sample taken from the gallbladder was sent for further biopsy.

                    Lately upon examination of the sample it was found that an operation of “Incidental Carcinoma gallbladder (post laparoscopic cholecystectomy) is necessary. My wife was consulted in ‘Gujarmal Modi Hospital & Research Centre for Medical Sciences’ by Dr. Harish Kapila and an estimate of Rs.2, 50, 000/- was informed by the said hospital for operation. Instead of getting the operation done in the said private hospital, I opted to go in AIIMS (All India Institute of Medical Sciences), New Delhi for the operation of the said disease. I incurred about Rs.30, 000/- in the Government hospital (AIIMS, New Delhi) and filed claim with all bills & consultation / diagnosis reports in original with your Delhi office on or about 31/3/2010. I followed up several times with your Delhi & Mumbai office and also on their demand sent additional papers. A receipt was obtained by me upon filing of the claim of Rs.30, 000/-.


                    Contd…p/2


                    : 2 :

                    To my utter surprise and astonishment I received a Cheque on 3/8/2010 bearing No.168044 dated 27/7/2010 for Rs.1, 410/- drawn on HDFC Bank Ltd. towards full and final settlement of my claim of Rs.30, 000/-. I being honest to your Company / Reliance Health Insurance went to Government Hospital so that minimum expense is incurred. I paid several visits to the said AIIMS, New Delhi for operation of my wife. I spent my time and money in AIIMS for the operation. The operation which was conducted in the Government hospital i.e. AIIMS, New Delhi would have definitely cost about Rs.2 Lakhs to your Company if done privately. Even in the AIIMS in private wards, it would have cost you about Rs.1 Lakh but I chose to go for general wards to minimize the expense. Still such an unfair trade practice at your end by clearing the claim for a meager amount of Rs.1, 410/- as against Rs.30, 000/-?

                    I wish to mention here that it is not full and final settlement of my claim as mentioned in your covering letter dated 28/7/2010. Your Company has to still pay me Rs.28, 600/-. I, therefore, request you to kindly send me your cheque for the balance amount at the earliest.

                    I acknowledge having received the said cheque of Rs.1, 400/- under protest. The same cheque is being deposited by me.

                    It is pertinent to mention here that in case my balance amount of the claim is not settled within 21 days, I shall approach appropriate forum for redressal of my grievance at your cost, expense and consequences, which please note.

                    Thanking you,

                    Sincerely yours


                    (G.P. MATHUR)


                    Encl :

                    1. Photocopy of Letter dated 31.03.2009
                    2. Photocopy of Letter dated 12.05.2010
                    3. Photocopy of Letter dated 13.07.2009
                    To Mediassist TPA
                    please take reference of claim No. 5666955
                    we have summitted claim paper on 23 feb 2011 with all paper and MLC to mediassist TPA delhi, but till date TPA raising descripency for MLC paper.
                    phone was not picked up by executive Dr Faisal and Dr. Alam in Delhi both are like dictator.
                    we will complain to IRDA

                    thanks
                    Rajender Singh Negi

                    Times Of India — NON REPLY OF QUERY

                    I have made several inquiries to the officials of TOI through email regarding subscription of the news paper. But I think either they are too busy or they are least bothered about the queries of the customers. I just wanted the subscription schemes available in north-east Delhi. Thanks & Regards.
                    my name is Chandrakanth D and I have a Medi Assist India Pvt Ltd policy through my employer Ref: EmpCode[protected]HCL)
                    and I have submitted a claim for my hospitalization on 15.12.2013 and submitted a claim on 29.11.2012.
                    Till today I have neither received the claim nor the company responding to my repeated reminders, even registered letter sent by me.
                    What should I do to get a relief for my grievance faced by this company and the mental agonies I have gone through
                    An early action in this regard would be appreciated
                    Chandrakanth D
                    Mob: [protected]
                    I was recently in Lilavati Hospital for some problem. I was under observation from 3rd January, 2014 to 5th January, 2014. My agent for medi-claim filed for reimbursement with Medi Assist India Pvt Ltd . I have been receiving queries after queries which are unnecessary and raised just to delay my legitimate claim. But despite my regular replies and follow-up, they are delaying the claim on flimsy grounds. HOW CAN A COMPANY CLAIMING TO BE ISO CERTIFIED BEHAVE LIKE A GOVERNMENT DEPARTMENT AND DELAY PAYMENT. Claim reference number quoted in the letter is 9778585. If the claim is delayed, I will be constrained to file Consumer Complaint and also highlight the issues in PRESS.

                    Hoping for early response and disbursal of my claim.

                    Regards,
                    Mayur V.Shanbhag.
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                      Rajesh vernekar
                      from Bengaluru, Karnataka
                      Feb 18, 2010
                      Resolved
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                      On December 14, 2009 my father had an MI which was treated at daksata hospital and Kle prabhakar kore hospital Belgaum. During that time i was told that cashless service will take time. As my father wanted an urgent angiography i paid the hospital bills in cash thinking that i will claim for the bills later on.and is submitted the bills on December 31st 2009 to mediassist for the claims, but till to date i have not received any information regarding the proceedings of the claim. My claim no is 4705969. My MAID is [protected]. The bills are of 44,914 rupees. Please help in this case.
                      Aug 14, 2020
                      Complaint marked as Resolved 
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                        anupamsingh82
                        from Pune, Maharashtra
                        Jan 12, 2010
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                        Hi

                        My name is Anupam Singh and my Medi Assist ID no Is- [protected]. I am working for HSBC and my policy falls under Medi Assist's corporate insurance category. I have submitted all the documents to my company HR manager 2 months ago and they have forwarded all to Medi Assist, but till I did not get any response regarding my claim , so please tell me when will i get the my claim money?

                        I am mailing them everyday but I am not getting any reply from medi assist. MEDI ASSIST are the worst health insurance provider. NEVER EVER THINK OF TO GO FOR MEDI ASSIST INSURANCE POLICY, ELSE YOU WILL REPENT.
                        Aug 13, 2020
                        Complaint marked as Resolved 
                        I have submitted my parental insurance claim documents 4 to 5 months back still they are saying the claim is in progress. I went and ask my corporate officials they also saying the same its in under progress. The medi assist people they are not responding when i called customer service they are thinking that they are paying the money from their pocket and even they don't know that we had paid the money well before for the premium in starting of the year. I don't know when these things and all get solve in india. Getting angry on lazy people who doesn't care about there job and there work. If anybody tell me how to approach to get reimburse for the claim submitted is there any short way.
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                          Vijay Kumar
                          from Gurgaon, Haryana
                          Nov 24, 2009
                          Resolved
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                          Hi

                          My name is Vijay Kumar and my Medi Assist ID no Is- ID NO[protected] and policy no- 1306/[protected], i have submitted all the documents in Delhi head office(Sant Nagar , East of Kailash) on 8/9/09, but till i dont get any response regarding my claim , so please tell me when will i get the my claim money?

                          i m not getting any reply from medi assist.

                          I have submitted all the documents more then 4-5 times in MEDI ASSIST Office

                          have submitted again all the documents as per your MEdi ASSIST REQUIREMENT submitted in DELHI (East of KAilash Branch) on 27/10/09 by Hand to Ms.Priyanka.

                          I m Submitting this my docs at 3rd time please process urgently, and one thing is more when i called to ur branch Delhi office east of kailash there is some person Mr AMIT he is not giving any proper answer and also missbehave on phone.


                          Thanks

                          Vijay Kumar

                          PH NO-[protected], [protected],[protected]
                          Aug 14, 2020
                          Complaint marked as Resolved 
                          I undersinged Mr.KETAN ATMARAM JAGTAP Aged 25 years. i am a member of pancard clubs.my folio no is AKP-269. You had assured us mediclaim policy with your membership.

                          I was admitted in FAUZIYA HOSPITAL KURLA on 27/06/2009 and discharged on 04/07/2009. i submitted all my original papers to you on 30/07/2009. My claim Application No. is VM-3732 then as per your requirement again twice you demanded me different documents which were immediately provided to you but still my medi claim is not sanctioned.

                          In this procedure 1 year & 2 months are passed but still medi claim is not sanctioned . let me me know the reason for non sanctioning my mediclaim mony.

                          Is it not your responsibility ?
                          please sanctioned my MEDI-CLAIM as early as possible.


                          YOURS FAITHFULLY,
                          (KETAN A . JAGTAP)
                          Hi
                          MY NAME SURESH OJHA MERA CLAIM NO.5330193, POLICY NO.1603/[protected] RELIANCE GENRAL INSURANCE LTD MERA CLAIM
                          CLEAR NAHI MIL RAHA HAY APPACTION DATE-7/01/2011, 07/02/2011/18/02/2011 KOI JAWAB NAHI MIL RAHA HAY

                          PLEASE URGENT ACTION LIYA JAI

                          [protected]@yahoo.co.in
                          suresh ojha surat
                          [protected]
                          [protected]

                          Mediassist — Claim is not settle

                          Hi,

                          I am TCS employee , I have registered the claim with mediassist in month of March , along with it I have also sent the original necessary documents but still claim is not settle.

                          Regards,
                          Akhilesh
                          Hi, My name is Todupunoori Srinivas, i met AN ACCIDENT ON[protected] subsequently i admitted in Hospital at Visakhapatnam, Andhrapradesh.
                          Imy M A Id No. is [protected] I insured with National Insurace co. Ltd and my premium No. policy No. 551112/48/11/[protected]. I have submited all the bills in the month of may'june 2012, but till date my claim is not solved. kindly expediate the action as early as possible.

                          with regards,

                          T. SRINIVAS
                          mail Id [protected]@yahoo.com
                          mobile No. [protected]/[protected]
                          [protected]
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                            ranajit_cc
                            from Mumbai, Maharashtra
                            Oct 22, 2009
                            Resolved
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                            Date- 22/10/2009
                            This information I am sharing to all as a well wisher.

                            My mother was hospitalised in Ruby General Hospital-Kolkata for a major gyneacological sugery on pre-authorisation from Medi Assist on[protected]. The hospital had initially estimated around Rs.69000/- and had got pre-approval of Rs.45000/-. Because of diabetic problem of my mother, post-surgery condition was quite critical and she was treated for some unforseen problems. On the day of discharged on[protected], the hospital had communicated Medi Assist for enhancement. The whole process had taken more 8 hrs and over that they had cleared bill of amount Rs.69000/- as against total bill of Rs.76111/-. Over hours of telephonic conversations, they simply said upfront thay won't just pay a single amount beyound Rs.69000/- although I was entitled for for Rs.400000/-. They said the hospital has charged more. I said why don't Medi Assist blacklist the hospital. They said the decison will be taken against the hospital in future and but for the time being the patient party has to pay the balance amount to get discharged. They had adviced me to argue with the hospital for charging more. But is it really possible for somebody to understand the charges made by a hospital.

                            However, I got my mother discharged from the hospital at around 8:30 PM where as the process had started at 9:00 AM on the same day.

                            Can you imagnine what kind of harresment this is by Medi Assist. It is difficult to realize the problem unless you have ever used this facility from the great mediclaim provider- Medi Assist.

                            I think Medi Assit has been understaffed. I have never been able to get into the conversation less 10 min. Over that I guess Medi Assist has employed no. of non-sense staffs who do not have attitude to talk. You can not imagine how they said upfront that enhancement beyound the specified amount has been declined.

                            It is really really a big harresment by Medi Assist.

                            Please ask you employer to change the mediclaim provider before you become a victim like me. It is a deceiving mediclaim provider. They will make your life no less than hell.

                            Please give this message a wide publicity for goodness of all.
                            Aug 13, 2020
                            Complaint marked as Resolved 
                            ur right medi assist service bad & employer not give to customer proper answer unsatisfaction
                            Hi

                            I have submitted again all the documents as per your requirement submitted in DELHI (East of KAilash Branch) on 27/10/09 by Hand to Ms.Priyanka.

                            I m Submitting this my docs at 3rd time please process urgently, and one thing is more when i called to ur branch Delhi office east of kailash there is some person Mr AMIT he is not giving any proper answer and also missbehave on phone.


                            THANKS



                            Thanks

                            Vijay Kumar

                            PH NO-[protected], [protected], [protected]
                            I had deposit my original medical bills with attested copy of hospital bills (Amount 254000 INR ) on dtd 26th Feb'10 at Delhi office, Kailash Plaza . At that time all they had confirm that claim will be cleared with in 2-3 wks.

                            Last month they had asked some addtional paper (Document) which i had also diposited in Delhi office.

                            But After 3& 1/2 Months has passed and no one of Medi Assist person are giving proper reply nor interested to discuss actual status (Matter).

                            Patient Name : SMITA KHARE
                            Policy No. :[protected]

                            Hope you understand my problem.

                            Waiting for your positive response.

                            Thanks & Regard's
                            Satat Khare
                            [protected]
                            [protected]
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                              sameer vora
                              from Mumbai, Maharashtra
                              Oct 1, 2009
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                              we have applied for reimbursment of medi claim.medi assist is tpa for new india assurance co ltd..each time they raise new query.its more than 2 months time..panel doctor raises query everytime while all the papers are with them only.patient aged 73years has to run to doctor for the papers.we requsted medi assist to inform us what papers needed by them at once..but in vain...
                              Aug 14, 2020
                              Complaint marked as Resolved 
                              PER YOUR LETTER REFERENCE NO.4431687/03.12.09 I AM VERY SOCK I HAVE SUBMITTED ALL DOCUMENT RELEATED ADMITTED IN APOLLO BSR HOSPITAL BHILAI ON 02.10.09 MY POLICY NO, 2303/[protected] EMP.CODE 70 VIBHUTI BHUSHAN BABU (SIMPLEX CASTINGS LITD.) MY CLAIM NO.4431687.IAM REQUESTED TO YOU PLEASE TAKE ACUTION OTHER WISE II AM GOING TO CUSTOMER CARE.MY EMAIL ID [protected]@simplexcastings.com .I AM WAITING YOUR REPLY
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                                Sam
                                from Mumbai, Maharashtra
                                Aug 19, 2009
                                Resolved
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                                I have been trying for the last two days to get Medi Assit to give me an approval so that we can do tests recommended by the hospital. I dont think Medi Assit is serious about giving approval as they keep asking for new reports and telling me that the fax is missing or not received properly.
                                Everytime I try to fix something, they come-up with a new excuse.

                                I feel the company is nothing but a front used by insurance company to harras consumers. If you happen to take a new claim and your TPA is Medi Assit, please run!!

                                The people working for this company are equally crooked. They lie through thier teeth and make sure you have a tough time getting your claim. I hope these people once go through similar experience so that they understand the pain of having a loved one in a hospital while trying to your policy cleared.

                                Their call center is equally bad. The woman who attend to me literally banged the phone while I was in middle of a conversation.
                                Aug 14, 2020
                                Complaint marked as Resolved 
                                I have been trying for the last twenty five days to get Medi Assit to give me an approval so that we can do tests recommended by the doctors, as per my phisician the treatment is need to be done within one & half month but till date we didn't received any confirmation form your side.

                                I am unhappy with medi assist service.

                                please do needfull.my policy no. is 140100/34/10/12/00007867
                                Hi, I am Anbu raja, I am from TCS, I am having the mediassit insurance for the past four for me, my mother and for my father. I have not done any claims ever before. Now i am in a situation to take an operation for my mother. I consult the Doctor in MIOT Hospital Chennai. They asked to take the operation. So, I collected all the document and I have summited to mediassit through MIOT Hospital. I have applied on[protected]. Still i didn't get any approval or feedback from mediassit or from MOIT hospital. When i went to the hospital they told that me simply it is not approved.

                                When I spoke to mediassit in this [protected] number given my Ramaswamy.
                                They are telling me that they will not approve it.

                                Please tell me know what I can do now.
                                What is the purpose of taking the insurance?
                                Also I want to ask my office why they have given mediassit insurance for TCS.

                                Thanks,
                                Anburaja
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                                  Chandra Mohan Sharma
                                  Aug 7, 2009
                                  Resolved
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                                  I HAVE SUBMIT ALL DOCUMENTS WITH CLAIM FORM ON[protected] AT SANT NAGAR DELHI OFFICE BUT STILL I DIDN'T GET ANY REPLY FROM MEDI ASSIST.
                                  PL DO NEEDFULL AS SOON AS POSSIBLE.
                                  Aug 14, 2020
                                  Complaint marked as Resolved 
                                  I HAVE SUBMIT ALL DOCUMENTS WITH CLAIM FORM ON[protected] AT J B NAGAR, ANDHERI, MUMBAI OFFICE BUT STILL I DIDN'T GET ANY REPLY FROM MEDI ASSIST.
                                  PL DO NEEDFULL AS SOON AS POSSIBLE.
                                  NO BODY PICK UP THE PHONE AT ANDHERI MUMBAI OFFICE ON[protected].
                                  Myself Dhiraj Raval working in Reliance Next Link Pvt. Ltd as Sub Area Manager at Ahmedabad cluster.
                                  I was admitted at hospital in the month of July.
                                  i was discharged from hospital on July.
                                  I have put the claim after 10days but still not cleared after 20days from the submit date.
                                  As per teletalk with Ms. Ekta at local ahmedabad mediassist officer, she had informed that my claim has denied.
                                  Please give the status about my claim.

                                  Employee Name : Dhiraj raval
                                  Employee ID :23505314
                                  Claim No : 4275880
                                  Sir,
                                  Please refer CCN#4209568 under Policy 1306/[protected]

                                  I have received your reminder on dated 13 Aug 09 to submit the original documents

                                  I don's not why my claim is still pending with you last more two months, can you contract me for an early settlement of claim on telephone [protected] Jitender kumar and Mr BK bararia [protected]. Further I would like to inform your that my all original documents are still with hospital Administration because this claim was submitted through hospital when patient was admitted..

                                  thanks

                                  jitender
                                  Sir,
                                  Please refer CCN#4209568 under Policy 1306/[protected]

                                  I have received your reminder on dated 13 Aug 09 to submit the original documents

                                  I don's not why my claim is still pending with you last more two months, can you contract me for an early settlement of claim on telephone [protected] Jitender kumar and Mr BK bararia [protected]. Further I would like to inform your that my all original documents are still with hospital Administration because this claim was submitted through hospital when patient was admitted..

                                  thanks

                                  jitender
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                                    Ravi Rajkrishna
                                    Jul 13, 2009
                                    Resolved
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                                    Please never ever take any Insurances which have Medi Assist as their TPA.
                                    I was waiting in the Hospital for 2 days to get my Cashless approved by them, in these 2 days I spend nearly Rs.1000 to enquire about status to Medi Assist call center from where I used to get responses from call center in the Trained Recorded messages asking same details again & again, finally aproval never came.

                                    Story never ends here, If you are unhappy with response and pay the cash in the Hospital, later try to get it re-imbursed from Medi Assist, beware your bills are verified by so called Executives in Medi Assist in the intention of Rejecting it, finally you'll be suprised to see your claims got rejected and you are going to loose your Hard earned money of this recession time.

                                    I was in twin bed room where there was one more pateint with some other Insurance, he got the approval for his fever within 5 Hrs of hospitalization, mine was some surgery procedure done with anasthesia, I paid the cash after 2 days of waiting in Hospital for approval, it never came, after I submitted the bills for re-imbursment where the bills got rejected by giving stupid reason.
                                    I told them to change their name as Medi ASSIST is not appropriate for them, I don't know why the hell these Insurance companies select this Medi Asist as TPA to spoil their name also.
                                    Aug 14, 2020
                                    Complaint marked as Resolved 
                                    i agree with the above comments
                                    Hi,
                                    Well the exact same this is happening to me right now. It's been two days and I am waiting for the approval to come.
                                    Till now, they've sent the application back to the hospital stating some useless query. The letter from the doctor clearly mentioned that the patient's disease is to be diagnosed and treated. The question that those cheap crooks are asking me back is that what's the cause of my illness.

                                    If I or the doctor would have known the same, why we would have applied for claim...

                                    I've called the office in B'lore number of times till now... It's not a toll free number and they keep their customers waiting in queue for at least 3-6 minutes before an executive addresses the customer.

                                    Absolutely pathetic service.
                                    Dear all,

                                    There are so many terms and conditions for a health insurance policy. like : waiting periods for most of the illness, sublimits of the sum assured, rent restrictions for rooms, icu, OT charges, Doctor fees, Nursing cares. Those terms & conditions are some what for a normal common people to understand. And these rules are mainly done by IRDA, not by any individual company. Because once IRDA approves a policy then only insurence company can sale the policy. Mainly delay can be happened due to few reasons, eg : critical cases, document not receive on time from hospital, enrollment problem, if claims ratio is more(over all), claim verification, past details etc etc...

                                    So i request you all to go through the terms & conditions before taking a policy & before hospitalisation & during hospitalisations so that this will help you lotz during hospitalisation.

                                    Regards,

                                    Mrinal Das
                                    Medicare TPA services
                                    Bangalore
                                    I am working in one hospital to serve the patients and facilitate the process of cashless services to them. Most of the times approval comes so late that patient gets discharged and has to pay from his own pocket. In critical conditions if patient has to stay more than the normal duration there is a lot of time to process the enhancement request, still they don't consider the same and patient is left in bad shape to pay the remaining.
                                    Customer care services are so poor that i am compelled to wait at least for half an hour or even more to get the line connected.
                                    If we call the direct numbers to reach the authoritative person for some information, they deny the request saying call the customer care no., which is highly ridiculous.
                                    I'm trying to contact Delhi office of Medi Assist TPA to know the status of Reimbursement Claim. But these people just don't pick the phone. I'm trying to call them since last three days. They just don't PCIK THE PHONE.
                                    My policy id [protected]. Claim no 1530286. I am vallivelmurugan, working in "The Hindu" newspaper in kochi.I Used your card for past five years onwards.I submited my form August 26 but you took my form september 20.There is no response till today.Your staff only says its go under processing.I spend my money for phone is comparetively should be high.kindly do the needful otherwise i go for other insurance next year onwards.thankyou
                                    My policy no is[protected] and claim no is 4271446. Please do some favour. having problem from TPA, they don't pick up our call whole day. Mr Rajender pal in delhi branch contact no[protected] is the direct person who deals in claim settlement but he is not ready to listen us.
                                    Dear Sir,
                                    I am working in a private nursing home call Greenland Nursing Home in the post of Front Office In-charge and Computer Operator since 2005 and now I offer myself to serve you esteemed institute. So, I request you to kindly select me for serve your institute. My contact no is [protected] and my address is - Near- LGBI airport, V.I.P., Azara, Guwahati-781015, (Assam.)
                                    Thanking You,
                                    Your's Faithfully,
                                    Mukut Nath.
                                    16/3/2007.
                                    M rahul from Sita Hospital Nd we want to be Emapnal with your reputed TPA Comapnay so give us response address are given below:-

                                    dr. sanjay Jain
                                    Sita Hospital
                                    Ganaur(Haryana)
                                    Hi
                                    My claim no. 1313866 and policy no. [protected] of Reliance General(Medi Assist) I have filed my claim on 29 .6.2010 for Rs.12760.00 but no any response coming regarding that and if asked to toll free no. they give me answer to I don't know what the reason for that ask to your claim TPA incharge but he is not picking phone.

                                    Kindly do help me.
                                    Dear sir,

                                    My claim no. CCN5125784 and Policy no. [protected] I have filed my claim for reimbursement for Rs, 12760.00 but still Reliance General Insurance per son asking contact to TPA we can not give reason why this claim is not passed.

                                    Kindly do needful
                                    Vijay Shah
                                    [protected]
                                    Hi,
                                    I totally agree with the complaints by the patients and the attitude of TPA personnels...same case is here, , , i hv applied for reimbursement of claim from Mediassist, , and its in process for last 2 months, , , they keep on sending stupid queries and objections, , despite a genuine case, , when we visit them there is not a single responsible person to entertain us, , , these stupid nonmedicos sitting there and just harrasing the gen. public...ridiculous...
                                    .Rachnna
                                    Please never take a health insurance which has Mediassist as a TPA, , , , , ,
                                    Medi Assist is perhaps the worst TPA in India. My wife was admitted in a nursing home with some respiratory distress problems.The cashless approval never came...and the documents were asked again and again. Moreover the call centre people are too reluctant to receive the calls. What surprises me most is the fact that how company like National Insurance Company can hire such a cheater.Perhaps the nationalized insurance companies are loosing ground in front of private sector companies which are miles away in claim settlement.> [protected]@yahoo.co.in
                                    Hi

                                    Most of the times click on links of Medi assist on any given day is this.

                                    Server Error in '/' Application.
                                    The resource cannot be found.

                                    Description: HTTP 404. The resource you are looking for (or one of its dependencies) could have been removed, had its name changed, or is temporarily unavailable. Please review the following URL and make sure that it is spelled correctly.

                                    Very technical way to avoid assistance.

                                    I dont have a choice as i am registered with coporate insurance claim.

                                    Asif
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