Medi Assist India Complaints & Reviews

Hi All,

It is being 2 months, I have submitted a claim for Reimbursement of Rs. 57663, whatever document they asked me, I have submitted and sent through an email. still, the backend is taking huge time to proceed with it.

This is to formally register my complaint and disappointment with the way my claim has been handled by the mediassist team. The processed claim mail is mentioned in the mail trail below.

I have been a policy holder with National Insurance regularly paying my insurance premiums for over 20 years. This is the first time I've had to make a claim due to a serious knee injury which I'm yet to recover from.

I'm sad to say that Medi Assist has dealt with my claim in the most unprofessional and unsatisfactory way possible. Throughout the process there has been a deliberate attempt to ensure the patient is unable to claim their rightful dues.

To start with, the processed claim email mentions my procedure treatment planned as ' Laparoscopy other procedures on the appendix'. I was shocked to see that a person who's evaluated the claim would not know this basic detail of the procedure done. I have little faith left in the competence and sincerity with which my claim has been processed.

I have been trying to reach out to Mediassist through the portal repeatedly requesting them to call me to explain the queries. So far I haven't received any call from any member in spite of repeated requests.

The queries have been excessive & poorly worded with no specifics mentioned. In spite of this, I have responded to each query coordinating with the hospital authorities even while recovering. All requested information has been submitted on the portal as well as offline. There were no follow up questions after I submitted the hospital responses. It is natural for me to assume that you are satisfied with the responses. In case the person handling had issues, he/she should have asked follow up questions for the doctor and the hospital.

The process claim reference email came as a complete surprise. It has no explanation for comments like " under customary and reasonable" and " part of OT" for which deductions have been made. Please share how you've arrived at these conclusions. I have checked with several leading orthopedics and they feel this is justified given the nature and extent of the
injury.
In view of the gross discrepancies and violation of the norms in handling my claim, I request you to kindly re-assess it through a more competent person.

I have tried to raise the issue with the helpline number of Mediassist. Unfortunately they flatly refused to consider my complaint. No acknowledgement was provided and in fact I was told there is no way to escalate an incorrect claim processing.

I'm deeply troubled by the lack of process, quality checks, customer unfriendliness and this deliberate attempt to deny people their claims by burdening them through excessive and unclear documentation. I request you to kindly look into this so that other honest policy holders are not denied their rightful claims.

Hi team,

The above claim:[protected] is submitted on July month. The claim is getting failed again and again. It's been 4 months since the claim is submitted and I am not getting clear information why it is getting rejected. If the above claims are not settled by this week I will file complaint at Ombudsman and seek compensation for the delay in settlement of the claim. What is the use of insurance when the claim is not paid on time. It is really disgusting and disappointing to see there is no effort from Mediassist to solve the efforts.

I have a email proof on eligibility for Clim# 26065386 and claim is repudiated and due for more than 60 days, made man calls and set emails, same response "will update you soon", I am investing lots of time in following up with MediAssit for not my fault. I don't understand why Medi Assist behaving with customers.

Mine is corporate policy, still MediAssit creating problem to me.

Fake company, collecting money from people only

I had made payment for Order no # 1930 on 18 Oct but I don't receive order till now.

Even they are not responding on email and phone .

So don't try to make payment if want to save your money...

On 22 oct i had placed an order with medibuddy with order no 26327at a 50% discount offer. i had booked 3 itemsfor the amount of Rs 437 (1. toothpaste 200+100+brush- 1 qts, bournavita star magic 500 grms refill - 3 packs and sntoor sandal and turmeric soap 4 x 125 grms- 1 qts).
first item cost -153, second item cost -222 and third item cost - 155 total 487.00 for which the payment was done by googlepay with transaction id no[protected] on oct 22 at 7.15 pm. on 8 nov i recieved a message from dhani pharmacy that my medibuddy order is sent by them in bluedart courier no:-[protected] amounting 306. when i opened it contained Colgate strongteeth toopaste saver pack 300 gms 0 2 qty. only one qty is there in my order placed. Rest order is not there. still now no message from medibuddy . they have cheated me by fake advertisment . kindly help me.
thank you

1) 11th Nov 21 - Claim ID[protected] DESRAJMANGLA / SNEHLATA MANGLA / ORIENTAL INSURANCE
Hi Sir / Madam

I have called up your customer care and found out that the “awaiting information” in the below claim is hard copy of the cheque. I have however uploaded all the required document in the my.medibuddy app and the executive Abhishek kumar Singh has confirmed he can see all the documents.

I have previously...

Dear Team,
I want to download e-card from medi assist website but unable to download it. Kindly provide solution ASAP.

I sent my post hospitalization claim duly filled with all the attached documents in originals on November 02/21 and an employee of mediassist from andheri office Rohit Kunchikorve rejected my claim saying that i am not covered under OPD claims in my policy. I am trying to get this resolved by talking to mediassist for more than 7 days now and each time that I am calling mediassist my call is being disconnected or they just pass the buck saying they have escalated my issue. My claim number MUM01468259.. ticket no [protected]

My Claim no. is 25774761 . My EID is H 471506 .

I raised a request for claim on 6th of September and everything was approved and ready for payment process on 20th of September . Its approx. 2months now for me to raise a request . I tried to call customer care several time every time they gave new-new excuses and new timelines . I dropped several mail for few I got reply from mediasist . I can share all those mails . where in written they agreed and gave me new timelines, again all faulty timelines none were met . I haven’t received my money yet and the timelines and SLA is a joke .

Please take this matter seriously and revert back at the earliest .

Thanks & Regards
Rabi Mishra

Hi,

Greetings! Hope you are doing well.

After a long wait of more than 1.5 months since I raised my concern which is still partially resolved, I am now bound to reach for your intervention.

I am Umesh Chandra Chaudhary from LIC of India. My policy details are as below:

Group Policy No –[protected]
Org Name :Lic Of India
Employee ID: 04391234

I have taken two claims with claim IDs[protected] and[protected] from medi-assist. I since there is still an amount which is unpaid by Mediassist (beyond package limit), I would like to Partially Claim the remaining amount from my Son’s Corporate insurance policy under which I am also covered.

For this, I had requested Mediassist to provide verified hard copies of medical docs along with the settlement letter ( as asked by another insurer) of above mentioned claim IDs, I got the docs delivered at my provided address. But team sent me settlement letter of one claim ID (i.e.[protected] and medical documents of another claim ID (i.e.[protected]

On re-iterating and clarifying again and again that :

“I need settlement letter of claim ID[protected] and verified medical documents of claim ID[protected].”

But, Mediassist team sent me the details of the first courier in which they did not send the complete documents.

For your reference, I have extracted the email threads content in the .pdf which clearly mentioned what I exactly needed. I am not sure but either Meadiassist team did not read it clearly or they are illiterate (chances are low however). After back-forth of emails, my problem is still unresolved.

I would therefore humbly request you to kindly do the needful as soon as possible to resolve this matter as the policy where I have to claim is about to expire.

An immediate attention on this to resolve would be highly appreciated.

Thank you very much.
Himanshu
Mb-[protected]

Attachment: Mediassist Mail Thread.pdf

Hi,

I have filed a claim for my mother in April .The Hospital she admitted was under cashless, but i haven't got e cards at that time .So i have raised a claim reimbursement in June. I have got an email on Jun 25th for submitting the Documents . Due to some medical emergencies i have sent all documents clearly on 10th July and reached medi assist on 13th July.
After few days i.e., 19th July i got email saying your...

Hi,
I have filed a claim for my mother, who had post covid issue and was hospitalized in May 2021. The hospital she was admitted to, was under cashless hospitalization however Medi Assist didn't respond in time to hospital and despite of keeping my mother one extra day in the hospital just for the claim settlement, Medi Assist never responded and we had to discharge her paying out of pocket.

We had initiated the reimbursement...

I have raised a reimbursement request to Medi assist for hospitalization with claim number 25492220. Upon producing all the documents which i was given during the treatment and even post that, i was constantly asked to provide "Etiology of Ailment kindly enclose a letter from treating doctor mentioning the cause of the ailment".

I have called their customer care line almost 50-60 times and even have recording of each and every call that i have made. I wrote several emails as well stating that the root cause was not able to be provided by the initial treating hospital, so because of that i shifted my treatment to different hospital.

The hospital which i am getting the treatment provided written root cause of the issue as "HYPERTRIGLYCERIDEMANIA". Even providing the same thing and upon calling again i was told by the helpdesk supervisor as the documents will be enough and it will be closed on priority within 7 working day. I called back again after 10 working days only to discuss the whole story again and providing all the details, this time i was told that it will be resolved and you will get a reply in 48 hours. No reply, no call and no update. Upon calling again and being on hold for like 15-20 mins i get a different supervisor and same story repeats again and again.

Out of the blue i see my claim and repudiated without providing any update to me either via email or call. I am on call with them and getting disconnected 8th time in the row now.

I have raised claim with Mediassist in June 2021 .Status is showing as " Pending Claim Adjudication" from July. Called customer care more than 20 times each time they open a ticket and close it t saying "Resolved". But no update later.

Thanks,
Santosh...

Reimbursement claim raised on 17-Sep-2021
Claim id[protected]

Policy number -[protected]

Gross Amount(excluding refunds) - 734929
Discount Amount(given by hospital excluding refunds) - 151944
Net Paid Amount - 582985

Claim amount settled - 419813

Looks like the discount amount given by hospital(to policy holder) is again removed from the netpaid amount and the remaining balance is settled to us.

I want to understand why discount given by hospital to us is excluded from the netpaid amount again?

Also Neonatal warmer(equipment used to maintain temperature for new born babies while on ventilator) charges(approx 10K) is also excluded form the settled amount.

Raised multiple complaints and sent mails to the MediAssist.
The response we get all the time is, "we have forwarded the issue to the concerned team", but it will be same again from next day.

Corona kavach policy no.443390/48/2021/833 oriental insurance company ltd family floater plan.
Claim no.25924947, 25924974, 25924980.
Medi assist ack no.Coc01120718,

I have submitted the claim last mnth 20th aug'21 with the amount of 22k. However the claim was denied after 9days even without checking the complete document. Due to their irresponsible behaviour the claim got denied. Later I spoke with support team and teach them to how to open the document to verify the information. Even after multiple follow up the claim is still showing denied after 25day days ( still counting). Whenever I spoke with support team they are saying the same stories but nothing could help me on this and nobody ready to understand my situation. Due to lethargic attitude of your team, I am still suffering to get an update from yur end. I am highly disappointed with the way you treat your customers and never think about for solution and always looking for reasons to get out of it.

I have to bug your guys to send an acknowledgement. It is yur prime responsible to acknowledge yur customer queries which never happened. I am in the verge of bad condition in terms of financial & mental pressure because of you.

Claim id[protected]

Additionally I hve raised a tck as well which was closed again without any update or comment on this.
Tck I'd : [protected]

I have taken Arogya Plus Health Insurance from SBI(Policy No: POOPDH[protected]). Raised one domiciliary claim of Rs 670 on 08-Jun-2021.
There is no progress on the claim, called several times but not receiving any response.

Patient Name: Rishi Karmakar(M - Son)
MA-ID(Insurer Id): [protected] ([protected])
Policy No: POOPDH[protected]
Claim Submitted on 08-Jun-2021
Claimed Amount: Rs. 670 INR
Ticket No:[protected], [protected], [protected]

I am an IBM employee and I have submitted my Pre-hospitalization claims for Maternity expenses. My approved amount was Rs9000/- which was shown as Paid on their Website but the claim was not yet paid.
I am following up since then and I have also forward all the necessary documents for verification still I didn't receive my Claimed amount till yet.

Claim Id[protected]
Ticket Number - [protected]