Medi Assist India Complaints & Reviews

My claim Id 25119092 in which deductions has been made mentioning reason pre-post.But as per policy 1 month pre & 90 days post allowed then why deductions made for that period.
Why it has been categorised as maternity in general claim it would have been better then

Claim status for #24851518 is “processed ready for payment” for a month now and the settlement has not been done. After multiple follow ups via email and phone calls to customer care, I hear the same response that settlement would take 7 to 10 business days and the settlement is not made yet. Such a poor customer service by Medi Assist India.

Ref: Ticket number [protected] & [protected]

Sir,
I am Rohan Karhade
Working at CCCM Division MSEDCL Nagpur
CPF no 2569671
On dated 18/05/2021 & on 29/05/2021 I have admitted my Daughter Ku. Ahana Karhade Age 7 months at Aastha Childrens Hospital At RAMDASPETH Nagpur and she got discharged on 01.06.2021
I have already informed to you telephonically on 18/05/3021 & 29/05/2021 Also informed to you by email

Till now my daughter name is not added in the list of mediclaim.
On 05/06/2021 I have enrolled my daughter's name in the mediclaim till now her name is not showing in my benificery list.
For reimbursement process it is necessary to show name of my daughter in the Benificery list.

Till now no action has been taken from your side.
I have already submitted all the claim form along with all relevant documents.
Till now no response is received as well as nor updated my daughter's name.
It is once again requested to look into the matter.
Rohan Karhade
Dyee civil
Msedcl Nagpur Division
[protected]

Claim id 24746800
On 19th June status show processed ready for payment after that till now no change in status. I had mailed to medi assist but no response received...

Im a corporate policy holder and works with Credit Suisse India Pvt Ltd.
Emp id - 6574513

- 19thJune ’21 - I was hospitalized at Dr. LH Hiranandani Hospital, Powai for my Knee Ligament & Meniscal repair surgery.
- Pre authorized claim for amount 2Lakh was approved by Medi assist before admission.( refer attached )
- 21st June ’21 my discharge Summary was submitted to Medi assist with Gross amount of INR 578688 and net Bill INR 461041 after deducting hospital discount of INR 117647.
- Medi assist erroneously processed my claim on gross amount with incorrect hospital discounts ( refer attached document )
- As there is no mention of dedicated contact number anywhere specific to CS employees not even on signatures, after multiple rounds of calls I got the Contact of dedicated help line –[protected]
- I had to call them at least 15 times to brief them about as call was getting disconnected due to technical issue at their end
- After multiple round of calls I was told your case has been escalated and you shall get the response within 1 hour.
- No response was received and I struggled for 8 hours in pain and stress after surgery.
- At last I paid sum of INR 35142 post negotiation with the Doctor who treated me and later discharged on 21st June ’21 night @ 10pm after a long battle . The actual amount hospital was asking to pay INR 60, 000.
- Hospital Accounts department has already mentioned they will not entertain any refund queries once you get discharged and said to follow-up with Medi assist for reimbursement of amount I paid ( 35142 ).
- 22nd June ’21 I received a revised letter from Medi assist with correct bill amount and discounts.
- I have been following up with Medi assist since last 21st June and I’m yet to get a resolution.
- Medi assist has agreed it was an error from their end in claim processing and keep asking for more time on resolution.

I have raise for reumbursement to mediassist on june 1st regarding my husband's traetment and submitted all the documents with mediassist team. Every day i am calling them for ststus an they are telling me kyc pending and making me getting stress and i am bursting out with tears because of this issue.I have submitted kyc documents 10 times and stil. they are telling me that i have to submit documents for kycehat else i need to do for my claim...

In a case of emergency, I hospitalized my father in a private hospital in Hyderabad. I have insurance in mediassist india. They have deducted so much of amount nearly 50% and they mentioned reasons like hospital discount and excess room rent. Though I am eligible, even after writing and calling somany times to them, they are not responding at all. Kindly take action against this insurance people.Please do needful....

Hello Team,

I claimed for hospitalization for my spouse in April and once approved it was payment failed due to my bank account was changed then I updated my bank account again It was failed because they required cancelled cheque that also attached in after that 3rd time again it was failed on 22-Jun-2021 due to bank details.

After that i sent mail many times to mediassist regarding this issue haven't get any...

Since the last 1 month my COVID vaccination claim has not been paid. The customer service desk is utterly incapable. They respond with wrong claim reference, while ignoring the proper claim.

I really don't know if they are going to pay my claims. Iron is the status of the claim "Processing Payment". They have approved the same but not paying out.

I m working in cognizant. Employee id 626057.I have submitted claim[protected] for my baby on 28 April 2021. And status changed to ready for payment on may 4 but amount is not settled yet....

I was hospitalized due to covid and my insurance claim was repudiated saying wrong report format, Something is missing in the bill.
CLAIM NO: 24681588

and I had another claim, they didn't approve even 50% of the bill amount and even after 2 months its not even processed

Sir/madam

With reference to above, my claim Reference Number H[protected] has not been resolved. Kindly look into the matter at the earliest.

Thanks and regards....

Hi Team,

My wife got operated for cervical incompetence on June 7th 2021, submitted cash less claim from the hospital and Medi assist TPA asked for the query, upon submitting the required documents they rejected our claim telling surgery was not required. Again after few days we applied for Reimbursement Claim by submitting each and every document. Till date they have not settled our claim. Again they have come up with new story for a new document which i have already submitted with them. They are not even going through the document which we have sent. Blindly they are asking us the same document again and again. If you are not interested to settle our claim be specific I will take up the case with office and the IRDA .

Dear sir
Please fund transfer in my account for my claim
9 th aprail to till time Regular pending in process ready for payment
I Request you to please transffer amount this time is very critical I need money for very urjent please transffer my claim amount in my acount.
Claim no. 24040573

Policy no[protected]

Thanks and regards
Hritesh Kumar dhangar
Mob [protected]
[protected]

Patient Name : Dilipsing Rajput
Insurance: The new India Assurance Co.Ltd
Medi Assist Id: [protected]
Policy No:[protected]
Insurer Member ID: PO23909621
Insurer Claim No: TP[protected]

• Valid reason for delay intimation or no intimation of claim

but there is no delay in submitting documents

Ticket No:[protected]

Medi Asist TPA is not resolving this ticket and if they have resolved this ticket, they are not conveying the details of the resolution. They are also informing me that they will reply to my mail dated 22/06/2021 in 2 working days. But that is also not happening.

They have also informed that the issue has been sent to insurer. But insurer is also not responding.

Worst experience with Medi Assist TPA who are not transparent in communication and flagrantly violating IRDA norms set for settlement of claims.

Claims are rejected for reasons that do not fit into the rejection criteria and cases rejected are a fit case for referring this matter to IRDA at the time of renewal of license of Medi Assist TPA.

Hello Team,

I have a Medical insurance from my mother with New India Assurance company and the TPA is Mediassist. On 19th June 2021 my mother was admitted in Apollo Hospitals, Hyderabad and they have submitted a Cashless Preauthorization request on 20th June 2021. Today is 24th June 2021 and still haven't received any response from Mediassist. Due to this Apollo Hospitals is asking me to make a cash payment.

This is gross negligence on Mediassist part. I have logged a complaint with them on 21st June 2021(Ticket #: [protected]), nothing was done so far and it has been 3 days since.

I spoke to two individuals Priyadarshini and Siddhewar on 23rd June and 24th June respectively and they assured that the case will be resolved within few hours but due to their utter irresponsibility neither an update nor resolution was provided to me till date.

This is putting a lot of pressure on my entire family during this pandemic times. Kindly looking into this matter on priority.

Regards

Srinivas

My husband Sh. DEEPAK BALWANI was expired in this Covid-19 wave on[protected] during under treatment at hospital. I have submitted his medical expenses reimbursement claim form along with all required documents and bills on[protected] through post at your Kolkata office. But further till date I have not received the status of claim. I have no income source and I have urgent need of money. So kindly release the payment immediately update the status.

Your claim status portal is not working.

Details of insured person
Name: Deepak Balwani
Date of death:[protected]
Company name: Bandhan Bank limited
Policy No: H0404154
Employee Code: 165202
Member ID: [protected]

Thanks & regards
Himanshi Balwani
W/o Late Sh Deepak Balwani

I am registered with MEDI ASSIST. Under the Corporate policy Also I have taken Parent Policy (for My Mother and Father) from Medi assist. In total 3 family members are register as part of the GROUP MEDICAL INSURANCE POLICY ENROLLMENT from the Company.

Claim No 24742472
Policy#[protected]
Patient Name Anuj Gupta
MAID [protected]
Relation myself
Hospital sudhir clinic & nursing home
Treatment Date : [protected]:00 to[protected]:00
Ailment Summary viral fever
Claimed Amount : Rs. 25767

I have raised an initial claim request (Claim Number:[protected] on Medi assist thru courier for claim reimbursement on 20-May-2021.

I have send all claim-related documents of the reports, bill recipts, medical prescription from the doctor in the tool. Also, I have emailed all documents to Medi Assist Team via email documents is pending.

During the Claim Processing below finding Medi Assist Team have found and informed to Insurer via email as below.

Kindly provide qualified Dr signature with stamp, x-ray report, orignal bill with stamp and signature etc... Continue received
RESPONSE from me: send again thru courier Original bill duly signed by Dr. And signature on same also sent via email

RESPONSE from me- I have send all the documents with duly signed by Dr with stamp.

I have provided all claim-related document in PDF format via Email, Responded to all Claim related queries to MEDI ASSIST Team.

After following all treatment process/protocol, uploading all docs, provided all queries response via original documents and finally, MEDI ASSIST company is saying that from our side, claim's is in information awaited still.

I have applied for a claim, every 5 days they will ask to submit the document, i will submit with in an hour, again after 5 days they will ask for the same document. i called the customer support and asked them to verify they confirmed all the documents are correct. It means very clear who is checking the document is not doing there job properly. simply keeping the claim for 5 days and 6 th day again they will copy paste the same sentence saying to upload the right documents. work stafs if the meddi assist management is not taking care of this then very soon they will be moved out of the insurance service provides.
evey one should complaining to the insurance company about medi assist service provider then only they will do there work properly.
WORST MANAGEMENT, WORST SERVICE, VERY LATE IN PROCESS, WORKS CUSTOME CARE.
Never take any premium from this company and also circulate to all your friends and relatives