Medi Assist India — MediAssist Corporate Policy-Submitted ALL Docs,Responded All Queries,& changed status with Repudiated-awaiting insurer concurrence

Address:

Tower D, 4th Floor, IBC Knowledge Park, 4/1, Bannerghatta Main Rd, Bengaluru, Karnataka 560029

I am registered with MEDI ASSIST past many years. Under the Corporate policy, Spouse and 2 Kids are registered along with me. Also I have taken Parent Policy (for My Mother and Father) from MediAssist. In total 6 family members are register as part of the GROUP MEDICAL INSURANCE POLICY ENROLLMENT from the Company.

Claim No 24582886
Policy#[protected]
Patient Name Nisha B Desai
MAID [protected]
Relation Spouse
Hospital Covid Hosp Care
Treatment Date : [protected]:00 to[protected]:00
Ailment Summary COVID POSITIVE - HOME ISOLATED
Claimed Amount : Rs. 16516

I have raised an initial claim request (Claim Number:[protected] on MediAssist Website for claim reimbursement on 01-May-2021. After some days MediAssist team had created the new Claim No 24582886 on the same website under Policy#[protected] on 07-May-2021.

I have uploaded all claim-related documents around 35 pages 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 as well.

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

05-May-2021 -Kindly provide daily doctors notes, treatment details, vitals chart, with daily oxygen saturation level throughout the home isolation period for further processing
RESPONSE from Insurer: Provided Original Document and uploaded in the Tool and also sent via email

05-May-2021 -kINDLY ENCLOSE THE TREATING DOCTOR LETTER FOR HOME ISOLATION WITH DOCTOR SEAL AND SIGNATURE
RESPONSE from Insurer- Provided Original Document and uploaded in the Tool and also sent via email

05-May-2021 -List of bills submitted with the amount under each bill-kINDLY ENCLOSE A PRENUMBERED BILL OF RS 1300 OF 29.04.2021(ENCLOSED IS MENTIONED ON CONSULTATION PAPER WHICH IS NOT ACCEPTABLE)
RESPONSE from Insurer- Provided Original Document and uploaded in the Tool and also sent via email

05-May-2021 -Kindly confirm whether there is a is a continuous active line of treatment with monitoring of the health status by a medical practitioner for each day throughout the duration of the home care treatment
RESPONSE from Insurer- Provided confirmation

13-May-2021 -List of bills submitted with the amount under each bill-KINDLY RECONFIRM THE CLAIMED AMOUNT ONCE BY PROVIDING A WRITTEN NOTE
RESPONSE from Insurer- Provided Written note through the email and all details of the claim on 13-May

I have provided all claim-related document in PDF format via Email, Responded to all Claim related queries to MEDI ASSIST Team via original documents as request and parallel to that also I have uploaded all same document on their website in the online tool.

I have called your contact center nearly more than 20 times but no one is taking ownership to get it processed. It is very one of the Worst Experience that I have come across. Even complaint team is not available to take up the call or get this fixed and back end team just keep sending email for a ticket which I have raised saying It is resolved.

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 Repudiated but we are still awaiting insurer concurrence (HDFC ERGO).