Medi Assist India — pathetic settlement of payment - change the brand name "medi assist"

Address:Bangalore, Karnataka, 560076

I am Alakesh Chakravarty, working in TechM, Bangalore (Member Id.- 25522). Let me elaborate this situation and I request you to treat this a Highest level of Escalation.

14.05.2018 - Visited FORTIS Hospitals, Bannerghatta Road. My wife was advised to undergo surgery for “Laparascopic Bi Lateral Hernia Repair” immediately.
14.05.2018 - Received the estimation Sheet for approx. 2 lakh for the surgery plus other charges of 38K.
15.05.2018 - Contacted my colleagues/friends and decided not to choose Fortis for the surgery.
15.05.2018 - Written to Medi Assist team sitting in TechM premise, asking for the Insurance limit of Hernia surgery but none responded to my mail. They have created a ticket number : 3783719 but no action was taken as if a generated ticket will resolve their issues. Pathetic!!
17.05.2018 (06:30 a.m.) - Admitted my wife in Q-Medical Center, Dickenson Road, Bangalore-560042 for the surgery and surgery was done by Dr. Shabeer Ahmed M.S., F.R.C.S., MMAS.

Final Diagnosis : BI LATERAL HERNIA (Bilateral TEP)
Description : LAPARASCOPIC BI LATERAL HERNIA REPAIR
Chief Complaints : Lump on both groins for the duration of one month.

18.05.2018 - My wife was discharged on this day.

Payment through cheque -
Rs. 90, 000/- was paid for the surgery of Bi lateral Hernia Repair.
Rs. 25, 000/- was paid for Laparascopic Tubectomy.

14.06.2018 - Submitted ALL ORIGINAL documents to Mr. Prem. from Medi Assist sitting in TechM premise in E-City. All old recoreds of my wife, all documents related to Surgery from Q Medical center, all Pre-Hospitalization Bills, Hospitalization Bills, Post-Hospitalization Bills. I was given a Claim Reference No. 17198467.

09.07.2018 - I was asked for few more documents, whereas I was looking for the settlement amount to be paid to me. Received those documents from Q Medical center on 15.07.2018 to Mr. Prem from medi Assist sitting in TechM E-City.

18.07.2018 - Received the SURPRISED mail from Medi Assist with Subject: Approval for Claim Reference:CCN# 17198467 under policy# 021700/28/17/P1/19045393.
Approved Amount : Rs 60000 from Amount Claimed : Rs 134431.

This is something I never expected. Your team said there is a fixed rate for Hernia operation which is Rs. 60K in my case. WHY? WHO fixed this rate in Medi Assist? Is this rate fixed by a Doctor or by a Clerk? Why I was not informed by the Medi Assist guys when I enquired them about the Hernia surgery coverage? I have chosen to go for Q Medical center because Fortis was quoting me much higher. I was not given the Pre-Hospitalization and Post-Hospitalization Medical bills saying my slab was already reached 60K.

Would you send back all the ORIGINAL Medical bills, Medical reports of my wife which were not been considered for the claim immediately to me? If Pre and Post medical expenses are not payable, then WHY did you guys collect all the medical bills/medical reports from me?

Representatives from Medi Assist sitting in TechM premise here in B’lore E-City was not aware of your 60K limit for Hernia surgery? In that case, only surgery report would have sufficed for this 60K.

Terrible experience with Medi Assist. I would surely like to get your “rule book” to see your policies when it comes to Settling the Payment to the Policy Holders.

You can ask your Medi Assist team sitting in TechM premises for the mails I had been sending to them after receiving the settlement letter.

I understand that this Escalating to Medi Assist about their poor payment settlement...! Also, I know What would be the outcome of my escalation...

Thanks - Alakesh/Tech Mahindra
Was this information helpful?
No (0)
Yes (0)
Medi Assist India customer support has been notified about the posted complaint.
Complaint comments 

Post your Comment

    I want to submit Complaint Positive Review Neutral Comment
    code
    By clicking Submit you agree to our Terms of Use
    Submit
    Medi Assist India
    customer care contact
    Customer satisfaction rating Customer satisfaction rating is a complex algorithm that helps our users determine how good a company is at responding and resolving complaints by granting from 1 to 5 stars for each complaint and then ultimately combining them all for an overall score.
    Read more
    10%
    Complaints
    1173
    Pending
    0
    Resolved
    114
    Medi Assist India Phone
    +91 80 2658 4811
    Medi Assist India Address
    “Sri Krishna Arcade”, 47/1, 9th Cross, 1st Main Road, Sarakki Industrial Layout, 3rd Phase, J P Nagar, Bangalore, Karnataka, India - 560078
    View all Medi Assist India contact information