Mediassist — Query with regards to mediclaim reimbursement

Address: Bangalore, Karnataka, 400708

Website: www.mediassistindia.net/IWP/Account/LogOn?ReturnUrl=%2fIWP

I am writing with regards to an insurance claim reimbursement which was submitted to medi assist.


The claim was for lasik surgery for both eyes which is quite eligible for reimbursement (confirmed by mediassist on call) as i had a power of -7 and more in both the eyes.
I had a package of 45000 inr with some additional relevant medical bills which totals to 46055 inr for which i had claimed. for which i had submitted all the relevant documents in original.
My claim has not been approved yet and in spite of 8-10 follow ups with the helpline i get no valid reply except some illogical arguments. they say they want the following:
• need original detailed discharge summery with diagnosis details (final diagnosis details not mentioned) - discharge letter is only valid when a person is admitted for days long but mine was a daycare operation for which no such document is required nor stands valid.

• need original final impateint bill and breakup (not enclosed) – no breakup can be provided as it’s a lasik surgery and does not include steps/phases. it’s a single surgery and is considered as a package.

• need original pre-numbered cash paid receipt for rs 45000/- (enclosed not a pre numbered not acceptable) – now a days 90% hospitals and clinic have shifted to computers. as usual my clinic has also provided me with a printed computerized receipt with signatures. obviously the cash memo has become outdated. now just for these people the clinic/hospital can’t change their process.

• require letter from the treating doctor stating the refractive error on both eyes prior admission : this is very much provided with the doctor’s signature in the authentic letter head. don’t understand what more they need

Could you please assist in this matter as i haven’t received any response for over a month now?
I have been following up with them asking for next steps, as it is due to their miscommunication regarding the policy rules that has led to a financial loss for me.


If you want you can ask them to crosscheck from the respective clinic as well about the authenticity. also i need this to be sorted out immediately as i went for the surgery only after their confirmation. i do not understand why even after providing all, the docs, no action has been taken yet and every time i get some irrelevant arguments without any logic

If they do not want to reimburse why this stageshow of mediclaim.
Just fyi - even i will be escalating this matter to their higher authorities and might even go to consumer forum if i don’t see any action this time.