Medsave Healthcare (TPA) Limited Complaints & Reviews

Dear Madam/ Sir,
Please arrange to process the Payment for details below:

Claim Status For Policy No:-272100/48/2023/366
Card No [protected]F

I was the employee of the organzation of this company and I joined the comapany on 22 Feb 2017 and left the organisation on 22 July 2019. After three year still I did not received the final settelment amount.

My name is Sanghita Basu and my mother Sarmistha Basu was admitted in Hiranandani Hospital ward 504 bed 4 and had been discharged yesterday (11/09/2022) after a complex knee reconstruction surgery under Dr. Sanjeev Jain Sir. She had fallen down on a road in Pipeline Area near Sakinaka in Mumbai as she could not see the bumper. Mediclaim policy of Rs 220000 is available in her name upto 12th November 2022 after which a renewal has to be done. Her Policy number is[protected]. Our TPA is MEDSAVE. Our Mediclaim agent Mr. Ranjan Majumder working in National Insurance company in Kolkata branch (Contact number: [protected]) did not corporate us at our time of crisis. A very irresponsible agent who doesn't pick up his phone most of the time. TPA approved 90, 000 initially on 9th September and the enhanced amount of Rs 40747 was approved later at the time of discharge from hospital. A total of 130747 was approved when my mother had an assured insurance amount of Rs 220000. Around 50K was charged by Hiranandani Hospital payable at cash at the time of discharge. Got panicked, we immediately called the surgeon and he was generous enough to reduce 25000 rs and we needed to pay an amount of Rs 23655 by cash (attaching the transaction details). Now I would like to claim the amount of Rs 23655 as refund after bearing medical expenses. I have detailed bills and documents which I can submit through mails or directly at Mumbai office. If I need to pay so much after having Mediclaim policy, what is the use of having a Mediclaim policy for which I need to pay a substantial amount to you as premium? Why you have kept such irresponsible employees who doesn't pick up his phone at the crisis period? I will not renew policy under this agent and have planned to transfer the policy in hands of some other professional agent. Check the attached screenshot. Very unprofessional attitude from your side and worst experience I had for the first time with a reputed government insurance company like you. And MEDSAVE is pathetic. Neither toll free number is o[censored]se nor the official email ID. Yesterday only someone picked up the phone and told me to submit at MEDSAVE Office located near my residence. I will do that. But your resolve process is so slow and bad. I have doubt will our problems have resolvation?

My name is Sanghita Basu and my mother Sarmistha Basu is admitted in Hiranandani Hospital ward 504 bed 4. She had fell down on road in Pipeline Area near Sakinaka in Mumbai as she could not see the bumper. Mediclaim policy of Rs 220000 is available in her name and Hiranandani hospital has sent you pre-authorization request to you for approval of 211764 rs and the hospital received an acknowledgement of this. But our mediclaim agent Mr. Ranjan Majumder working in National Insurance company in Kolkata branch he is saying that you have sent query mail regarding how the accident has occurred. MLC report is ready to attach but the hospital is denying on not receiving your query request. You can send the same query mail to them at [protected]@hiranandanihospital.org so that they can send you attachment a d you can process the request. Sir if you kindly send this by 8 am, because the surgery is scheduled at 1:30 pm. Check the attached documents and screenshots. Otherwise I need to pay the whole amount which is practically impossible and the surgery will get delayed incurring more expenses. Please do the needful by 8 am or as earliest as possible. Kindly send an acknowledgement mail. You can contact mediclaim agent Ranjan Majumder at [protected]. I have explained the same to him.

Hi Sir/Medam,

This is praveen Kumar, working on Ovation services Pvt Ltd.Chennai. I admitted my wife P.Sureka in hospital on 24/05/22 due to delivery pain. The same day born new girl baby with cesarean and discharged from hospital on 27/05/22.

After that I applied for reimbursement amount RS.64222 with necessary documents directly on Chennai med save office. But they approved only RS.14854 and around RS.48668 they rejected due to limit exceed reason.

Again I directly sent to med save and asked about reason for the rejected amount. They said "maternity is the package with 50000 max. limit and you already claimed RS.35146 on February reimbursement for cervical stich issue"

I admitted my wife in hospital on 29/01/22 with emergency situation for cervical stich disease due to the uterus open.

I asked them to explain me how the 4 month back cervical stitch considered as maternity package. But they simply said raise query with official email. Still I have RS.150000 in claim amount per my policy but not able to claim when we required even submit enough documents from hospitals.

I spent the amount in hospital based on that we can be claim. But these kind of rejection really painful to us spare the money at this crucial situation.

We are paying the amount for policy, but they are finding the reason for reject the amount even we have enough documents and balance amount in policy. Please kindly get me RS.48668 rejected due to reason limit exceed.

MED SAVE CARD NUMBER: [protected]C

Please see the attached snaps for your quick reference. Please let us know If you need more documents.

Thanks

Praveen.N

Hello Team Medsave,

Greetings from IRIS Hospital,

This mail is to bring in your notice that the Hospital has not received payment against claim ID[protected]B007CH02852 since nearly last 1 year. ( Final approval letter received on date:- 25.06.2020- attached).

As per MSMED Act 2006 the Credit payment period is only of 45 days. Our Hospital is eligible for the directly register for the delayed payment of our patients. So kindly do needful as soon as possible kindly revert back within 2 days

We had done follow up with the involved TPA representative, still the solution is not done and no payment received yet.

We wish Insurance company to intervene and clear the due in this month on priority.

Hoping immediate and positive response from your end as it's been a year now.

Claim haven't proceed yet against the tpa id-[protected]Z. I courier all my doctor original slip at tpa office Delhi lado Sarai. Courier number-EU[protected]IN on 05/04/2021.kindly process my refund

Operation of Sri Anjan Kumar Das has been done at CMC Vellore. Patient is waiting for discharge. Clearance from your end is yet to be completed.File No.20201111B011CH05229

Myself and my wife was admitted in the holy family hospital mumbai for 10 days due to covid 19. The said hospital was not having cashless facilities o[censored]iic. We have made the payment and our claim form is ready for submission. We tried to contact your mumbai office trough telephone and email but there is no response from them. Now i would like to know how and where we have to submit the claim form.
With regards,
. Pappachan...

Dear medsave team (Service provider)

I, kandasaami mohan, a practicing advocate after retiring from a corporate company have been a policy holder for my parents in united india insurance company for over 15 years. I have been paying my premiums regularly on time. I filed a claim on 26.04.2019 for rs.3 25, 000 after spending over rs.400000 on her hospitalization and today on 26.08.2019, the claim has been pending over 120 days.

I have sent 23 mail so far and made over 50 phone calls. I am told that claim is pending for investigation as the claim was higher. This investigation was going on for close to a month. Then the paper the paper is to be scrutinized and their medsave.in site says that this was completed only on 12th august 2019.
The approved amount is pending with finance for over 15 days and now it is still lying for the final signature and transferring the amount to my credit. The very purpose of having insurance gets defeated and more so in my case there are very few specialists and very few bigger hospitals in a place like trichy, tamilnadu and the kaveri medical center, one of the big hospitals does not come under cashless program with medsave. It is time that government should bring out regulations ensuring settlement within a short period of time, say 30 to 45 days and if there is any delay the insurance companies should be made to pay 10% interest over the 45 days period. Let us assume a situation that the policy holder has taken a loan at 15% and the settled amount normally would only be 60% to 70%. You can calculate where the policy holder ends.
Also while settling the claim the company should clearly state as to why the entire amount has not been paid with details so that if the policy is aggrieved, he or she can take up the matter to different levels for suitable action. To make the long story to one sentence, theses companies are run with policy holders money but when it comes to the question of settlement policy holders are treated differently. You are dealing with human beings and their comfort and hence speedy clearance of claims is a must in every case.

Kandasaami mohan
Chennai 600028

I have applied for a medical claim by november 2018 for my mother's surgery. A query has been raised and i have submitted the relevant documents necessary to close it. But no information has been provided about this and the claim has been closed. I'm trying to contact the medsave personalities regarding this but i have got no positive responses. Kindly process the same since it is a long pending.

Thanks & regards in advance.

I am claim on[protected] & still i could't got my claim money. Claim insurance has to need my xray report with duly sign by radiologist nu my doctor is MS in chest and in hospital they provide xray machine and write report. but insurance company has been said it is invalid. also doctor write that patient suffered last 10 days. i am justify that i am not check up any other doctor before meeting this doctor.

Please tell me what i can do? and if insurance company are not send my claim money within 3 days i will go for consumer court. last 5 months i have waiting my money and there is no reply for my agent as well as head/Executive of Medsave insurance, Anand, Gujarat Branch.

I am sending my remainder 2 which is send by insurance company to me.

Also, i need my full money because i have suffer lot of thing and i will paid interest for that money.

Do needful help.

Employee id[protected]
Company - aeml
Location - dahanu thermal power station
Employee name - kanishka shukla
Patient name - anshu dev sharma
Contact number - [protected]/[protected]

My father in laws claim has been withheld for past 2 months. Have been ignored constantly by the medsave tpa mumbai. No response by the medsave team at all.

Have been trying continuosly but no help being provided.

Dear sir i am employee of indian overseas bank. My uiicl med save card no:[protected]z. My father suffering from cardiac problem. I admitted my father to v cardiac & multi speciality hospital tenali guntur district. This hospital listed in med save. Hospital manager not responding properly by treatment uiicl medsave. They demanding cash treatment. Though i am eligible cashless treatmentment by medsave, please suggest me to do needful.
Thanking you sir

P. Bhikoji
Indian overseas bank
Med save card no:[protected]z
Patient name. P. Bikshalu

I am bank employee, my wife has done dental care two rct has been done with capping, i have sent document. They rejected my claim. I have contacted them earlier wether rct and capping will be covered in the policy or not. But now they are rejected the issue, still after 15 days they didn't contacted me till now. I have collected all bills and make every document ready for this thing, after doing all this we have to suffer from these harrassment from the company. Don't know why there email is inactive all the time and there phone number is also not prompt for response.

My name is jalpa shah. Employee of indian overseas bank
Card no.: [protected]z
Patient name: kaivan shah (Dependent)
Date of admission: 10/11/2018
Date of discharge: 13/11/2018
Disease: acute laryngo tracheo bronchitis (Hyper throat infaction)
I had submitted the documents on 21/11/2018
And resubmitted the same on 18/12/2018 as original document are missing at their end.
Till date claims not reimbursed. Whenever i call them, they tell after 2 days it will be settled. I talked to mr. Georgefelix, ms kavita, ms monika, mr bhaskaran,, they all are not responding well and no co-operation from the company,
Due to this people i suffered financially as well mentally.

I have applied for cashless, they have not approved in time, they ask me to apply reimbursement with in 15 days it will be setteled.
I have applied medical reimbursement on 16/09/2018, till date its in process only, in middle they had ask for some documents those also i submitted in october within a week. But till this time they are not moving my file. From last 2 months its in same place only.
Now they are not reponding my mails and not giving proper contact details also.

My policy no:[protected]p[protected] patient card no:[protected]f kohilakonda ramchander query was raised and i have provided the required documents to medsave chennai on 1/12/2018 manager gerge felix[protected] & concern person kavitha-[protected] as the are not yet all responding. But query not updated & i am getting remainder-2 from their end.

Madam/sir,

We have taken mediclaim insurance from united indian insurance ltd in 2017 and thereafter renew it in 2018 for me and my spouse.in 2017 there was no any claim. The card is valid up to 19/05/2019. The card was issued by tpa medsave.

Suddenly, my spouse nandu chouhan age about 62 yrs attacked with onset and admitted to panel hospital kantilal gandhi memorial hospital, tata nagar, jharkhand.

The doctors admitted him for 5 days from 7/8/2018 under panel of tpa medsave.
The same is intimated to the medsave by the hospital.

Without going through the case, simply medsave rejected the claim saying not admissible.

I was helpless even i had the mediclaim policy. My spouse was suffering so much, i collected the money from the relative and pay the bill from my pocket to save my spouse.

I called the customer care of medsave, they said sometimes doctors are in hurry so please send the same in reimbursement.

We did the same. All documents whatever provided by the hospital at the time of discharge, we sent to the medsave office at 701a, lado sarai, mehrauli, new delhi - 110030.

Again doctors raised the query and i also complied the same attached herewith for your kind perusal and necessary action.

And, again simply medsave rejected the claim marking not admission.

Therefore, we are praying from you for the judgement at your earliest.

—
Thanks and regards.

Jaimurti devi.

15 October 2018

From

Nitu Nivedita
Jesus Calls, IPC church building
2nd Floor, C-8, Sector 8 Rohini
New Delhi 110085

To
The Grievance Cell,
National insurance Company Ltd
No.190, Hamid Building, 2nd Floor,
Anna Salai, Greams Road,
Mount Road, Chennai – 600002

Reg: Formal complaint against Non-settlement of claims under...