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mediassist India

India,
Tamil Nadu

Consumer complaints and reviews about mediassist India

SINGULURI RAMAKRISHNA
 
Feb 13, 2019

Settlement of claim partially

To Dated: February 2019
The Manager
Medi Assist Insurance TPA Pvt. Ltd.
Registered Office Tower D, IV FLOOR, IBC, KNOWLEDGE PARK,
4/1, BANNERUGHATTA ROAD, BANGALORE-560029
CELL No. +91 80-49698000

Respected Sir

Sub: Hospitalisation Medical Claim

Ref: MEDICAL CLAIM No. 18179637 Dated: 26th October 2018
Additional Information Apollo Hospital case sheet submitted on
17th December 2018 and further additional Medical reports submitted
during the month of January 2019 Claim No. 18179637 Amount of
Rs.1,32,910 againt that we received only Rs. 20,593 on 02nd February 2019.

I have submitted My wife Smt. N. P. THANGAMANI W/O RAMAN RAMAKRISHNA NAIR POLICE No.5007078551 Medical Claim No. 18179637 on 26th October 20018. My wife admitted in Appolo Hospital Jubilee Hills on 05th October 2018 0324 AM and operated gallbladder stones Surgery on 06th October 2018. And discharged on 06th October 2018 0516 PM (Evening). Because of severe pain emergency condition she was admitted in Apollo Hospital, Jubilee Hills Hyderabad.

At that time our son is not available in Hyderabad. We does not know the procedure for cashless Hospitalisation at that emergency situation. So that we were forced to admitted my wife Smt. N.P. THANGAMANI, MEDI ASSIST ID No.5007078551 and My MEDI ASSIST ID No.5007078550 RAMAKRISHNA, HAL BADGE No.1387 retired on 31-08-2004. And my Savings, Bank Account No. 62457464654, IFSC: SBHY0022018, State Bank of India,
VENKATADIRI JUBILEE HILLS BRANCH, HYDERABAD.

On what reasons you have not the paid the Hospitalisation Full Bill amount of Rs.1,32,190 (One Lakhs Thirty Two Thousand One Hundered Ninty Rupees only) Please send me details to our neighbours e-mail ID: [email protected]
And my Cell No. +91 99490 99695.

Enclosed Duplicate XEROX COPIES FOR YOUR PERUSAL AND FURTHER ACTION.


Thanking you
yours faithfully

MANI
(RAMAKRISHNA)
Employee ID No.1387
EX-HAL EMPLOYEE HYDERABAD DIVISIOON
Medi Assist ID No. 5007078550
Copy to:
General Manager (HR),
Registered Office, 15/1, Cubbon Road,
Corporate Office, Hindustan Aeronautics Limited, Vimanapura Post, Bangalore-560 001
Copy to:
Attention: Ms. Anitha N, Mobile No. +91 7899371222
Attention: Sri Sandeep D, Mobile No. +91 9980503649
agelesstraveller
 
Jan 31, 2019

Blatantly violates the service SLAs with customers

Medi Assist is one of the most shameful TPA company that operates around in the country. They blatantly violates all the SLAs they tell to the customer. I have a private insurance (non-corporate) so Medi Assist understands I have the least leverage with them. I opened up two tickets 5556189 and 5721439 with them and never received any response for their resolution even after multiple follow ups and calls with customer care for more than a month. They might reply in response to this review that we will address the issue but finally they never do it.

It is a company which is trying to maintain social media reputation by providing false responses. The real aim of the company is to reduce the claim approval to as minimum as possible so that they can make maximum commission from their respective insurance company clients. My suggestion to all private insurers and corporate HR teams is to never select Medi Assist as TPA agent. Reject such insurance company offers.
meafis
 
Jan 24, 2019

Claim not settled 18348920

We been trying to reach Mediassist and there is no proper response nor on mail and call.

Patient Name : Alice
Claim # : 18348920

Kindly settle the amount ASAP.
vkri2122
 
Dec 22, 2018

Worst response from medi assist where my claim was put on hold for more than 3 months

I have used Medi assist insurance for my Mom’s uterus surgery undergone in chennai Vihaa hospital. It was a reimbursement claim since that was not a in network hospital. It was an emergency situation and I didnt have any options left. Surgery happened on Oct 11 and she was discharged on Oct 17. Initially when j trying to submit all documents portal was down and I couldnt do it. I had to travel abroad and I seeked my friends help to get it submitted. After long struggle I did that. After 2 weeks of time I got an email that they need some more additional documents to process the claim. It was nothing but same documents which I submitted earlier like operative notes, first consulation paper, doctors letter on the treatment made, hospital tarrif. I called the customer care rep and asked why do they beed these again since I submitted already. They were not sure on what documents were submitted and they dont have idea too. Then I sent multiple emails and calls and all I got the same response. I then requested my sister who was expecting and no other way to go to doctor to get all these. They said all docs were provided already and there was a letter given by her. I then asked my friend to drop these through my company. It again took 2 weeks to submit. You know what same problm againasking for same set of documents. Till today I have looped all ppl I kew but medi assist did not respond. I sent all these docs again from hospital third time. Now I got an email that out of 152000 only 50000 is approved and rest all are out of limit. This is really a shit to use medi assist. I am in US and I spent 2lakhs for my travel to take care of my mother. I could have used that money for her surgery. I am very much annoyed by medi assist behavior. And to all insurance company do not pay attention only collecting premium and documents. Its all abt life. Better stat away drom
Ppl.
shailajaP
 
Nov 14, 2018

Claim

Service is very very poor. Even they do not pick up phone. Dont know what service they are providing. I tried calling multiple times and finally they picked up my call and they hanged up my phone. I will give 0 star rating for their service.
lakshanth
 
Sep 5, 2018

MediBuddy Claim Documents

I have submitted 2 claims from a corporate policy which got rejected citing some reasons. And since then i have been requesting to get the original documents back to an address. The claimwas raised on 26th june and the request for documents was raised on 27th july,with ticket number-4282052.
Even after daily followups for 3 months, i have not recieved any response from the team .It was a personal emergency and got no reply despite every call with the customer care numbers and the personal email ids.
Sonupriya
 
Jul 26, 2018

5 months has passed but claim has not bern settled

Hi, to whom it may concern, this is not the way to handle your customer complaint. I have neen waiting since 5 month despite of my claim has been approved. The reason is not. Been told on why it has been delayed. Claim id- 16511786.

The complaint i am writing will also not be adressed in at proper time. It way too frustating on waiting such long and receiving extended date.

Please inform me if i am getting or not? Waiting for the response
Ashish.ghosh86
 
Jun 13, 2018

Claim not settled >2 months - Claim ID- 16835405

Hello Team,

With reference to the claim no 16835405.

It's more than 2 months my claim amount has yet not cleared by your team. I spoke to your customer service more than 30 times mailed for support for > 15 times but no one is responding properly and only gives me TAT. Everytime your team told me that the case was with investigation team. Now, after a long period of time without any investigation happened (Neither mine nor the hospital), I have got a reply that your claim has been denied due to negative verification.
Is this the way you people behave with your customers. We have taken the claim for benefits when required and paid the policy amount as well and when we require your support you deny. Wow!! What a service.
I want to get the claim settled properly without any further deviations and misconduct and frauds.
Kindly close the issue asap.

Regards,
Ashish Ghosh
Rajsee Shah
 
May 23, 2018

FOR CASHLESS CLAIM NO 12966559 - 3506533

DEAR SIR/MADAM,

I HAD APPLIED FOR CASHLESS AND THE NEW INDIA ASSURANCE CO LTD HAD APPROVED MY APPLICATION ON 18/07/2016 VIA APPROVAL NUMBER 5022946085.
MY POLICY NUMBER ############/00000049. TOTAL AMOUNT OF BILL WAS 194250/- BUT APPROVED FOR RS 155400/- AND REMAINIG AMOUNT WAS PAID BY ME. NOW THE APPROVED PAYMENT IS NOT PAID TO HOSPITAL TILL DAY AND HOSPITAL IS DEMANDING THE SAME AMOUNT FROM ME. AS I HAVE APPLIED FOR CASHLESS BECAUSE I HAVE MEDICLAIM SO I DO NOT HAVE TO PAY ANYTHING.

SO PLEASE DO NEEDFUL IN THIS REGARDS AND MAKE PAYMENY TO HOSPITAL.
ALSO SEND A MAIL OR LETTER TO THE HOSPITAL THAT PATIENT IS NOT LIABLE TO PAY ANYTHING AS THE CLAIM IS APPROVED FOR CASHLESS.

THANKS AND REGARDS
BHARATBHAI N SHAH
7990257877
9428292639
Mda Carvan
 
Apr 16, 2018

Medi assist is fraud and cheap

Below are the review words for Medi assist from :- https://www.mouthshut.com/product-reviews/Medi-Assist-India-reviews-925668185

Extortion, Shoddy, Cheap , Cheat, medi assist is fraud and cheap, From My prospective its totally a FRAUD companynever recommend anyone to insurance from medi assist,
complete fraud., all the loot stuff, Never prescribe anybody to protection from medi help. medi help is extortion and shoddy .
cheat individuals, awful experience, medi assist is fraud and cheap .what these guys do is plain robbery.
Mediassist is one of the worst Insurance company, Fraud Insurance company, Mediassist is a totally fraud company
Medi Assist are BIG FRAUDS.
Pareshpandya
 
Jan 30, 2018

Claim is 16033458 not settled always ask for wait

Dear all
I have submitted claim no 16033458 which was approved by the company on 10 Jan 2018 but your executive giving me 7 working days time than 16 day and today on 30 th Jan 2018.they ask me to wait for 21 days .
It is too much to make fool to customer now I am going to complain through consumer form and IT'S A.
I will just wait till 1 Feb 2018 for your response.

Regards
Paresh pandya
Ex employee kotakbank
9898444902
saurabh gupta 33354
 
Jan 14, 2018

Claim ID 16074883

1. You want clarification on diagnosis, It is clearly
mentioned on second page of discharge certificate.
2. Regarding Time of admission, Hospitals have their
own format and they will not change anything for you,
In case of any situation of doubt you yourself can
contact to hospital and ask for clarifications, why shall
I keep on running. If this was important than you
should have mentioned it before, I have called you
before submitting the documents.
3. You are telling that diagnosis is not clear and require
etiology, sir everything is written on discharge
certificate that is your problem to findout under which
catogary claim will fall.
4. You are asking for hospital registration number and
number of beds, I think CMO number is mandatory
and that is clearly mentioned on hospital bill.
regarding number of beds, I am not able to understand
why bed count is mandatory for settlement of any
claim.

Saurabh Gupta
Mob# 9971896985
Rentu M R
 
Jan 11, 2018

Claim not settled

Claim number: 15304730 for hospitalization at Suraksha Women Children Hospital for Date of Admission:02-Sep-02017 till could not claim settled. I could not get any response from Medi Assist. Who is the response person ???...
Najeeb Tikkoti
 
Dec 22, 2017

Claim not settled

My claim no 15318061 approved on 23/10/2017 ..it is not yet settled .Contacted many times through phone and email . They are telling it will take time and you will get it soon .....but still not settled
bhaskar1111
 
Dec 17, 2017

Reimbursement

Hi,

Refer claim id 15705745, my claim has been approved on 23/11/17. Its being more than 3 weeks and I haven't received the reimbursement amount. Kindly provide the feedback.

Thanks,
Bhaskar Mandal
RMO
 
Dec 7, 2017

Payment not settled

Sir,
Kindly Check this outstanding payment is not received since almost one year.
Mr. Avijeet says that its been cleared after 3 or 4 month period. since no reply or feedback in your side. If you are not able to do this, please tell us. we go for the legal way.



Or try to setteled these payment as soon as possible.

Thanks & Regards


Patient Details:-

Patient Name..... Sobia
Claim no............11406024
Medi Assi ID.......5019098716
Settled Amount...24300/-
Dated.................14/07/2015
Address.........Sarvodaya Hospital & Research Center
KJ-7, Kavi Nagar Ghaziabad-201002


Patient Name.......Shuchi Jain
Claim No.............11885947
Medi Assi ID........5010250487
Settled Amount....32674/-
Dated..................13/11/2015
Address.........Narayana Multispecialty Hospital.


Thanks & Regards

Sarvodaya Hospital & Trauma Centre
342, Sec-4, Vaishali. Ghaziabad (U.P)
Phone.. 0120-4128589, 0120-2774739
Rakesh Bublani
 
Dec 1, 2017

No response to the Claim

My Claim No is 15233146. You are a fraud it looks. No one cares. No one bothers. I submitted my claim on 27/8/17. I followed up and was asked to submit a copy of cancelled cheque which i did on 5/10/17. It was confirmed that this was received. I tried to talk many a time but in vain. Luckily I talked to Manjula towards the end of October 17 and she was apologetic for the delay. Said it would be cleared in 7 days. I waited and again talked to her on 14/11/17. She was again apologetic and said due to technical hitch it has been delayed and sought further time....Today when I talked to sana she put the receiver down...
ankit9010
 
Nov 17, 2017

Regarding Approval of claim 15005403

I have submitted all the original documents but still my claim is pending and the reason is being my documents are missing. I have resend the all documents again but they have again same query regarding it.

I am really harassed with this situation now. i have used my all hard earned money and now i have left with no hope. please sir this is my humble request with folded hands to approve my claim.

Claim amount Rs.50,077

Claim id : 15005403

Admission date : 29 April 2017

Patient name : Naresh Kumar Prabhakar
[email protected]
 
Nov 17, 2017

No proper response from Mediassist

I haven't seen any such worst customer care cell, where Mediassit executives cut the call (almost 7 times) when we ask for the queries.
They are rude when we ask for the information.

I had submitted a claim for which I was chasing Mediassit for almost 2 months to get the updates. Instead giving me the update they are very rude during the call and cut my call instantly.

Very bad service from Mediassit.

From next cycle on wards for sure am not going to enroll through this worst mediassit.
bsjagtap
 
Oct 30, 2017

Claim denied

please do not take claim from Mediassist. Very worst insurance company
Geeta Jain Faridabad
 
Oct 14, 2017

reimbursement of claim no. L5633734351

Dear Sir / Madam

I have submitted all the original documents through registered post dated 04.09.2017 at your banglore office and i have got a paper receiving confirmation message on 09.09.2017 with tracking no. L5633734351. my policy no. for financial year 2017-18 is ############/3336 dated 22.06.2017. after passing more than one month i have not received my claim amount in my a/c as i am your esteemed customer more than 8 years and without any break i have renewed all my policies every year. kindly try to settle my claim amount as soon as possible.

my details are as follows:

Current Policy No. ############/3336

Previous Policy No. ############/3278

Name : Mrs. Geeta Jain

Policy Holder Name : Mr. Narender Kumar Jain

Relation with Policy Holder : Spouse

MA ID No. 5003959968

Claim Amount : 25351/-
gdgoyal46
 
Oct 5, 2017

CLAIM NOT APPROVED FOR FULL AMOUNT

I HAVE SUBMITTED CLAIM FOR RS.18624/on 22/9/17 but approved for Rs.10047/only when my balance in retired emolyees medical policy is more than 3lac why claim no 15404086 dt 29/9/17 .I am sbi retired officer
Balajitelang
 
Sep 23, 2017

My claim no. 14970913 denied by Medi Assist without genuine reason

Dear sir,

My claim no. 14970913 is denied by you after two months of submitting the doc. My question is if you want to only reject the claims then why you people taking this much time??

I was admitted due to chronic diahrea, vomiting & nausea.
After investigation it is found that it was tropical sprue, so doctor treated me as per that and after getting normal condition I was discharged.
Now Medi Assist is saying that this disease is not listed in their policy & there is no active line of treatments & this could be done as outpatient.
I don't know for what purpose this policy is? Very bad experience of service by Medi Assist so my suggestion to Medi Assist is please give good service to people & change your policies so that you & people both will get benefit of this policy.
If possible please approve my claim as I spent very hard earned money for this treatment & fortunately I'm feeling better after treatment.

Regards,
Balaji Telang
MA-ID 5024772893
cust
 
Sep 8, 2017

Please do not take insurance if TPA is Medi Assist.

Please do not take insurance if TPA is Medi Assist.
Worst experience.
No support. no mail report.
Take Medical insurance from agent only. I got medical policy from BOB bank.
Prasadgopathi
 
Aug 23, 2017

Claim Rejected due to spouse details not updated

Hi i have health insurance through my company when I was joined in my company that time I didn't updated my dependency details for that reason they Rejected my claim.

But if I get this reason within in 10 or 15 days after submitting my claim my wife can able to process in her company.

But They updated this reason after 50 days every week i am checking with medi assist person in my company even he also not updated this reason..

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