Hi All
I Would like to share the pathetic experience I have with Medi- Assist . At the time of purchasing they will give all assurance regarding reimbursement but when the actual time comes even after submitting all the hard copies of the documents . They will claim that they have not received 1 or 2 documents and hence delay the reimbursement and finally declining the claim
How it started .
I am working in IBM and as per the medi- Assist policy they assured that they will bear 80% of the total surgery cost of the dependent . My WIfe had to go for Laproscopy surgery on 21st Aug . I paid the complete bill of 70k and thought I will submit all the bills and documents and go for reimbursement because hospital charge more if you go for cashless . So after the surgery I uploaded all the bills, discharge copies, lab reports, docters prescription, even the laprosocopy photos during the operation as given by Rainbow hospital. Then they said that I should submit the hardcopies of all documents including patient history which was missing . I submitted the hardcopies related to my wife on 6th Sep via their helpdesk in hyderabad. After few days they said that they need proof of some random prescription bill, luckily as I had submitted online so I provided the screenshot of the proof . After few days then they came up with a cheap tatic saying that the hardcopies which I had submitted, there are few documents are missing . I told them that since I have submitted all the hardcopies and now I dont have any more hardcopy
I gave them all the details of the docter and hospital where the surgery was taken place . A person named Srinivas told me that he wil go to the hospital and collect the documents and process the claim . After few days when I again contacted them they said that since the 2 hardcopies of the bill are missing hence they cannot process the claim
So basically just to avoid reiumbursement they themselves misplace the documents and then deny the claim . Now I have understood why they do this If the patient goes for cashless the patient has to pay 20% of the total bill(As you know as soon as u tell hospital that we willl go for cashless 70k bill will become 1.5K) and if we go for reimbursement they will themselves misplace few hard copies and then decline the claim so basically they will be in Win- win situation
This is the most un-ethical practice they follow and play with your money . I will definitely say that they will never realize till the time their own family members face the situation .