Medi Assist TPA: claim status, helpline and who decides your claim
Medi Assist Insurance TPA Private Limited is a third-party administrator registered with IRDAI under number 003. Medi Assist handles claims for insurers, but your insurer, not Medi Assist, decides the claim and pays it. To check a claim, use the number on your health card; IRDAI’s list of TPAs (as on 18 February 2026) gives Medi Assist’s toll-free number as 1800 425 9449.
| Registered name | Medi Assist Insurance TPA Private Limited |
|---|---|
| IRDAI registration | No. 003 |
| Certificate valid to, as listed | 20 March 2026 (list as on 18 February 2026; registrations run three years at a time) |
| Merged into it | Raksha Health Insurance TPA Private Limited, from 1 January 2025 |
| Head office | Bengaluru |
| Toll-free number (IRDAI list) | 1800 425 9449 |
| Senior citizen helpline (IRDAI list) | 1800 419 9493 |
| Website | www.mediassist.in |
| Who decides your claim | Your insurer, not the TPA |
| Cashless decision | Within 1 hour of the request; final approval within 3 hours of discharge request (IRDAI, 29 May 2024) |
| Reimbursement | Settled within 15 days of submission (IRDAI, 5 September 2024) |
IRDAI, List of Third Party Administrators as on 18 February 2026; still the current list on IRDAI’s site when we checked on 24 October 2026, so the validity date shown may have passed without a newer list being published. Medi Assist holds the oldest registration number among the TPAs on IRDAI's current list. Raksha Health Insurance TPA merged into it with effect from 1 January 2025, so a card still printed with Raksha is administered by Medi Assist.
Written by Shifa NooraniReviewed by Shadab SayeedUpdated nyvo insurance Services LLP, IRDAI Corporate Agent (Composite) CA1085Salaried advisors, no commission-based ranking
If your card shows a different name
Raksha Health Insurance TPA Private Limited merged into Medi Assist with effect from 1 January 2025 (IRDAI). A health card still printed with the old name is administered by Medi Assist, and the old company no longer exists as a separate TPA.
What Medi Assist decides, and what it does not
This is the most useful thing to know, because it changes who you argue with. A TPA administers the claim: it issues the health card, receives the hospital’s pre-authorisation request, checks the documents against the policy and recommends an outcome. The insurer decides, and the insurer is the party your contract is with. Under IRDAI’s Master Circular on Health Insurance Business (29 May 2024), no claim can be rejected without the approval of the insurer’s Product Management Committee or its Claims Review Committee.
So when a claim is refused or cut down, escalating inside Medi Assist is usually the slow route. The accountable party is the insurer, and the escalation ladder below runs through the insurer, not the TPA.
How a Medi Assist cashless claim works
- Show your health card at the hospital’s insurance desk. For a planned admission, tell the claim desk on the card in advance.
- The hospital sends the pre-authorisation to Medi Assist with the diagnosis, the treatment plan and the estimate.
- The insurer decides within one hour of the request (IRDAI, 29 May 2024). Medi Assist may ask for more papers first; the hospital supplies them, not you.
- At discharge, the hospital sends the final bill and the insurer gives final approval within three hours. If it runs late, any extra the hospital charges for the delay is the insurer’s to pay.
- You pay only what the policy does not: non-payable items, any co-pay or deductible, and anything over the sum insured.
The full routine, with what to carry, is in our cashless claim checklist.
Finding the right Medi Assist number
IRDAI’s list gives Medi Assist’s toll-free number as 1800 425 9449 and its senior citizen helpline as 1800 419 9493. Those are the company’s general lines. A TPA also runs a separate claim desk for each insurer it serves, so for a claim, check these first, in order:
- Your health card or e-card. It carries the TPA name, your TPA ID and the number the hospital desk actually calls.
- Your policy schedule or welcome letter. Names the TPA and its claim-submission address.
- Your insurer’s helpline. Ask for the TPA and the TPA claim reference against your policy number. Our insurer claim guides carry the helpline for each insurer.
When a Medi Assist claim stalls: the escalation ladder
L1 – The insurer, not the TPA
Ask the insurer for the decision in writing with the policy clause it relies on. A TPA cannot give you a binding answer, and a verbal refusal is not a decision you can appeal.
L2 – The insurer's grievance cell
Must acknowledge your complaint immediately and resolve it within 14 days (IRDAI, 5 September 2024). Quote the claim number and attach the written refusal.
L3 – IRDAI Bima Bharosa
File at bimabharosa.irdai.gov.in if the insurer's answer is unsatisfactory or does not arrive in 14 days.
L4 – Insurance Ombudsman
Free, no lawyer. File within one year of the insurer's final reply, or of a month passing with no reply. The award binds the insurer, up to ₹50 lakh.
The full walkthrough, including what to write and the deadlines that bind the insurer, is in our Insurance Ombudsman complaint guide. Choosing an insurer instead? The claim settlement ratio of every health insurer sits next to how many complaints each one draws.
Medi Assist questions, answered
What is Medi Assist in health insurance?
Medi Assist Insurance TPA Private Limited is a third-party administrator registered with IRDAI under number 003. A TPA does not sell you a policy and does not decide your claim. It administers claims for the insurer: it issues the health card, receives the hospital's cashless request, checks the documents and recommends a decision. The insurer makes the final call and pays.
How do I check my Medi Assist claim status?
Use the claim or intimation number, not the policy number, on Medi Assist's own portal or app, or call the number printed on your health card, because a TPA runs a separate claim desk for each insurer it serves. If the status has not moved and no query has been raised, involve the insurer rather than calling the TPA again.
What is the Medi Assist toll-free number?
IRDAI's List of Third Party Administrators (as on 18 February 2026) gives Medi Assist's toll-free number as 1800 425 9449 and its senior citizen helpline as 1800 419 9493. For a claim, ring the number on your own health card first: it reaches the desk that handles your insurer's policies.
How long does Medi Assist take to approve a cashless claim?
The insurer must decide a cashless request within one hour and give final approval within three hours of the hospital's discharge request, under IRDAI's Master Circular on Health Insurance Business (29 May 2024). A reimbursement claim must be settled within 15 days of submission. These clocks bind the insurer whether or not Medi Assist sits in the middle.
Does Medi Assist decide what my policy covers, like maternity or my parents' cover?
No. Your policy wording decides what is covered, including maternity, pre-existing conditions and which family members are insured. Medi Assist only checks a claim against those terms. If you want maternity or parents' cover, it has to be in the policy you buy; no TPA can add it at claim time.
Medi Assist rejected my claim. Can I appeal?
Yes, with the insurer. A TPA recommends; the insurer decides and is accountable to you. Ask for the rejection in writing with the policy clause it relies on, then write to the insurer's grievance cell, which must acknowledge it immediately and resolve it within 14 days. After that comes IRDAI's Bima Bharosa portal and the Insurance Ombudsman.
Is Medi Assist the same as my insurance company?
No, and the difference matters when something goes wrong. Your contract is with the insurer. Medi Assist is a service company the insurer appointed, and the insurer can change TPA at renewal without your policy changing. Complaints about a claim decision belong with the insurer, not the TPA.
Other TPAs and claim guides
- What a TPA is, and all 17 registered with IRDAI
- FHPL TPA: claim status and helpline
- Vidal Health TPA: claim status and helpline
- Paramount TPA: claim status and helpline
- United India health claim guide, an insurer that assigns TPAs by region
Sources
- IRDAI, List of Third Party Administrators as on 18 February 2026: irdai.gov.in/list-of-tpas, read 24 October 2026
- IRDAI, Master Circular on Health Insurance Business, 29 May 2024: irdai.gov.in, read 24 October 2026
- IRDAI, Master Circular on Protection of Policyholders’ Interests, 5 September 2024: irdai.gov.in, read 24 October 2026
- Insurance Ombudsman Rules, 2017, as amended to 9 November 2023: cioins.co.in, read 24 October 2026
nyvo is an IRDAI-registered corporate agent (composite), licence CA1085. We are not affiliated with Medi Assist.