Paramount Tpa Complaints & Reviews

We had bought around 25K plus medicine from 1mg in duration of 3 months during my father's treatment which falls under reimbursement period. We had submitted all the relevant bill provided by 1mg to Paramount. Paramount rejected these bills on mere ground of duplicate copy though similar bills from 1mg were accepted by other insurance providing in the past. I don't understand the logic used by Paramount as other insurance provider like the...

[protected]..Girish Kaleti Uber Auto driver. Accidental reimbursement claim

I sent two Hospitalisation claim form one is swati Yadav and other baby of Swati Yadav via post to Delhi branch/office in July 2021.
Claim of Swati Yadav is approved but claim of baby of Swati Yadav is pending since July 2021. Dependents are also updated in union pariwar which is staff portal o[censored]nion bank of India.
I attached file of Swati Yadav for reference, I post/courier to Delhi office on same date.
Thanks
Sadarambr...

Sir,

I had suffered a serious covid 19 phenomenon in the month of may this year and l have already submitted the medical documents with required forms and formats but I am being harassed as everytime the same documents is asked as a deficiency.
Doctor has already signed every documents with her seal and still I am being asked about her degree and qualification.
I have already submitted all bills in originals...

TPA has released the claim @Rs.12000/- per day inclusive of all on the grounds of a Circular issued by Government of Bihar on 20/08/2020.

But the said Circular no where indicates that the said amount of Rs.12000/- per day includes cost of medicines, cost of pathology charges, cost of HRCT tests & pre and post hospitalization expenses.

Request to go through the said Circular once again and settle the claim properly at the earliest please.

Regards

Abhay Kumar
Mobile: [protected]
Email: [protected]@yahoo.com

After my mother got admitted for Covid-19 treatment(admitted and discharged in April 2021), regarding the claim we have been trying to contact Paramount tpa but they never responded via email and while calling they used to hang the call once we ask query. we continued for 4 months to follow up and no response.

Hai, it a bad company for insurance they playing with life, I never know until we applied for my father covid treatment we thought we were paying for SBI later SBI manager told it this company first they delay we didn’t get bills later they say it’s not medical expenses we have to join together and sue them we should stop before they explode more people. SBI please do pay attention and have good company not scammer like paramount

I was send my medicin Bill with Mediclaim document with prescription
But my medicine amount which is 18093 is deducted from it. This is cheating by paramount

Team,

My Name is Amit Sheth and My Father who was hospitalized in November 2020 for Covid Treatment. He got Discharged on 15th of November and I submitted my claim with Paramount on 19th November.

Policy Holder Name: Rajesh Sheth
Policy Number:[protected]

Below issues I have faces so far,

1. Post submission of Claim online on 19th December got first Acknowledgement on 26th November. (They took 6 Days just to process online submitted document???)

2. They commit claim processing period as 20 Days which seemed impossible so I started following up 2 times a Week. First email I received on additional documentation on 5th December which I submitted.

3. I got same email with same Query number to submit those documents again on 12th December. So I started email chain.

4. Since 12th December I am asking for further updates but they are still checking god knows what?

5. On 2nd January I received another email after almost 5 email and 10+ calls on additional documents which I submitted on 19th November itself.

6. Senior Executive Mr. Abdul Jamadar is not even answering my calls or MSGes with whom all email communication is happening.

7. Till today there is no response and Claim Amount is not small, during this difficult time we also need money to survive and these guys are wasting my energy in such follow ups which ideally should get resolved in 5 Days.

It's now 45 days but no update and they are still checking documents. I would like to highlight this as Mental and Physical Harassments where no one takes ownership of the service they supposed to provide.

Kindly help on this matter as next step from my side will be to file FIR with nearest Police station and Submit same with IRDA.

Regards,
Amit Sheth
[protected]

I Am Having Health Insurance Of Edelweiss And TPA Is Paramount. The Relationship Executives Are Unskilled And Do Not Deal Good With Customers. My Insurance Claim Around 70K INR Has Stucked Because O[censored]nprofessionalism Of TPA Peoples. They Just Want To Cheat Poor Patients And Not To Pay Claim Amount.

My policy no 251100/50/20/10000250
My spouse name is not added till now.i m a union bank staff.kindly add his name and get back to me

My wife was admitted in columbia asia hospital on 23 dec 19 for severe spinal pain... Cashless services was denied on the ground that she is morbidly obesed... Doctor certified that this pain is not due to obesity... I was forced to take out my wife from hospital without proper treatment... This has harashed me mentally... A repeated request with doctors certificate submitted but no result received... My total loss of rs.38, 000/-... Please help me to resolve the issue...

My wife was admitted to supra hospital on 21st sep 2019 to 23rd sep 2019 for the treatment o[censored]mbilical hernia and total expenses incurred including pharmacy bills is inr 87, 056.

There was some deficiency in the documents submitted and same was provided on 1st oct 2019.

Now the tpa has come out with claim approval of inr 37, 754 and there is some incremental deduction of inr 44, 700 which i don't understand and it is against the coverage provided. There's no such clause as incremental deduction.

Request you to process the claim once again and provide the complete claim settlement as per the documents provided and it understandable that there will be few non-medical expenses which will be deducted

Insured name - imran a
Name of the patient - naghma banu
Corporate - karvat cover more assist pvt ltd
Fir no. - 4434300

I have phs id 23356510. And submitted a claim for reimburesment for chronic pancreatitis. Paramount tpa had raised a deficiency that the delayed intimation letter should be signed by nodal authority.. Now its been 2 months that our nodal authority is saying that they have handed ober the hard copy of the same repeatedly to mr naveen heeralal in hyderabad. But still paramount tpa executives are saying it is pending. Kindly look into the matter.

Dear sir/madam,

This is in regard to my reimbursement case for the medical treatment i underwent at cure emergency hospital (Secure medical service pvt ltd.) employee insurance cover o[censored]nited india insurance company ltd.
On request, my tpa was approved and partial amount for my medical treatment was transferred to my cashless card. I got admitted to the hospital on the advise of the doctor and underwent the complete treatment. At the time of getting discharged during full and final payment, i was taken aback when instead of providing full payment paramount withdrew even the partial amount offered previously on initial approval. The reason given was that hospitalization wasn’t required for the treatment i underwent.
If the insurance was to be denied, it should have rejected straightaway because paramount knew i was to go what treatment, at what hospital, on which dates and with which doctor. If it got approved once, there was no sense to deny it later as it was on paramount assurance and basis that i went for the full treatment, having confidence that my treatment charges would be taken care by paramount but i felt let down and duped and i was forced to lend money to pay for my charges.
I put in the case for reimbursement via my company along with the doctor’s prescription that indeed the hospitalization was requirement for my treatment defying the grounds on which paramount denied my insurance but it again rejected my insurance request without even commenting on it or citing any reason.
I am requesting you to consider my case as it is genuine and kindly help to process my insurance payment so that i can return my lent amount.
Thanking you in anticipation.
Regards.
Sahdeo das
Branch manager
Andhra bank
Rudrampur branch [protected]
Claim no /cc no 4168835
Phs id 23369263, policy no 500100/28/18/p1/09892911
Employe no 26596

Hello,
my self Sunil Kumar PHS ID 22405774
I was admit in hospital 19 to 21 March 2019 which hospital list of TPA cashlesh facility and same time all reports send to.TPA office by hospital but bill not approved by TPA. then I talked to customer care and he told me That due to some technically problem your bill cannot approve. and if you want to discharge Then pay the bill and do the lim in future so I paid the bill that time.
after that I send the all orginal documents to TPA and my claim file received in TPA office on 03 April 2019 but no any query ask and not claim approved by TPA till June end.
In July first week TPA ask some query then I send the all query documents but till now my claim not approved.
I asked the some question to Mr Sumesh Gupta, Ajay Rawat, Narender Shahi by mail but nobody reply the answer of my query.
1). Why were you not approved the my bill during admit time.
2). What is the Min & Max days for claim approval in procedure.
3). Why were you not ask the any query from discharge to June end
4). Who is responsible for claim approval delay.

I will never suggested to any person for paramount TPA.

Dear sir,
I am employee of andhra bank and took group health insurance policy from united india insurance through your tpa (Phs id: ui ber 23365405 abank). My brother has been suffering from stomach pain, doctor advised for surgery after taking all medical tests and ct scan. We have approached one of your network hospital in anantapur (Ysr memorial hospital) and submitted all relevant documents (Our insurance cards, id proof of patient, my id proof and my employee id card on[protected]. After taking all the documents hospital people told us that they will intimate us after recieving initial approval from paramount. We are doingregular follow up to hospital, they continuously told us approval not received yet. But when we asked them on[protected] by personal, they told some employee has changed and please give all details once again. Immediate effect we have submitted all documents once again to hospital. After that we have also intimated to paramount through toll free number. But each and every time they are saying it is under process, you talk to our delhi team. We got same response from them also. After continuous follow up on[protected], i received call from one of paramount executive for investigation. I have submitted document formy relationship with patient and other relevant documents. But till now i have not received any response from your side. When i checked today evening[protected] in your website by sign in, i found status of the claim is "wrongly entered and closed". Regarding this i have contacted your toll free number, after a long wait your executive said it is still under process and contact to delhi team tomorrow 10.30am. I have asked about the maximum time for the processing he simply disconnected the call.
As i am an employee, each and every hour contacting you and your network hospital is may not be possible. So kindly take up this issue and resolve it as early as possible.

Regards,
Saleem basha
Asst manager
Andhra bank
Govt cocoon market branch

My father was admitted in hospital on 11.09.2018 in AYUSH HOSPITAL in VIJAYAWADA, ANDHRA PRADESH. my employer (INDIAN BANK) taken family health insurance, sum of Rs.300000/- (parents/parents-in-law+ spouse+children with no age bar) i chosen my father+my mother+ me+my wife.
my PHS ID:23397669
COMPANY: UNITED INDIA INSURANCE
POLICY PERIOD: 01/09/2017 TO 30/09/2018.
Now they are not approving my father cashless facility and suggesting me take Reimbursement because of AGE difference between Aadhar card and insurance data. my submitted data( my father DOB:01.01.1956) as on 30.09.2017 is as per aadhar later in april.2018 he updated aadhar as per his studied certificates for pan card purpose as 04/02/1952. now TPA is trying to deny n hospital forced to pay cash.

Dear Sir,

I am retired Indian Bank Employee. I have submitted the Domicilliary claim for my spouse PHS ID: UI MAD 23396505 IBANK W & PHS ID: UI MAD 31205735 IBANKR W) for 8 months Domicilliary bill, but more that 6 months still only one bill has settled by the Paramount TPA. What about my others bills, no response from their end after following with you so many times and also i have conducted their representative Mr.Vinoth who is in-charge for our Indian Bank employees, Madurai. I request you to settle the claim without delay.

I have already raised the complaint with PHS Ticket No.PHS001980

We hereby submitting the claim details for your reference.

Month
Claim amount
May 2016
Rs.6572.25(Pending)
August 2016
Rs.1712.00 (Pending)
September 2016
Rs.2480.55 (Pending)
October 2016
Rs.1988.05 (Pending)
November 2016
Rs.2889.00 (Pending)
December 2016
Rs.2267.00 (Pending)
January 2016
Rs.3272.00 (Pending)
February 2016
Rs.3562.85 (Settled on 07.04.17)

Sub :- Non Receipt of Claim. Claim No. – 66620808 / 09 Dated 21.07.2015. Ref :- Policy No. – 240600 / 46 / 14 / [protected]. Intimation No. – 8169763. PHS ID – NA MUM 22808487 JIO. Dear Sir / Madam, With reference to above, I have submitted all my papers on 21st July 2015, than you send requirement of papers & 2nd paper submission on 1st August 2015, than we give all papers & you said that your claim is settled than you say that you do not make payment of any NRO Account. So, we give Dena Bank details by email on 2nd Dec 2015 to Miss. Shubha Jadhav & also she talk with us that your account will be credited by above claim in 24 hrs. but till date no claim settled & I call at tollfree or any paramount company they says call with anita sharma/ shubha & madhuri but nobody can take phone Miss. Shubha Jadhav / Anita Sharma & Madhuri is responsible for non Receipt of credit. So, I will send above details & send me any query at my email [protected]@rediffmail.com. My telephone – 28657607, mobile no –[protected].

My Name is Rohit Sharma my PHS ID is 20497164.I have submitted the Claim of Rs. 15880 /- on 08-Aug-2012 to the Paramount Executive in Vadodara. At the time of submission he was telling it will take min 2 Month for settlement as the claim is Late Submission.

From last five Month i was following from them ( Paramount Local or Delhi Office ) but still they are telling it is in under process.I have already spent approximate 1000...