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Paramount Health Services & Insurance Tpa Private Limited: Partial Reminder Letter Without Prejudice

This partial reminder letter from Paramount Health Services & Insurance TPA Private Limited requests additional documents from IDBI INTECH LTD. regarding an insurance claim. Key details include a hospitalization from June 8-10, 2023 for Ca Breast. While some documents have been received, the letter requests original discharge documents and claim form with claimed amount. All investigation reports are also requested, noting that if documents are not received within 9 days, the claim will be processed based on what has been provided.

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56 views1 page

Paramount Health Services & Insurance Tpa Private Limited: Partial Reminder Letter Without Prejudice

This partial reminder letter from Paramount Health Services & Insurance TPA Private Limited requests additional documents from IDBI INTECH LTD. regarding an insurance claim. Key details include a hospitalization from June 8-10, 2023 for Ca Breast. While some documents have been received, the letter requests original discharge documents and claim form with claimed amount. All investigation reports are also requested, noting that if documents are not received within 9 days, the claim will be processed based on what has been provided.

Uploaded by

pritimm979
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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PARAMOUNT HEALTH SERVICES & INSURANCE TPA PRIVATE LIMITED(IRDA License No.

006)
Validity: From 21-03-2023 to 20-03-2026

[formerly known as PARAMOUNT HEALTH SERVICES(TPA)PVT.LTD]

Plot No.A-442,Road No-28.M.I.D.C Industrial Area,Wagale Estate,Ram Nagar, Vitthal Rukhumani Mandir,Thane-400604 Tel-66620808, ,Fax-68342454 / 55,E-mail
-contact.phs@paramounttpa.com,

PARTIAL REMINDER LETTER


Without Prejudice

To, Date : 15/09/2023


IDBI INTECH LTD.,

Email id :rahul.mishra@idbiintech.com
Mobile No. : 9930777336

Policy & Member Details Claim Details

Insurance Company : ICICI Lombard CCN No. : 6192555 Ext: Partial :

Policy No. : 4016/X/293234089/00/000 Name of patient :KM PRITI

Policy Validity : 22/04/2023 to 21/04/2024 Date of Admission :08/06/2023

Employee Name : RAHUL MISHRA Date of Discharge :10/06/2023

PHS ID.No. : 38396257 Employee No. : INT10273


Provider Name:TATA MEMORIAL HOSPITAL,MUMBAI
Insurance Claim No:

Ailment : Ca Breast

Dear Sir / Madam,

With reference to the above mentioned claim and earlier deficiency letter sent to you on 30/08/2023, we regret to inform you that the below mentioned
documents have not been received by us till date.

Received
Sr.No Deficiency Type Status
date

1 HOSPITALIZATION SUMMARY

a Original hospital detailed discharge card or summary. Pending

2 CLAIM FORM: Duly filled & signed original claim form ( ICICI Lombard ) with the claimed amount. Pending

MEDICINE PRESCRIPTION: Prescriptions for all medicines purchased (prior and after) the hospitalization required, of which
3 Recieved 28/08/2023
medicine bills are submitted.

4 INVESTIGATION REPORTS Particular Bill No Bill Date Amount

Kindly provide all Investigation reports against the


a 250 10/06/2023 8260 Pending
submitted bills with MD pathologist sign.

Please note that we are required to pay, partially pay or deny the claim based on the documents received. In case of non receipt of the documents within 9
days of this letter the claim will be dealt accordingly.

Yours faithfully,

Medical Officer
For Paramount Health Services & Insurance TPA Private Limited

Disclaimer: This is an E-notification, generated automatically. Please ignore, if you have already submitted all the requirement / required documents.

Please Provide your Email Id. & Contact No. for future correspondence.

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