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
[email protected]
Deficiency Letter
Without Prejudice
To, Date : 10/03/2025
PARLE AGRO PVT. LTD.,
C/O N JANARDHAN,
H NO 2-23, BC Colony, Thummalapally,
Near Govt School, Mittadoddi,
Mahbubnagar, Telangana-509127
Email id:
[email protected]Mobile No. : 9959509611
Policy & Member Details Claim Details
Insurance Company : Magma General Insurance Limited CCN No. : 7316338 Ext: Partial :
Policy No. : P0025200002/6115/100157 Name of Patient :KHANAPURAM SRAVANI
Policy Validity : 27/10/2024 to 26/10/2025 Date of Admission :06/02/2025
Employee Name : N JANARDHAN Date of Discharge :10/02/2025
PHS ID.No. : 30160032 Employee No. : 12001
Provider Name:SRI RAGHAVENDRA MOTHER & CHILD HOSPITAL
Insurance Claim No:
Ailment : Primi With Tg With Aph
Dear Sir/Madam,
We are in receipt of the documents forwarded by you pertaining to the captioned claim. On scrutinizing the documents,it is observed that the following
documents / information are required to process your claim:
Sr.No Deficiency Type Mandatory Status
1 MAIN HOSPITAL BILL Hospital Name Bill No Bill Date Amount
Original Scan final hospital bill with breakup of SRI RAGHAVENDRA MOTHER
a 19 10/02/2025 24700 Yes Pending
(details/amt), as submitted is a Xerox.. & CHILD HOSPITAL
2 INVESTIGATION REPORTS Particular Bill No Bill Date Amount
Original Scan investigation report - as submitted is
a Xerox report (Sri Raghavendra Diagnostics) Rs.3100/- 1 Yes Pending
Original Scan investigation bill required.
3 Main HOSPITAL BILL PAYMENT Particular Bill No Bill Date Amount
Original payment receipt of final Hospital bill, with bill
a 24700 Yes Pending
number & receipt number.
You are requested to submit the original documents as mentioned above within 14 days from the receipt of this letter,so that we can proceed further and
process the claim.Please note that the conclusion regarding the eligibility of coverage/admissibility amount can only be decided once we have a full set of
original documents. Your co-operation in this regard shall be highly appreciated.
Kindly quote the CCN for all future correspondence regarding this claim.
Thanking You,
Medical Officer
For Paramount Health Services & Insurance TPA Private Limited
Please Provide your Email Id. & Contact No. for future correspondence.
For complete guidance on your current claim status,please log on to our website www.paramounttpa.com
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
[email protected]
CLAIM ACKNOWLEDGMENT SHEET
Name of Insurer : Magma General Insurance Limited CCN NO : 7316338
Insured Name : N JANARDHAN Policy No : P0025200002/6115/100157
PHS ID : 30160032 Patient Name : KHANAPURAM SRAVANI
Mobile No : 9959509611 Employee No : 12001
Name of Corporate :
Type of Claim (To be ticked) : Main Hospitalisation / Pre-Post Hospitalisation / OPD Claim
Total no of documents received 96
Sr No. Category Document received Yes/no No of documents
1 claim Form YES 9
2 KYC DOCUMENTS NO 0
3 NEFT DOCUMENTS YES 1
4 DELAY INTIMATION / SUBMISSION DOCUMENTS NO 0
5 DISCHARGE CARD /DEATH SUMMARY /TRANSFER SUMMARY YES 1
6 Indoor Case Paper YES 4
7 FINAL HOSPITAL BILL YES 2
8 FINAL HOSPITAL CASH RECEIPT NO 0
9 CONSULTATION CASH RECEIPT YES 1
10 INVESTIGATION CASH RECEIPT YES 1
11 INVESTIGATION REPORT YES 14
12 MEDICINE CASH RECEIPT YES 7
13 MEDICINE PRISCRIPTION NO 0
14 IMPLANT STICKER NO 0
15 64 VB DOCUMENTS NO 0
16 POLICY COPY NO 0
17 PAN CARD NO 0
18 AADHAR CARD YES 2
19 CKYC NO 0
20 Other YES 53
