Paramount Health Services & Insurance TPA Pvt. Ltd. was founded in 1996 and it acquired a license from the IRDA in 2002 as a TPA. PHS has created benchmarks in the insurance industry with its expertise in claims processing and quality customer service. The company operates in more than 165 locations across India.
Read further to get a detailed explanation of Paramount TPA claim process which includes, advice on filling the claim form, completing the documentation, and other intricacies of claim submission.
'Know Your Customer' documents verify the identity of the policyholder. The list of KYC documents includes:
- Patient’s Aadhar card copy
- A copy of PAN card or any other government ID proof of the main policyholder
- Original cancelled cheque in the name of policyholder
- A copy of the Paramount TPA e-card or insurance certificate
To generate your Paramount Insurance TPA E-card online, click here.
With the Paramount TPA insurance reimbursement claim form, you will need to attach all the hospital originals. Which means that the documents must be on the official letterhead of the network hospital. The documents include breakup of all the hospital bills, the discharge summary, payment receipts, break up of the package amount added to the bills, etc. Moreover, these few things must be ensured:
- The bills you will receive from the hospital are summarized, so ask for the breakup of the total amount in the bill.
- If one or more surgery packages were added to the bill, ask for its breakup on the official letterhead or on a plain paper with the hospital’s seal.
- Get receipts of the payment against the hospital bill to attach with the claim form. Total amount in the receipt should be equal to the total bill amount.
In case of pre and post hospitalization claims, just the originals of consultation, pharmacy or lab bills are enough. You need not ask for a bill breakup after the discharge.
Note: Check if you’re eligible for the claim as per pre and post hospitalization duration specified in the policy. Without a doctor's prescription as a proof, Paramount won’t pay for pre and post hospitalization expenses.
Examine the lab investigation reports and submit the original reports to the insurance company. Reports printed on plain paper with lab’s or hospital’s seal will not be accepted by Paramount Health Insurance.
If you do not have the reports handy yet, add a cover-note and the missing reports’ date-wise list to the claim. Paramount will raise a query and you will get enough time to get hold of all the necessary documents.
If you do not submit originals of the reports or if reports are missing, there will be a deduction in the claim amount.
If you’re claiming pre and post hospitalization expenses, the investigation reports must be supported by the doctor’s prescription on the official letterhead.
Accident Details, if Applicable
If the patient has had an accident, submitting a Medico-legal certificate is mandatory. If the accident has been reported, attach the FIR of the case with the claim form.