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Paramount TPA Pvt Ltd - Mental harrassment by paramount tpa in hospitalization

Seema Rani filed complaint against Paramount TPA Pvt Ltd on Oct 12, 2019

---------- Forwarded message ---------
From: Er Seema Garg <ss.thaparian@gmail.com>
Date: Sat, ** Oct ****, **:**


I Ms Seema Rani PF no ****** officer working at Union Bank of India.

Our bank has tie up with Paramount TPA vide insurance company United India Insurance for the medical Insurance. 

My PHS ID is ********.

Being a patient of IBD ulcerative colitis I have regular follow up from Fortis Mohali.Many a times I have to hospitalized and my bill is done by TPA cashless.

As it is a chronic disease I have been reimbursed for the same in domiciliary also.

On *th October **** I have regular follow up with doctor Mr Arvind Sahni Fortis Mohali.

As there was chief complaint of around ** stools with blood .Doctor said that there is C difficile toxin infection and I had to get admitted at the earliest in IPD as he has to do investigations and to keep under his observation.

I got admitted on *th October ****.

Fortis sent the necessary documents for pre approval.

On *th October TPA sent the pre approval for Rs *****.

As per doctor there is ** days treatment for this toxin infection and doctor also said as the stool no comes down we will be discharged. 

On **th October **** when we have to get discharged Hospital sent for the final approval 

But the pathetic part was that they denial the cashless approval despite dr has given in written that being a patient of ulcerative colitis he has admitted and he has to keep under his observation. 

I got harassed whole day and around * PM we paid ***** from our pocket and after whole day harassment in sick condition we came back home.

As I had been hospitalised for * days

Which is more than ** hours 

Whatever is the way doctor  treated 

Through medicine 

Through investigations.

One thing more if they must have declined the pre approval itself so that I might have taken step on *th October it self that I will not be paid cashless.

As I have been mentally harassed you are requested to advise insurance company all my payment done to hospital.

If steps not taken to reimburse I will put the case in consumer forum and company will have to pay all the bill plus litigation and harassment cost too.

Regards

Ms Seema 

**********



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Complaint Status

Resolution Demanded:

Refund / Credit for purchase

Paramount TPA Pvt Ltd

3

Total Complaints

1

Total Resolved

33.33%

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