Cashless Treatment at Risk for Thousands in India

In India, a major issue is brewing for thousands of health policyholders as Bajaj Allianz and Care Health Insurance may suspend cashless hospitalization services starting September 1. This decision by the Association of Healthcare Providers (AHPI) has raised significant concern and confusion among citizens who rely on these services for financial protection and timely medical care.

The General Insurance Council (GI Council), which represents insurers, has criticized AHPI's unilateral move, stating that it jeopardizes public trust in the health insurance ecosystem. The Council emphasized that such abrupt actions do not facilitate dialogue, but rather create uncertainty for policyholders across the country. This situation is particularly alarming given the ongoing push by the Insurance Regulatory and Development Authority of India (IRDAI) for 100 percent cashless treatment nationwide.

As healthcare costs in India continue to soar, driven by rising treatment charges, the affordability and accessibility of quality medical services are increasingly at risk. The GI Council pointed out that disruption in cashless services not only leads to higher upfront costs for families but can also threaten the survival of patients requiring immediate medical attention. In critical situations, policyholders should not be forced to make financial arrangements for treatments.

AHPI's decision to halt cashless services stems from the non-revision of treatment costs, as medical inflation in India has remained around 7-8 percent annually. Hospitals argue that operating under outdated reimbursement rates compromises patient care, which they cannot allow. This ongoing tension between insurers and hospitals highlights the need for a collaborative approach to ensure that healthcare remains accessible and reliable for all Indians.

IRDAI has mandated that insurance companies transition to cashless settlements by August 1, 2024, making claim processes smoother and faster for policyholders. The authority has urged insurers to minimize reimbursement claims and enhance cashless claim settlements, reinforcing the importance of a trustworthy health insurance framework.

The GI Council has called for AHPI to withdraw its advisory and encouraged member hospitals to engage in constructive discussions with insurers. The overarching goal is to maintain cashless facilities for health insurance policyholders and safeguard the well-being of patients who depend on these essential services. As the industry navigates these challenges, it is crucial to prioritize patient care and uphold the integrity of health insurance for the benefit of all.