The dispute between hospitals and insurance companies over cashless policies is growing.
More than 15,000 hospitals across the country have announced that they will stop providing cashless facilities for patients covered under Bajaj Allianz
and Care Health from September 1. This may cause difficulties for patients who depend on cashless treatment.
This information was shared by the Association of Healthcare Providers India (AHPI), which represents hospitals.
According to AHPI, insurance companies have not revised the treatment expense rates, even though hospital costs are constantly rising.
Apart from this, companies often delay payments and ask for unnecessary documents, creating hurdles in claim settlement.
AHPI has also issued a notice to Care Health to discuss these issues related to cashless bill payments.
If no solution is reached, the cashless facility will be completely stopped from September 1.
Main Cause of Dispute
Hospitals allege that Bajaj Allianz has refused to increase treatment rates under old contracts.
2As per the agreement, rates should be revised every two years, but the company has not done so.
Instead, it has started reducing costs of medicines, diagnostic tests, and room charges without any explanation.
Another complaint is that the final bill approval after patient discharge is being delayed, forcing patients to wait in the hospital for hours. So far, neither Bajaj Allianz nor Care Health has given any response to these allegations.
Impact on Patients
If the cashless facility stops, patients insured with these companies will have to pay their hospital bills upfront and later apply for reimbursement from the insurance company.
AHPI Director General Dr. Girdhar Gyani said that both companies are cutting treatment-related bills without reason.
“Even after the patient is discharged, bills are being approved only after 6–7 hours.
We have called meetings with Care Health on Wednesday and Bajaj Allianz on Thursday. If no solution is found, the cashless service will be stopped,” he added.
Policy Premium Concerns
Apart from the cashless issue, hospitals have also raised concerns about the way insurance companies increase premiums.
Many companies initially attract customers by offering low-premium policies with limited coverage.
In the following year, they offer to include coverage for critical illnesses but increase the premium by ₹2,000–₹3,000.
Policyholders often agree, but later the average premium rises by about 10% each year.
For example, a policy that initially cost ₹20,000 can reach ₹25,000–₹27,000 within just two years.
