Care Health Insurance has temporarily suspended cashless claim settlements at 12 Max hospitals in Delhi-NCR, effective February 17, 2025. This means that patients will no longer be able to receive cashless treatment at these hospitals, and instead will have to pay out of pocket and then seek reimbursement from the insurance company. The affected hospitals include eight super-specialty hospitals, two multi-specialty centers, a hospital in Gurugram, and a cancer care center in Lajpat Nagar, Delhi.
However, patients can still avail of reimbursement options, and Care Insurance policyholders can also receive cashless treatment at other Max hospitals nationwide. Additionally, patients undergoing long-term treatment for chronic ailments such as chemotherapy and dialysis can continue to receive cashless treatment at Max hospitals in Delhi/NCR.
Experts have expressed concern about the impact of this move on patients, particularly those in medical emergencies. Alay Razvi, Managing Partner at Accord Juris, noted that patients who expect cashless treatment may be forced to pay upfront and seek reimbursement later, which can be time-consuming and financially stressful. Biplab Lenin, Partner at Cyril Amarchand Mangaldas, highlighted the ongoing friction between insurers and healthcare providers over pricing and reimbursement models, and emphasized the need for greater transparency and a balanced approach that safeguards both financial viability and patient interests.
According to sources, Care Health Insurance is in continuous touch with Max hospitals and is negotiating the best possible price to resume services as early as possible. In the meantime, patients can raise a claim when admitted to the hospital, and a representative from the insurance company will verify the amount and transfer it to the patient’s bank account. While this may provide some relief, the temporary suspension of cashless claims is likely to cause significant inconvenience and financial strain on patients requiring immediate treatment.