Niva Bupa Health Insurance has denied allegations of denying a cashless claim to a policyholder, Chandra Kumar Jain, who is battling Myeloid Leukaemia and needs a Bone Marrow Transplant (BMT) at Sir HN Reliance Foundation Hospital in Mumbai. The allegations were made in a viral post on LinkedIn by health insurance and investments advisor Avigyan Mitra, which stated that the patient’s Rs 61 lakh cashless claim was denied despite having a Rs 2.40 crore policy.
Niva Bupa has termed the allegations as “baseless” and clarified that the patient has already availed claims worth Rs 22.72 lakh in the past. The company had approved a pre-authorisation cashless request of Rs 25 lakh for the current treatment, as well as an additional charge of Rs 77,000. However, the hospital’s request to increase the pre-authorisation amount to Rs 61 lakh was not approved due to escalating treatment costs.
Niva Bupa has emphasized that the originally approved Rs 25 lakh pre-authorisation still stands valid and that the company has not denied the claim. The company has also criticized those who label the health insurance sector as a “scam”, stating that health insurance plays a vital role in protecting families against unforeseen medical expenses.
In a separate development, Niva Bupa has suspended the cashless treatment facility at Max Hospitals across India due to a dispute over premium revisions. The company’s agreement with Max expired in May 2025, and talks over premium revisions did not reach an agreement. Max Hospitals has clarified that it continued to provide cashless services to Niva Bupa policyholders even after the contract expired and has set up an express desk to help patients claim reimbursements from insurers without having to make upfront payments.
The dispute between Niva Bupa and Max Hospitals has highlighted the challenges faced by the health insurance sector in India. While Niva Bupa has denied the allegations of denying a cashless claim, the suspension of cashless treatment facilities at Max Hospitals may cause inconvenience to policyholders. The company’s emphasis on the importance of health insurance in protecting families against unforeseen medical expenses is a timely reminder of the sector’s vital role in India’s healthcare system.