The General Insurance Council (GI Council) has criticized the Association of Healthcare Providers (India) (AHPI) for deciding to stop cashless treatment to policyholders of two insurance companies, Bajaj Allianz General Insurance and Care Health Insurance. The GI Council has termed the decision as arbitrary, stating that it will create massive confusion among policyholders and undermine the sanctity of human life, especially in emergency hospitalization situations. The council has urged AHPI to withdraw its advice to its members and engage constructively with the insurance companies to continue cashless services for all health insurance policyholders.
AHPI had decided to stop cashless treatment to policyholders of Bajaj Allianz General Insurance and Care Health Insurance, citing the insurance companies’ failure to update hospital reimbursement rates in line with growing medical expenses. The association, which represents 15,200 hospitals across India, had received complaints from its member hospitals about the insurance companies’ unilateral deductions, payment delays, and long time taken for issuing pre-auth and pre-discharge approvals.
Bajaj Allianz General Insurance has stated that it was taken by surprise by AHPI’s decision and is working with the association to arrive at a solution that is in the best interests of customers. Care Health Insurance has also responded, stating that it received a generic communication from AHPI and is confident of amicably resolving any issues with the forum.
The GI Council has raised concerns about the impact of AHPI’s decision on policyholders, particularly in emergency situations where they may be forced to make financial arrangements. The council has emphasized the need for constructive engagement between insurance companies and healthcare providers to ensure that policyholders receive cashless treatment.
The dispute between AHPI and the insurance companies highlights the challenges faced by the healthcare industry in India, where medical inflation is rising, and hospitals are facing increasing costs. The issue also underscores the need for greater transparency and communication between insurance companies, healthcare providers, and policyholders to ensure that patients receive timely and quality medical care. The GI Council’s intervention is aimed at resolving the issue and ensuring that policyholders are not denied cashless treatment, which is a critical component of health insurance policies.