Thaindian News

New Delhi/Chennai, July 10 (IANS) Policyholders and corporates subscribing to medical cover are appalled by a move by state-run insurance firms to withdraw cashless facility for treatment, even as several hospitals have made written complaints to the industry’s regulator.
“The withdrawal of cashless facility by companies is a retrograde measure,” said Anjan Bose, chairman of the health services committee of the Federation of Indian Chambers of Commerce and Industry (Ficci), reacting to the move initiated this month.

“This will put the policyholders, particularly the middle class patients who do not have ready cash available with them, at a disadvantage. Such a step will have adverse impact on the penetration of health Insurance market in India.”

Those holding such medical insurance policies were all the more taken aback when it came to light that state-run insurance companies were the ones that have decided to withdraw the cashless facility.

The four insurance firms that terminated the cashless facility at some 150-odd hospitals across the country are National Insurance, New India Assurance, Oriental Insurance and United India Insurance.

The decision was taken by their umbrella body called the General Insurance Public Sector Association, that particularly targeted some 150 hospitals of big chains, such as Max, Fortis, Escorts, Apollo and Rockland, saying they were over-charging patients.

“We took the decision after a year-long investigation,” said M. Ramadoss, chairman and of New India Assurance.

“We have documentary proof on hospitals charging differential rates — higher for those with a policy and lower for others,” Ramadoss told IANS.

“Also, we have not scrapped the cashless treatment facility. It is available in around 350 hospitals in the four metros. There are also many hospitals who want to join our network. The panel of hospitals are expandable.”

But hospitals did not buy the argument.

“This is an unnecessary step aimed at hassling patients. Our tariff is always discussed and transparent. That is why insurance companies empanel us. There is nothing to hide,” said Shweta Bajaj, an administrator with Escorts Heart Institute.

Another apex chamber, the Confederation of Indian Industry (CII), has also taken up the matter and its relevant committee, which has already met here to take the matter up with relevant authorities.

“Insurance companies and healthcare providers have always been playing this cat and the mouse game all over the world,” said noted cardiologist Naresh Trehan, who chairs the chamber’s healh committee.

“Things will change only if we bring in laws that will punish every stakeholder if any fraud is detected,” Trehan said after one such meeting, where they decided to approach the Insurance Development and Regulatory Authority.

“I will call for a report on Monday from the four public sector general insurers. Only than I can comment,” K.K.Srinivasan, a member of the insurance regulator dealing with non-life matters, told IANS.

According to an official at Max Super-speciality Hospital at Saket in south Delhi, the state-run insurance companies did not communicate to them and that matter came to light a few days ago when several cashless requests were rejected.

“I have a health insurance from United mainly because cashless facility was the main selling point. I also know how difficult it is to arrange for cash at short notice,” said Gurpreet Singh Gill, a senior executive with a logistics firm.

“They (insurance companies) are the ones who gave me a list of hospitals where I can go or take my family. How can they withdraw it arbitrarily? I have no letter no notice from my insurance company,” Gill added.

Experts said rather than taking such a retrograde step, insurance firms must sit with hospitals and professionals to standardise treatments, define ailments and improve billing formats to induce transparency in the system and build trust among stakeholders.