New Delhi: From September 1, thousands of policyholders of Bajaj Allianz General Insurance may lose access to cashless treatment in several top hospitals across North India. The Association of Healthcare Providers India (AHPI) has advised its 15,000 member hospitals — including Max Healthcare and Medanta — to suspend cashless facilities for Bajaj Allianz customers.
Why hospitals are taking this step
Hospitals allege that Bajaj Allianz has not revised reimbursement tariffs in line with rising healthcare costs. Instead, the insurer has been pushing hospitals to cut rates further, despite existing agreements having already expired.
They also flagged unilateral deductions, delayed claim payments, and slow approvals for treatments and discharges.
“Medical inflation in India is nearly 7–8 percent every year due to rising staff costs, medicines, utilities and overheads. Continuing at outdated rates is unsustainable and may hurt patient care,” said Dr. Girdhar Gyani, Director General of AHPI.
Impact on policyholders
From September, Bajaj Allianz policyholders can still seek treatment at these hospitals, but they must pay out of pocket first and later file for reimbursement directly with the insurer. This could mean more hassle and financial stress for patients seeking urgent or expensive care.
Possible action against another insurer
AHPI also shared that it has issued a similar notice to Care Health Insurance on August 22, asking the company to respond by August 31. If issues are not resolved, cashless services for Care Health customers may also be suspended.
Care Health Insurance Issues Statement
Manish Dodeja, Chief Operating Officer of Care Health Insurance issued statement and said, "We are surprised to see this reportage as we are in receipt of a mail from AHPI only today (Aug 22nd) evening. The said communication is generic and does not carry any details such as, names of affected providers, tariff or claim deduction challenges etc."
He further said, "We have had a sustained, progressive association with AHPI, and even today connected with the forum to get specific information in this regard. However, they were unable to provide any specific details."
He also said, "We have also reached out to hospitals ( Members of AHPI) who haven’t mentioned any challenges with our services. We are confident of amicably resolving any issues with the said forum, provided our customers’ interests remain the sole objective for any productive outcome."
