Cashless Health Insurance Policy row: Will pay directly to customers, says Bajaj Allianz

Kolkata: Even as the dispute between the Association of Healthcare Providers (India) (AHPI) and health insurance companies rages on, Bajaj Allianz has assured its policyholders that it will protect their interests and if cashless treatment is denied, it could directly pay them into their accounts, reports stated. Bajaj Allianz is one of the companies which has been threatened by AHPI with the discontinuation of cashless services if the dispute is not resolved by the end of this month.

At the heart of the dispute is the allegation by AHPI that a few insurance companies such as Bajaj Alliance refuse to agree to an upward revision of treatment charges every two years, which AHPI officials say becomes necessary on account of rising costs from employee to medicines, medical equipment to utilities such as electricity and water. AHPI authorities alleged to the media that Bajaj Allianz has been rejecting the demand to revise treatment rates. They also said that Bajaj Allianz wanted to reduce rates and evena alleged that the insurer delayed in settling claims.

Bajaj Allianz happens to the fifth-largest health insurance player in India with a health insurance premium of Rs 2,202 crore between April and July this year.

"No undue pressure will buckle us down, none of our customers will suffer. As of now, we have not received a single case of denial of cashless, but even if we do, we shall ensure that our customer gets the money in his/her account before they have to pay the hospital,” Tapan Singhel, MD & CEO, Bajaj Allianz General Insurance was quoted in the media as saying.

Responding to the APHI allegation, the General Insurance Council has said that the step of AHPI is "arbitrary, lacking clarity or actionable details”. It also said that the decision of AHPI has given rise to a lot of avoidable confusion among policyholders. The step by the hospitals body will eventually be detrimental to the interest of the families by forcing them to incur upfront high expenditure. It could even jeopardise the life of patients if the situation is critical requiring immediate medical attention, by withdrawing cashless treatment facilities. The AHPI action "undermines the sanctity of a human life, especially in cases requiring emergency hospitalisation”, said the insurers body.

The insurance council has asked AHPI to immediately withdraw its advice to discontinue cashless treatment and begin discussion with the insurers to restore and continue cashless treatment. "Disruption in cashless service not just directly impacts families through higher upfront spends on treatments and out-of-pocket expenses, it also threatens survival of patients in critical medical conditions requiring immediate medical attention,” the council said.

The insurers council also emphasised that the AHPI step goes against the initiatives such as Cashless Everywhere and the National Health Claims Exchange, since they pave the way for treatment without payments to be made upfront.