Hospitals in Ahmedabad to suspend cashless facilities for three insurers

AHNA officials engaged in multiple rounds of discussions with these companies, highlighting issues such as unjustified claim deductions, unwarranted claim rejections, and unexplained delisting of hospitals and nursing homes from their network without due process, the statement noted.

AHNA claimed, “Despite repeated assurances and negotiations, these companies have persisted with their unfair practices, adversely impacting both patients and healthcare providers. Such one-sided actions by the insurers are unacceptable and contrary to the principles of fairness and natural justice.”

AHNA said that while it is exploring tie-ups with financial institutions to offer cashless payment alternatives for affected patients, this may not be applicable to Star Health patients.

Detailing this, it said, “We have made every effort to resolve these issues amicably through multiple discussions. However, despite commitments to reform their policies, these insurers have continued their malpractices. This has left us with no choice but to take this firm stand to protect both our patients and our member hospitals.”

A statement from Star Health Insurance said, “As India’s leading health insurer, Star Health Insurance is committed to providing affordable, accessible and customer-centric healthcare through our longstanding and valued relationships nurtured over the last 19 years with our 14,000+ strong hospital network. While the health insurance sector adheres to stringent IRDAI regulations, the lack of regulatory oversight in the hospital industry can lead to certain challenges. Customer interests are paramount to us and we remain focused to provide uninterrupted access to necessary healthcare services.”

A statement from a spokesperson of TATA AIG said, “At TATA AIG, our commitment to ethical healthcare partnerships and customer-centric services remains unwavering. We are actively engaged with all our relevant stakeholders to resolve the matter at the earliest. This decision aligns with industry-wide efforts to safeguard policyholders’ interests and uphold transparency in our practices. We place customer interests at the core of all our decisions and, thus ensure that access to necessary healthcare services will remain uninterrupted. TATA AIG continues to collaborate with an extensive network of over 11,400 hospitals across India, reaffirming our commitment to all our customers.”

Representatives of Care Health Insurance could not be contacted for comment.

AHNA said it has written to the Insurance Regulatory and Development Authority of India (IRDAI), urging them to take strict action against the insurers.