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Patients in cash-trouble

Jul 13, 2010

Four major state-run insurance companies have decided to stop cash-less hospitalisation at select hospitals in India. According to the companies, fake claims by some hospitals have forced them to scrap the facility while there are voices of concern from industry quarters.

New Delhi: Insurance companies are scrapping cash-less hospitalisation across the country which is going to affect those in need of medical treatment.

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Five days ago 34-year-old Nandita was admitted to a hospital with severe anemia. Three days later she has shelled out Rs 70,000 rupees for treatment in cash as despite paying for cashless hospitalisation her health insurance providers have changed its policy.

"My treatment is halfway. I am going home and I don't know what is going to happen to me. If something happens will these insurance people be responsible?" asks Nandita.

The General Insurance Public Sector Association consisting of four major state-run insurance companies - United India, New India, Oriental Insurance and National Insurance - decided to stop cash-less hospitalisation at select hospitals.

"According to the companies, the hospitals make false claims. They show high costs and charge the insurance companies so much more. That is why we have taken away the facility from some hospitals," says Oriental Insurance.

The hospitals concerned are outraged.

"Please bring though evidence these culprits to book. If today I am guilty there is a process of law. Here what are you doing? You are just hanging and berating so-called soft target corporate hospitals," says Sanjay Rai, Director, Max.

While three of them will reimburse medical costs to those insured, the National Insurance will not offer any new cashless policies. Regulatory bodies across the board have also slammed their decision.
In 2008-2009, PSU insurance companies collected health premium of about Rs 3,824 crore out of the total Rs 6,625 crore, about 57% of the health premium business.

"We at FICCI believe that it is a retrograde step. Health care has two components: one deliverer or the provider, payer that is the insurance ministry. They should be able to sit together arrive at a consensus and then move forward so that the consumer does not get hurt," says Dr Narottam Puri, advisor, health and health insurance.

It's going to prove tough to explain the reason behind this change in policy to patients at 150 major hospitals from Apollo, Escorts, Fortis, Max and Rockland, in the capital, NCR region, Bangalore, Mumbai and Chennai.

Source : IBN Live
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