General Insurance Council says AHPI's action against Bajaj Allianz is 'arbitrary, lacking clarity'

General Insurance Council says AHPI's action against Bajaj Allianz is 'arbitrary, lacking clarity'

General Insurance Council (GIC) on August 26 said the decision of Association of Healthcare Providers (India) (AHPI) to suspend cashless facility for Bajaj Allianz policyholders in North India from September as "arbitrary, lacking clarity".

"This sudden unilateral action on part of AHPI has created unnecessary confusion and concerns amongst citizens, impacting the trust in the health insurance ecosystem. Instead of enabling dialogue and resolution, a press statement was abruptly issued, prejudicing the interests of policyholders across the country," said GIC.

AHPI is a representative body of hospitals and healthcare institutions.

According to AHPI, the decision follows repeated complaints by member hospitals that the insurer refused to revise reimbursement rates in line with rising medical costs, and instead pressured healthcare providers to cut tariffs agreed upon years ago under now-expired contracts. Hospitals have also alleged unilateral deductions, delays in payments and excessive time taken for pre-authorization and pre-discharge approvals, which they claim have further strained operations.

The Council said it "strongly believes that any action which disrupts cashless access ultimately harms the citizens".

"The health insurance industry in India has consistently worked to make quality healthcare accessible and affordable for all. Initiatives such as Cashless Everywhere and the National Health Claims Exchange (NHCX) have been launched with the sole aim of ensuring that citizens can avail seamless treatment anywhere in the country without financial stress. Insurers have invested heavily in building these reforms and have supported crores of health ensure enrolments and settled more than Rs 87,000 crore in claims during 2023-24, a direct demonstration of their commitment to the people of India," said GIC.

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, added GIC.