Cashless hospital claims in all major hospitals

The four state-owned health insurance companies New India Assurance, National Insurance, United India Insurance and Oriental Insurance Company, had withdrawn cashless treatment facilities at major hospitals, last year in the month of July.

The decision was taken after hospitals started overbilling health insurance policyholders who opted for cashless claim settlement. This caused a lot of discomfort among the four public sector insurers, who collectively held over half of the health insurance market share in the country.

Almost a month back, negotiations between the big hospitals and the four state owned insurers finally came to an end. With the exception of Apollo Hospitals, all major hospitals have agreed on the new set of tariffs for certain procedures.

Earlier, under the old tariff, the ratio of payment claims to premiums was almost as high as 120%. The new tariffs however are expected to bring the claims ratio to around 85%.

According to industry sources, these insurers are in talks with Apollo Hospitals to come to a resolution. Apollo Hospital has submitted its revised tariffs and is awaiting clearance on the same.