In a major setback for patients relying on health insurance, Niva Bupa, Star health, and Care health Insurance have discontinued their cashless treatment facility at all branches of Max Hospital across India. This move comes shortly after the hospital network ended its cashless tie-up with Bajaj Allianz General Insurance.

Here’s a detailed breakdown of what it means for patients and what steps they need to take next.


1. Which Insurance Companies Are Affected?

Patients holding policies from these companies will no longer be able to avail cashless treatment at Max Hospital.


2. What Does It Mean for Patients?

  • Patients will now have to pay hospital bills upfront.
  • They can later claim reimbursement from their insurance company.
  • This may lead to higher out-of-pocket expenses at the time of treatment.


3. Why Was the Cashless Facility Stopped?

  • Dispute over treatment rates and settlement delays between hospitals and insurance companies.
  • AHPI (Association of Healthcare Providers of India) stated that medical costs in india are rising by 7–8% annually, making old reimbursement rates unsustainable.
  • Insurance companies allegedly refused to revise treatment packages, leading to the breakdown of agreements.


4. Reimbursement Process for Patients

If you are insured with these companies and need treatment at Max Hospital, follow these steps:

  • Collect all original documents including:
    • Discharge summary
    • Medical reports & prescriptions
    • Itemized hospital bills
    • Doctor’s notes
    • Aadhaar card, PAN card, and a cancelled cheque
  • Submit documents to your insurance company for reimbursement.
  • Claim settlement will be processed after verification.


5. Earlier Dispute with Bajaj Allianz

  • Two days earlier, AHPI advised hospitals to stop cashless treatment for Bajaj Allianz policyholders from September 1, 2025.
  • Over 20,000 hospitals, including Max and Fortis Escorts, were asked to comply.
  • The move was triggered by delayed claim approvals and disagreements on rate revisions.


6. Impact on Patients

  • Patients may face financial burden during hospitalization.
  • Reimbursement claims may take time to process, leading to cash flow issues.
  • Patients should keep multiple insurance options or confirm network tie-ups before emergency admissions.


7. Key Takeaway

Policyholders of Niva Bupa, Star health, Care health Insurance, and Bajaj Allianz should prepare for reimbursement-based claims when seeking treatment at Max Hospital. Hospitals and insurers may still renegotiate terms, but until then, patients must arrange funds in advance.

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Patients

Kokila Chokkanathan

30/08/2025 04:59 PM