The increasing dispute over rates between insurance companies and hospitals increased the difficulties of patients. Cashless treatment stopped at many places, claims of claim rejections increased. The report states that people’s trust in insurance companies has started to waver.
Health insurance takes hopes that they will get better facilities and financial support at the time of treatment; But the attitude of insurance companies in the latest situation has shook this belief.
Hospitals say that insurance companies are pressurizing the treatment rates below 2022. According to him, such a step may have a negative impact on the availability of doctors, investment of modern equipment. Major hospital groups have expressed the same concern in the recent cases. He says that it will not be possible to treat the old rates and if such conditions are imposed, it will directly affect the patient.
The impact of this dispute is also visible on the cashless facility. In many hospitals, agreements with insurance companies are being postponed and cashless treatment is being temporarily prevented. Companies connect it to paper processes and contracts, but are for real problems for patients – they suddenly have to pay advance or find a second hospital. Many times this delay can overshadow the life of the patient.
The problems of policy holders do not end here. The premium is increasing every year, while the problem of not getting the claim is constantly deepening. Insurance Ombudsman Report 2023-24 also suggests the seriousness of the situation. According to the report, companies like Star Health, Care and Niva Bupa have the highest number of complaints. 13,308 complaints were filed against Star Health alone, most of which were associated with claim rejections.
Along with this, the figures of Incurred Claims Ratio (ICR) also increase anxiety. The ICR of many insurance companies has been between 54% to 67% only. That is, a large part of the premium recovered from customers was not spent on the claim. This means that either claims are not being repaid properly, or companies are giving priority to profits. Both conditions are harmful to patients.
The result of all this is that the common man, who considers insurance as his security and gives premium every year, is facing the most difficulties. Sometimes he has to get upset when he does not get a claim, sometimes he has to change the hospital. Today the situation is that people’s trust in insurance is starting to waver. In such a situation, patients are forced to think that insurance is actually support for them or another burden.