Revoke suspension, create affordable & sustainable model: AHPI to health insurance firms

New Delhi, Sep 1 (IANS) As thousands of health policyholders in India are suffering due to loss of access to cashless hospitalisation, the Association of Healthcare Providers - India (AHPI) on Monday asked health insurance firms to revoke suspension and create an affordable as well as sustainable model.

Speaking to IANS, AHPI Director General Dr. Girdhar Gyani said that AHPI has asked insurance companies to restore the cashless service wherever they have removed hospitals from their panel.

He noted that the association will facilitate conversations between hospitals and insurance firms to address the root cause and provide respite to patients.

"We have sent notice to seven of the insurance companies asking them to revoke suspension on hospitals that were removed from the panel. After bringing the services back, we will sit across with them at the table on the issues and fix the rates,” Gyani said.

“Similarly, we are telling hospitals to be reasonable," he added.

His comments come as Niva Bupa Health Insurance on Monday said it has suspended the cashless treatment facility at Max Hospitals across India.

In a statement to IANS, Dr. Bhabhtosh Mishra, Director and COO of Niva Bupa Health Insurance, said the company’s agreement with Max expired in May 2025. Talks over premium revisions did not reach an agreement, leading to the suspension of cashless services.

“We would like to inform you that our cashless services at Max Hospitals are currently unavailable,” Mishra stated, adding that Star Health and Care Health also face similar issues with Max Hospitals.

The AHPI first advised its member hospitals in North India to stop providing cashless treatment facilities for policyholders of Bajaj Allianz General Insurance Company, with effect from September 1, 2025.

Gyani said that “the suspension was revoked as the company came forward and addressed all the concerns, and they removed the embargo on some of our major hospitals”.

A similar notice was also served to Care Health Insurance, with a request for their response by August 31, which they did.

Care Health told IANS that it is providing cashless services.

"Please rest assured that valued customers of Care Health Insurance will always receive seamless cashless services at all our network hospitals. We continue to work closely with each one of our partner hospitals to ensure our customers experience the quality care they deserve," Manish Dodeja, Chief Operating Officer, Care Health Insurance, told IANS.

Gyani explained that while the government and the public in general want affordable healthcare, insurance companies and the hospitals seek sustainability.

However, sustainability means they have to now improve their operating efficiency, the expert said.

“For example, you know, insurance companies in India, they spend roughly 30-35 per cent of the money collected from the premium on the administrative, commissions, and sales. So, we are telling them to cut down on this aspect, because otherwise every year they are raising the premium, so the public is worried about it,” Gyani said.

“Similarly, even hospitals must improve their operational efficiency and cut down the expenses that can be cut down. Ultimately, we have to move in the direction that healthcare is affordable at the same time sustainable for hospitals and insurance companies,” he told IANS.

--IANS

rvt/