Key Points

The decision comes after several hospitals complained that the insurer has not revised hospital reimbursement rates in line with rising medical costs.

According to AHPI, Bajaj Allianz has instead pressured hospitals to lower tariffs that were agreed upon years ago under contracts which have since expired.

Hospitals also raised concerns over unilateral deductions, delayed payments, and long waiting times for pre-authorisation and discharge approvals.

AHPI said it had earlier written to Bajaj Allianz about these issues but received no response.

Explaining the decision, Dr. Girdhar Gyani, Director General of AHPI, said medical inflation in India is about 7-8 per cent every year due to rising costs of staff, medicines, consumables, and utilities.

“Continuing at outdated rates, let alone lowering them, is unsustainable and risks compromising patient care -- something AHPI and its members will not accept,” he said.

The association has recommended that tariffs be revised every two years in line with medical inflation.

However, it said Bajaj Allianz has refused to consider this and has instead sought further reductions, creating what it called an “untenable” situation.

AHPI said member hospitals will continue treating Bajaj Allianz policyholders but only on self-pay basis. Patients can later claim reimbursement directly from the insurer.

In addition, AHPI has also served a notice to Care Health Insurance, asking for a response by August 31.

If no solution is reached, cashless services for Care Health Insurance customers may also be suspended from next month.

Despite the move, AHPI said it remains committed to working with insurers to ensure affordable and quality healthcare and is open to constructive discussions to resolve the issue in the interest of patients.

- IANS