Key Points

The AHPI noted that many of its member hospitals are facing an alarming situation where ‘Star Health Insurance’ has suspended cashless services, leaving hospitals to manage irate and distressed patients who are suddenly denied the most basic facility of cashless treatment.

Based on information available with AHPI, cashless services have been suspended arbitrarily in many hospitals, including Manipal Hospital - Delhi and Gurugram, Max Hospitals - North India, Metro Hospital- Faridabad, Medanta Hospital - Lucknow, Rajiv Gandhi Cancer Hospital - New Delhi, among others.

Hospitals and nursing homes, part of the IMA Hospital Board, also shared similar concerns.

Further, AHPI alleged that Star Health has also slowed down or outright stopped the empanelment of some hospitals, denying patients wider access to cashless services. The list includes Fortis Hospital, Manesar, Max Hospital, Dwarka, Medanta Hospital, Noida, etc.

Such delays in empanelment are restricting patient choice and forcing many families into the reimbursement route, which defeats the purpose of health insurance.

“AHPI strongly insists that cashless services must be restored immediately to all affected hospitals, to protect patients from financial and emotional stress, and empanelment of new hospitals must be expedited, so that patients can access care across India without disruption,” said the Association, representing over 15,000 hospitals and healthcare institutions across the country.

“Patients buy health insurance with the clear expectation of receiving cashless treatment at quality hospitals. It is unjust for insurers to withhold this facility after collecting premiums, leaving families to scramble for funds at the time of hospitalisation,” according to a joint statement by Dr Girdhar Gyani, Director General, AHPI, and Dr Abul Hasan, Chairman, IMA Hospital Board.

"Patients deserve seamless access, and hospitals deserve fair treatment as service providers. Star Health must act urgently to restore trust and ensure that its insured members are not penalised for choosing the hospitals best suited to their medical needs," the statement added.

Earlier on September 12, the AHPI issued a formal notice to Star Health against “unfair practices” and warned suspension of cashless services by member hospitals by September 22.

In response, Star Health, in a statement, called out AHPI for issuing “threats of suspending cashless services in a manner that is arbitrary, lacking clarity or actionable details”.

Meanwhile, the General Insurance Council extended its support to Star Health, urging AHPI to withdraw its threat of disrupting cashless services. Policyholders’ access to healthcare remains fully safeguarded.

Denying the allegation, AHPI said that "its decision was neither arbitrary nor unilateral, but a necessary response to the unilateral and arbitrary actions of Star Health Insurance in de-empanelling hospitals and withdrawing cashless services".

- IANS