Ahmedabad
Citing “prolonged and unresolved grievances” from patients and hospitals, Ahmedabad Hospitals and Nursing Homes Association (AHNA) announced that all member hospitals in Ahmedabad will indefinitely suspend cashless facilities for clients of three insurance companies — Star Health and Allied Insurance Co. Ltd, Care Health Insurance and Tata AIG Health Insurance — starting April 2.
AHNA officials engaged in multiple rounds of discussion with these companies, highlighting issues such as unjustified claim deductions, unwarranted claim rejections, and unexplained delisting of hospitals and nursing homes from their network without due process, the body stated in a statement issued, Tuesday. “Despite repeated assurances and negotiations, these companies have persisted with their unfair practices, adversely impacting both patients and healthcare providers,” AHNA stated.
Citing the 2023-24, annual report of Council of Insurance Ombudsman, Ahmedabad, AHNA pointed out that Ahmedabad had the third highest number of complaints related to health insurance after Mumbai and Pune. A total of 3300 complaints were received by the Insurance Ombudsman of Ahmedabad office during 2023-24, recording nine complaints a day. When contacted on Wednesday, AHNA officials said they have not changed their stance with regard to the three insurance companies and continued to hold deliberations in this regard.
Tata AIG Health Insurance spokesperson in a statement said, “At TATA AIG, our commitment to ethical healthcare partnerships and customer-centric services remains unwavering. We are actively engaged with all our relevant stakeholders to resolve the matter at the earliest. This decision aligns with industry-wide efforts to safeguard policyholders’ interests and uphold transparency in our practices. We place customer interests at the core of all our decisions and, thus ensure that access to necessary healthcare services will remain uninterrupted. TATA AIG continues to collaborate with an extensive network of over 11,400 hospitals across India, reaffirming our commitment to all our customers.”
A similar statement was also released by Star Health Insurance. “As India’s leading health insurer, Star Health Insurance is committed to providing affordable, accessible and customer-centric healthcare through our longstanding and valued relationships nurtured over the last 19 years with our 14,000+ strong hospital network. While the health insurance sector adheres to stringent IRDAI regulations, the lack of regulatory oversight in the hospital industry can lead to certain challenges. Customer interests are paramount to us and we remain focused to provide uninterrupted access to necessary healthcare services,” the statement added.
