AHPI Advises North India Hospitals to Halt Cashless Services for Bajaj Allianz Policyholders

In a significant development for the healthcare insurance sector, the Association of Healthcare Providers - India (AHPI) has recommended its North India members to discontinue cashless treatment facilities for Bajaj Allianz General Insurance policyholders starting September 1. This decision comes amidst growing tensions between healthcare providers and the insurance company over reimbursement rates and payment practices.

Key Points of Contention

The AHPI, which represents a substantial network of 15,200 hospitals across India, has cited several issues leading to this advisory:

• Reimbursement Rates: Bajaj Allianz has allegedly refused to revise reimbursement rates to keep pace with rising medical costs.
• Tariff Pressure: Hospitals report being pressured to reduce tariffs based on expired contracts.
• Payment Issues: Complaints include unilateral deductions and delays in payments.
• Approval Process: Hospitals face lengthy approval processes for claims.

Medical Inflation Concerns

AHPI Director General Girdhar Gyani highlighted the impact of medical inflation, stating that it has been increasing at a rate of 7-8% annually. This inflation is primarily driven by rising input costs in the healthcare sector, putting pressure on hospitals to adjust their rates accordingly.

Bajaj Allianz's Response

Bajaj Allianz General Insurance expressed surprise at the AHPI's announcement. The company stated that it is actively engaged in discussions with AHPI to find a solution that focuses on customer interests. This response suggests that negotiations may still be ongoing between the two parties.

Potential Wider Impact

The AHPI's action is not limited to Bajaj Allianz. The association has also served a similar notice to Care Health Insurance, with a deadline of August 31, 2025, for response. If no resolution is reached, AHPI threatens to discontinue cashless services for Care Health Insurance beneficiaries as well.

Implications for Policyholders

If implemented, this decision could significantly impact Bajaj Allianz policyholders in North India. Patients may need to pay for their treatments upfront and then claim reimbursements from the insurance company, potentially causing financial strain and inconvenience.

The situation highlights the ongoing challenges in balancing the interests of healthcare providers, insurance companies, and patients in India's evolving healthcare landscape. As negotiations continue, all eyes will be on potential resolutions that could set precedents for future interactions between hospitals and insurance providers.