The Association of Healthcare Providers–India (AHPI), a body representing over 15,000 hospitals, has issued a warning that could significantly impact Star Health Insurance policyholders. The association has stated that it may suspend cashless services for these policyholders starting September 22, 2025, unless several key concerns are addressed.

Key Issues Raised by AHPI

The AHPI has highlighted several critical issues in its communication:

1. Lack of Tariff Revisions: The association points out that tariffs have not been adequately revised to keep pace with rising healthcare costs.
2. Pressure on Existing Tariffs: Hospitals are facing pressure to reduce their current tariffs.
3. Claim Deductions: Approved claims are subject to deductions.
4. Post-Approval Rejections: Claims are being rejected even after receiving final approval.
5. Abrupt Cashless Service Withdrawals: Sudden discontinuation of cashless services has been reported.

Complaint Statistics

The AHPI's concerns are further substantiated by data from the Insurance Ombudsman Annual Report 2023–24. According to this report:

Implications for Policyholders

If the AHPI follows through with its warning, the impact on Star Health Insurance policyholders could be significant:

• Cashless services at AHPI member hospitals may be suspended from September 22, 2025.
• Policyholders would still receive treatment but on a self-pay basis.
• Patients would need to seek reimbursement from Star Health Insurance after paying for their medical expenses out of pocket.

Openness to Resolution

Despite the stern warning, the AHPI has expressed willingness to engage in constructive dialogue. Dr. Girdhar Gyani, Director General of AHPI, stated that the association remains open to discussions aimed at finding a positive resolution to these issues.

This development underscores the ongoing challenges in the healthcare insurance sector, particularly concerning claim settlements and the balance between healthcare costs and insurance coverage. As the deadline approaches, both Star Health Insurance and its policyholders will be keenly watching for any developments or resolutions to this potential disruption in cashless services.

Star Health and Allied Insurance Company Limited , India's leading retail health insurance provider, has introduced a groundbreaking in-app feature called 'Know Your Policy'. This innovative tool aims to simplify health insurance coverage understanding for its customers, aligning with regulatory requirements and enhancing consumer protection.

Key Features of 'Know Your Policy'

The new feature, accessible through the Star Health customer app, offers a concise summary of policy details, including:

• What's Included: A snapshot of key policy benefits such as hospitalization, emergency care, maternity and child coverage, and any additional features or add-ons.
• What's Not Included: Information on common exclusions and waiting periods for specific diseases and pre-existing conditions.

Impressive User Adoption

Since its launch, the 'Know Your Policy' feature has already benefited 300,000 customers. Users spend an average of 2 minutes exploring the tool, indicating its effectiveness in providing valuable information.

Impact on Customer Service

Star Health has observed a reduction in customer calls following the introduction of this feature, suggesting improved customer satisfaction and preparedness. The tool empowers customers with instant, structured information, promoting more informed and proactive engagement.

Digital Strategy Success

The launch of 'Know Your Policy' is part of Star Health's broader digital strategy, which has shown remarkable results:

• The Star Health app has surpassed 11 million downloads
• Over 1.2 million monthly active users
• 63% of renewals are now processed automatically
• More than 75% of new business comes through digital channels
• High user ratings: 4.6 on the App Store and 4.4 on Google Play

Executive Insight

Mr. Anand Roy, Managing Director & CEO of Star Health and Allied Insurance, commented on the initiative: "Star Health's 'Know Your Policy' initiative is our effort towards making insurance terms more consumer-friendly. By creating a simplified, accessible version of the Customer Information Sheet (CIS), we are going beyond mere regulatory compliance to genuinely help customers understand what they're purchasing."

Industry Impact

This initiative sets a positive precedent for the insurance industry, demonstrating a commitment to transparency and customer empowerment. By simplifying complex insurance terms and making critical information easily accessible, Star Health is taking a significant step towards improving customer experience in the health insurance sector.

As the insurance landscape continues to evolve, tools like 'Know Your Policy' are likely to become increasingly important in building trust and fostering better understanding between insurers and policyholders.