AHPI Withdraws Suspension Notice After Reaching Agreement with Bajaj Allianz
After a meeting with Bajaj Allianz General Insurance Company, AHPI declared that, “there was general concurrence on all the issues and with their consent to resolve all issues formally the issued service suspension notice was withdrawn instantly.
New Delhi: North Indian hospitals will reinstate cashless services for Bajaj Allianz policyholders after the industry body AHPI successfully resolved its long-standing dispute with the insurer over reimbursement and tariff rates.
Following a meeting with Bajaj Allianz General Insurance Company, AHPI said that, “there was general consensus on all the matters and the Bajaj Allianz has agreed to settle different concerns with formal measures and with their commitment …”we withdraw suspension notice issued to Bajaj Allianz with immediate effect.
Verifying the development Dr. Tapan Singhel, MD and CEO, Bajaj Allianz General Insurance Co. Ltd said, “We are relieved that the matter has been resolved in the interest of policyholders and citizens who should never be made to undergo interruptions in their access to cashless healthcare.
“Insurers have always worked collaboratively with hospitals to address operational realities and we will continue to do so in a spirit of partnership,” he further added.
In its fold, the Association of Healthcare Providers of India (AHPI) has over 15,000 member hospitals that include noted listed corporate chains such as Max, Fortis etc.
The transaction comes just weeks after the body of hospitals had directed its member hospitals to halt cashless services for the customers of the insurer temporarily, citing a difference in rates of reimbursement and predatory pricing tactics.
The insurers have not revised the rates for years placing undue financial burden on the hospitals and are coming with their own rates using collective bargaining to pressurize the hospitals, the body had stated.
Our member hospitals are being requested to reduce the rates again and are being “threatened” that in case they do not reduce the rates, cashless facilities will be withdrawn, it further added.
Further AHPI, also complained that, “the insurers are increasingly questioning clinical judgments of the treating physicians in favor of using cost-lower drugs/implants which may be not in the interest of the patient.
According to AHPI, India is experiencing a 7-8 per cent medical inflation every year driven by the rising cost of consumables, utilities, and other overheads and persisting on the same rates creating an unsustainable scenario for healthcare providers.
While this on its part, insurers are arguing that opaque pricing and variable treatment charges at hospitals warrant the existence of a central regulator for standardization of charges and to settle repeated controversies.
Certain insurers have also suggested bringing hospitals onto the National Health Claims Exchange, (NHCX) where insurers already have their presence to bring in pricing transparency for consumers.
Interestingly, NHCX, an online platform of health insurance claims designed by the Ministry of Health and Family, is a centralized single window which standardizes and makes simple claim processing of health insurance claims in the country.
Besides Ayushman—a govt subsidized insurance plan—the centralized platform also caters to private reimbursement claims with the added requirement of insurers and Third-Party Administrators (TPAs) registration on the portal.
conclusion
The settlement between Bajaj Allianz General Insurance and the Association of Healthcare Providers of India (AHPI) has ended the standoff, with over 15,000 hospitals including top chains Fortis and Max signing up to restart cashless services for policyholders. The standoff over low reimbursement rates, rising medical inflation, and clinical autonomy had briefly disrupted services, leaving patients in an anxious state. With AHPI retracting its suspension notice, both sides committed to working together on tariff, transparency, and operational issues, with insurers also underscoring standardization through channels such as the National Health Claims Exchange (NHCX). This accord not only ensures uninterrupted access to cashless healthcare but also stresses the call for ongoing dialogue for hospital sustainability and affordable health insurance. For policyholders, the result is welcome relief and confidence that their healthcare requirements will continue to be given precedence without future interruption in services.