Recently, we came across news in an online Publication, business-standard.com
The decision by public sector health insurance companies to deny cashless services to their clients has been criticised by Fortis, a leading corporate healthcare chain.
Chains such as Fortis generate a significant portion of their revenue through health insurance policy reimbursements.
The Federation of Indian Chambers of Commerce and Industry was also critical. Pointing out that private insurance firms are managing to offer cashless services to policy holders, it wanted public sector firms to review their decision to suddenly withdraw this facility. “Withdrawal of an important component of a financial contract without sufficient notice is not fair and just,” it said. National Insurance Co Ltd, New India Assurance Co Ltd, Oriental Insurance Co Ltd and United India Insurance Co Ltd have said many leading hospitals are charging exorbitantly for treatments offered to insurance-protected patients. The hospitals say the problem is not with their fare structure, but with the policy packages offered by the insurance firms.
To read full news, click here
Experts from Medimanage.com give their opinion:
Sudhir Sarnobat:
Though there are cases of inflated billing from hospitals, that’s not the sole reason for higher claims. An Hernia is a secondary care surgery but often, insurance patients get this done in Tertiary care hospital because there is no norm that restricts the person from not visiting such hospitals. The normal cost of 30-35 K goes up to 60-70K because the overheads of such hospitals are higher. This generally inflates the cost but cannot be termed as wrong-doing by the hospital.
The higher claims ratio has two components: One is Premium & the Other is claims. For better claims ratio, the correct premium pricing is also an important factor. The way the premium pricing is done currently is also faulty & hence, that’s an area which needs to be looked into too.
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Comments
21. July 2010, 21:34
Pranjal
In today's time we can not even rely on the well reputed companies like "Oriental Insurance" etc. Me and all my family members have there mediclaim policies since 10 year and above, but till date I am not at all satisfied with any of there services because of their Incompetent agents and service providers. I had already faced a big problem in the past with this company when we waited extremely long for the repayment of hospital bills & the refund of the left over policy amount of my dad's policy after he passed away in 2006,we ran every where but no one paid any attention to our problem, then we requested consumer court to file our case against the company etc. it took lot of time more then 1.5 years for solving the problem with the help of top company officers, who were very understanding and really helpful to us, I am still thankful to all who understood us and helped us. Today I felt forced to write this mail coz of Mr. A.K CHOUDHARY's continues Irresponsible behavior and also filed a case in consumer court www.consumercourt.in/.../...riental-insurance.html , from last many year (almost 3-4 years) every time he came for the renewal of the policy, always took our photos for the cashless cards etc but always misplace it and never send the cashless card ever on time, sometimes cards comes after 5-6 months but along with the time the delay time was not reduced rather was becoming worse, all the times we submitted the photos twice or even thrice but this time from last almost 8-9 months we haven’t received our cashless card as yet, even they delay in sending the complete policy papers many times. We as an old and loyal customers never said anything from so long time but now this is the height of irresponsibility on company's part. Now i am no more interested to continue my policy, rather this time I’ll close it down with this company once and for all. Regards, Pranjal
24. July 2010, 09:29
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