Solution for Cashless Insurance Beneficiaries Expected Soon

Uniformity in rates for the same procedure among all hospitals. This process should be finalized by the stakeholders with transparency.

Union minister for environment and forests, Prakash Javadekar, said that a finance ministry expert will be consulted on the issue within a week. Javadekar had met representatives from the hospital association’s consumer bodies and insurance companies when he said this.

Public sector insurance companies have asked private hospitals in Pune and Pimpri Chinchwad to stop offering cashless treatment facility to individual policy holders, but big hospitals have been asked to continue with the facility for corporate policy holders.

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"An expert from the finance ministry will meet the stakeholders and find a solution. At present, cashless facility for medical insurance offered by public sector insurance companies is available only at 40 hospitals in Pune. We will see how we can expand its base and involve more hospitals," Javadekar said at a news conference after the meeting.

Nitin Bhagali, an orthopaedic surgeon and president of the Association of Hospitals, Nursing Home and Clinic Owners of Pune, said, "We are opposed to the idea of classifying hospitals on the basis of infrastructure. Instead, expertise, seniority and the bio-data of doctors should be given more weight age in deciding the rate list for various procedures."

"There should be uniformity in the rates and the rate list should be finalized in consensus with the stakeholders. The whole process should be absolutely transparent. The Union minister was surprised when we told him about the rates disparity. He said experts from the All India Institute of Medical Science (AIIMS) should be roped in to finalize the rate list," Bhagali said.

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"The current uproar in Pune is uncalled for. The system is running smoothly in other cities. The rates are different in metros and non-metro cities. Pune is under the non-metro category, hence the rates are lesser than what they are in metro cities," said an insurance company official in Pune.

Public sector insurance companies like New India Assurance Company, United India Insurance Company, Oriental Insurance Company and National Insurance Company, under the banner of General Insurance Public Sector Association (GIPSA), sell nearly 80% of the health insurance policies in the country. They had floated fixed rates in metros three years ago and are now extending it to Pune and other two-tier cities.