WHILE public sector general insurance companies are fighting a battle with hospitals and nursing homes over `inflated rates', their private sector counterparts continue to provide cashless claim settlements, albeit cautiously.
Private general insurance companies have a 30 per cent to 35 per cent share in the health insurance market.
Private general insurers Financial Chronicle spoke to said it is business as usual on their part.
TA Ramalingam, head of underwriting at Bajaj Allianz General Insurance, said the insurer had not stopped cashless facility in any of the network hospitals.
"We have exclusive arrangements with our network hospitals as we do not have a TPA. In case of admissible claims from hospitals, which are not in our network, we have a turnaround time of 14 days from the date of submission of all documents," said Ramalingam.
Higher claims ratio has hit the private sector insurers too. For many companies, health insurance business is turning unviable, but they are forced to carry on with the business without hiking premia because of stiff competition.
According to a senior official at ICICI Lombard, the biggest private general insurance company by market share, fraudulent claims and inflated bills are a cause of worry to it too. "We tackle these on a case to case basis and do not plan to withdraw the service all together," the official said.
Rahul Agarwal, CEO of Optima Insurance Brokers, said the no-cashless problem in mediclaim is limited to PSU insurers alone.
"Private sector insurers are in wait and watch mode.
We don't see the row being resolved anytime soon as the insurers have insisted on a roll back of rates at hospitals, which is unlikely to happen."
Standalone health insurers, too, have stayed out of the row. "We operate on a no-TPA model and this is to ensure hassle-free claim settlement. We ensure that our network hospitals advertise their cash rates, regular room charges and even doctor's fees and there is total transparency in the system," said Neeraj Basur, director of finance at Max Bupa.
