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Created by : Anita Rai, Marketing Manager, Leading Pharmaceutical Co.  | 07 13 2010 07:27:52 +0000
Industry : InsuranceFunctional Area : Business Policy(Strategy & Execution)
Activity:  390 views;  last activity : 07 22 2010 14:23:30 +0000

Insurance companies are scrapping cash-less hospitalisation across the country which is going to affect those in need of medical treatment.  People are claiming that for treatment they are paying in cash as despite having a cashless hospitalisation health insurance providers have changed their policy.

The General Insurance Public Sector Association consisting of four major state-run insurance companies - United India, New India, Oriental Insurance and National Insurance - decided to stop cash-less hospitalisation at select hospitals. According to the companies, the hospitals make false claims. They show high costs and charge the insurance companies so much more. That is why we have taken away the the facility from some hospitals.

What do you think people, is this a right move from Insurance Co's to scrap cash-less hospitalisation?? Share your thoughts on this....

 
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I don't think it is a right move in any way, if people are misusing here bring them to the court, let law take care of these things, this is a retrograde step in a way, where they are thinking about their profits and not people's lives which are at stake, they need sit and talk it out, I mean the Hospital management and the Insurance co's if hospitals are involved in such a scam in future, criminal action must be taken and the license should be revoked such that everyone learns a lesson here, both Insurance and Hospitals are there to take care of people and not the other way around. This is a bad decision from them...


By Anita Rai, Marketing Manager, Leading Pharmaceutical Co.  07 13 2010 07:27:52 +0000
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It's certainly a temporary step. The market needs to mature to properly utilize a benefit offered, & resist the urge to profit out of a disease. Insurance cos. are doing what is practical. Should they go bankrupt paying up (BLOWN UP)medical bills? Insurance works on the principle of spreading risks. If a few people are cheating money out of the co., the actual loser is YOU,you have paid a premium for their fake bills.
By Shreela Sen, Administrative Officer, Oriental Insurance Company Limited  | 07 14 2010 03:06:38 +0000
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There should definitely be other solution. Make a expert panel and give serious warning to the erring hospitals. Putting the whole burden to the poor patient is not a wise decision afterall he/she is not doing any wrong.
By Lambit Kanwar, Research Scientist, EID Parry (I) Ltd  | 07 13 2010 08:55:53 +0000
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I would say YES since, this move will enable companies to cut down on losses and streamline malfunctioning allies. Considering the fact that insurance co's and TPA's cant survive without hospitals presence and support, am sure they will reverse the decision once its streamlined.
By Reny Eby Varghese, Project Planning Manager, Hinduja Healthcare Pvt Ltd  | 07 13 2010 08:52:41 +0000
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let us not spend such a huge amount of money in premiums instead keep it safe in banks which are nowadays giving intrests on daily basis
By Dr.Rahul Maniyar, dentist, private practice  | 07 22 2010 14:23:30 +0000
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The yearly premium is more than double/tripple in case of cashless Mediclaim Insurance, what will happen to them, will it be refunded back to the insured persons!
By R N Bhattacharyya, Freelancer, Freelancer  | 07 16 2010 11:07:55 +0000
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There is a divide between the hospitals and the insurers,today it has come in newspaper stating hospitals will be categorised into A===>B==>C==>D Category depending on the strength pf bed i.e is it a 30 bedded Hospital or 1000 bedded hospital and the infrastructure and facilities. I personally feel this is going to be regressive step because the tendency of the insurers to make the customers go in for A or B Category;which is not within the reach of majority low and middle income group.It is not hotel industry to categorize into four groups the customers needs the best treatment at affordable price,hence the IRDA should stick to uniform rate only .
By kasturirangan.r , INSURANCE ADVISOR, Life Insurance Corporation Of India  | 07 14 2010 11:39:25 +0000
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No cashless facility shld not be withdrawn. Yes the erring hospitals & patients should be given harsh punishment for misusing the facility. It is in the interest of the people not to connive with the hospital to raise inflammatory bills & party to overcharge just because the insurance co. is paying.

Hospitals also should have ethical practice & ensure that for a few thousands of rupees they do loose their reputation & invite wrath of patients & insurance cos. It is a social crime on the part of the hospitals & dealt sternly by Law & Govt.

It is right time for insurance cos. private as well as PSU cos.to fix a standard,reasonable charges with variation plus/minus 20% & avoid inflated charges. A regulatory body should be formed involving both Insurance & Medical fretinity to arrive at a proper & amiable decision.

Initially, hosp.may relectent to come to negotiation table but ultimately they do give in as most of the patients do prefer settlement thro' insurance & day by day the Medical Insurance is growing by great demand.

It is observed that the surgery & treatment charges are higher by 20-25% by the so called prestigious hospitals but their ward charges are phenomenal running into lakhs for a 5 days stay.

It is in our own interest that we should choose a good moderate hospital for surgery & other major treatment if it is not emergency. Otherwise these speciality hospitals will fleece the patients as well as the insurance cos.  If they still insist for their way, let the govt. withdraw all the concessions & felicities provided to them.

SN Rao

 

 


By nagesh rao, Freelancer, Freelancer  | 07 14 2010 09:53:13 +0000
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ANITA I SUPPORT YOUR VIEW AND WOULD REITERATE THAT IT IS NOT PATIENTS BUT THE HOSPITAL MANAGEMENT, DOCTORS, AND TECHNICIANS WHO INFLATE THE TREATMENT COST BY KEEPING A PATIENT LONGER THAN REQUIRED. IN THE HOSPITAL,BY GETTING EXPENSIVE NON REQUIRED TESTS AND INVESTIGATIONS,FOR EVERY IN PATIENT TREATMENT NOW A DAYS THE HOSPITALS INSIST ON AVAILING A TREATMENT PACKAGE FOR AN ALL INCLUSIVE HOSPITAL STAY, WHICH DIRECTLY EFFECTS THE COSTS OF THE INSURANCE COMPANY. THEREBY LEADING TO THEIR LOSSES. BUT WHY SHOULD THE PATIENT SUFFER. THE INSURANCE COMPANIES HAVE A WRITTEN AGREEMENT WITH THE INSURER TO OFFER CASH LESS HOSPITALIZATION FOR WHICH THEY CHARGE A HEFTY PREMIUM YEAR AFTER YEAR. I FEEL INSURANCE COMPANY SHOULD BE BOUND BY SEBI AND IRDA TO HONOUR THEIR COMMITMENT WITH THE INSURED PERSON IN EVERY ASPECT, CASH LESS FACILITY BEING ONE OF THEM. GOVT MUST STEP IN TO SAVE POOR PATIENTS FROM MISERY.
By KAMAL TANDON, Sales Head, KEE PHARMA LIMITED  | 07 14 2010 05:22:50 +0000
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traditional pchysi of Indian Masses was of hoarding money and not investing. Probably this move would make the people once again resort to the retro mentality. Govt should infact make moves which make circulate revenue instead of blocking it.
By Devendra Singh, Branch Manager/Regional Manager, Luxor Writing Instruments Pvt. Ltd.  | 07 14 2010 04:21:06 +0000
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No, I strongly disagree this move taken by insurence compnies, once they feel cheated they become united to ban a very good step otherwise they always competeting each other,If they have problem with hospitals they should sit with hospital management and talk with them or they should consult some big institutions like AIIMS to cosult that what could be the maximum expenditure for any procedure or what are the necessory tests to diagnose any thing or they can put a cap on stay or doctors visiting fee etc.

I think a middle class person has to manage when it comes to give a premium of mediclaim policy how can he manage charges for medical facilities.

We always say we are growing fast but these types of step push us back.


By Chhavi Kumar Tyagi, Sales Executive/Officer, Pharma MNC  | 07 13 2010 19:24:47 +0000
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The discontinuation I think, will mean problems for many even though, it is related to elite  or select few hospitals considering most hospital are cash making ventures. In fact, it would be a nightmare given the current scenario where most hospital have increased, their charges manifold, as most patients are covered, under Insurance and the recovery is easy. Then there are added factors like, liberties given to other Doctors who visit at will, even if their services are not really required or related to patient’s treatment. These visits are charged to patient’s bill. The ironic part is that patient has little say in it. One often ends up in hospital as an emergency and sudden, not having enough time to arrange funds. I can not even begin to think their predicament. One hopes that they will honour those policies they have already issued.


By Soorain Vahie, Freelancer, Consulting  | 07 13 2010 17:43:11 +0000
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It's certainly not the right move. If we have to shell from our own pocket for all our medical expenses then what's the use of having an insurance. I know that insurance company will reimburse our money but it will take a long time because of their formalities.


By Ravishankar , M.Sc student, M.S. Ramaiah College Of Science, Bangalore  | 07 13 2010 13:12:43 +0000
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