Keep emergency fund, credit access ready to handle disruptions

Tata AIG General Insurance recently suspended cashless claims at Max’s hospitals in Delhi.

- SANJEEV SINHA.

This is not an isolated event, but rather part of a broader pattern of disputes between private hospital chains and health insurers nationwide.

“In recent months, Max Healthcare has faced high-profile cashless tie-up breakdowns with several insurers — Star Health, Niva Bupa, Care Health, and most recently, Tata AIG. The suspensions, affecting hospitals nationwide and in Delhi-National Capital Region, mirror a wave of standoffs between major hospital chains and private insurers,” says Shilpa Arora, co-founder and chief operating officer, Insurance Samadhan.

Why disputes arise

Conflicts typically stem from pricing disagreements, claim settlement delays, audits, and tariff renegotiations. “Hospitals accuse insurers of seeking tariff cuts mid-cycle or during renewal, while insurers cite steep hospital charges, coding and documentation gaps, and inflated package rates,” says Arora.