Prioritise patients, Streamline Claims: Maha Health Minister tells Insurers, private hospitals
Prakash Abitkar
Mumbai: Maharashtra Health Minister Prakash Abitkar has directed health insurance companies and private hospitals to keep patient welfare at the centre of their services and ensure transparency in medical billing and faster settlement of insurance claims.
The directions were issued during a high-level meeting aimed at addressing complaints regarding delays in claim approvals and excessive hospital charges.
The meeting was held at the Mantralaya in Mumbai and brought together representatives from the Insurance Regulatory and Development Authority of India (IRDAI), major insurance providers, and leading private hospitals. Among the insurance companies present were IndusInd General Insurance, Tata AIG General Insurance, SBI General Insurance, Star Health and Allied Insurance, and HDFC ERGO General Insurance, along with hospital representatives from Lilavati Hospital and Research Centre, Jaslok Hospital and Research Centre, and Wockhardt Hospitals.
According to a report by The Free Press Journal, the meeting focused on concerns raised by patients and healthcare providers regarding delays in insurance claim approvals and inconsistencies in hospital billing.
During the discussion, Abitkar noted that while hospitals and insurance companies operate on commercial lines, the healthcare system must remain patient-centric. He emphasised the need to develop a clear operational framework involving insurers, hospitals, IRDAI, and the state health department to streamline processes and improve patient services.
The minister also pointed out that the number of people purchasing health insurance is steadily rising, making it essential for hospitals and insurers to ensure transparent practices and prompt services. He warned that the government would take action if irregularities or malpractice were detected.
Abitkar further highlighted that cities such as Mumbai, Pune, and Nagpur already have strong medical infrastructure and experienced specialists, which gives Maharashtra significant potential to develop medical tourism.
The minister directed hospitals across the state to register themselves on the IRDAI portal and ensure that their institutional information remains updated. He also stressed the need to introduce a defined time limit for approving insurance claims, noting that poor coordination between hospitals and insurers often causes financial and emotional stress for patients.
At present, around 7,000 to 8,000 hospitals in Maharashtra provide treatment under insurance-based services. However, the government has received complaints about irregularities in certain cases. Abitkar said that strict action would be taken under the Bombay Nursing Act if malpractice is found, and suggested that major hospitals should display treatment rate charts to ensure greater transparency.
The meeting also discussed the possibility of developing standard treatment protocols to address significant variations in treatment charges across hospitals for the same medical condition. The state government is also considering introducing a common empanelment system for hospitals and insurance companies.
The Health Minister further instructed that data related to approved and rejected claims, along with patient complaints, should be regularly submitted to the health department. Complaints received in Maharashtra will be reviewed with the support of IRDAI, and the state may become the first in the country to implement such a monitoring mechanism.
