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Private hospitals force people to pay despite having cashless insurance

A number of patients undergoing treatment at private hospitals have to face much harassment owing to the technicalities in the approval of their health insurance claims and other formalities involved in the procedure.

Patients have to suffer humiliation at high-end private hospitals and are even forced to pay hefty amounts to get themselves discharged despite having cashless health cover.

“My father got admitted to a well-known multi-specialty hospital at Rohtak recently. He had a comprehensive health insurance policy. However, the hospital staff made some error in processing his insurance claim. Due to that, the approval of his claim as well as his discharge got delayed. All of us, including my ailing father himself, had to undergo much harassment and humiliation, but the hospital administration refused to admit its fault,” laments Gargi, an engineer.

Maintaining that the conduct and behaviour of the hospital staff was rude and unsympathetic, the working professional plans to move a consumer forum.

A number of patients complain of being subjected to such treatment at private hospitals for no fault of theirs.

On the other hand, the health insurance executives state that the patients should also be careful while buying insurance cover and getting admitted to private hospitals for treatment.

“Many a time, customers conceal their chronic diseases like hypertension and diabetes, etc at the time of buying insurance policies. In such cases, their claims may get denied later. Besides, they must adhere to their entitlement as per the sum assured while getting admitted to hospitals,” asserts Sweety Dalal, a cluster manager at a health insurance company.

Dr Arvind Dahiya, who runs a high-end multi-specialty hospital at Rohtak, states that he agrees with the patients. At the same time, he also points out that health insurance has made quality medical treatment accessible to the people, though there are several lacunae in the model.

“In its current form, the medical insurance model is far from ideal. There are lapses on part of the patients, insurance firms as well as unscrupulous private hospitals and it would not be right to point fingers at anyone. All stakeholders should come together to bring qualitative changes in the model in the larger interest,” observes Dr Dahiya. Tribune India

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