Good Change in Medical Insurance

The health insurance companies decided to stop cashless transactions in the high end hospitals (like Apollo, Fortis, Ganga Ram, Max or Medicity) in Delhi, NCR, Mumbai, Bangalore and Chennai. If we see the statistics, 11% of the hospitals are consuming more than 80% of the claims. More than 50% of the claims are from the top four metro cities. [Source: Times of India]

This is one very good step taken by health insurance companies. If you go to any big hospital, and get treatment done with insurance which provides cashless transaction, then the bill would be atleast double to the actual cost that you would have incurred, if you had paid from your pocket. In almost all the big hospitals, if they see anyone with health insurance, they just get unnecessary tests and treatments, and say that, since you have insurance, you don't need to worry. Most of the time, they double the treatment cost. If a hospital unnecessarily charging more money from the insurance company, then insurance company will increase it's premium, which in turn effect the consumer. If the premium is more, then those who do not use health insurance significantly, will drop out. And, there will be further increase in the premium amount, and if it continues, finally there may not be any benefit of having insurance.

If the treatment costs a lot, and if insurance company takes a lot of time to process the amount, then typically, consumers would prefer to go for cashless transaction. If the insurance companies process the claims quickly, then it would help both the company as well as the consumers.

Generally, I don't prefer to tell anyone that, I have health insurance. I know that, the moment I say that, they charge like anything. I would prefer to pay for the treatment, and later on reimburse it. Still, I had to tell this at almost all homeopathy hospitals. Since, no homeopathy doctor tells the medicine names that they are going to give, and no insurance company is going to process the claim without knowing the medicines they used. So, I had to tell them to get the information on the medicines they used.