Mumbai, March 11 In response to growing complaints regarding difficulties in health insurance claim approvals and exorbitant medical billing by private hospitals, Maharashtra’s Minister for Public Health and Family Welfare Prakash Abitkar on Wednesday issued strict directives stating that both insurance companies and hospitals must operate with the patient at the centre of their services.
At a meeting with the Insurance Regulatory and Development Authority of India (IRDAI), major private insurance companies and leading private hospitals, he emphasised that while insurance companies and hospitals operate as professional entities, patient welfare must remain the priority. Discussions were held to bring IRDAI, the Health Department and service providers onto a single platform to streamline patient care.
With the number of health insurance subscribers rising daily, the Minister noted that providing satisfactory service is a mandatory responsibility.
“The government will take strict action if any irregularities are found in the claim process or hospital billing. Given the advanced medical infrastructure and expert doctors in cities like Mumbai, Pune and Nagpur, there is massive potential for medical tourism. This can only be achieved by increasing credibility through better service. All hospitals in the state must register on the IRDAI portal and keep their information updated,” he said.
The Minister underscored the need for a definitive timeframe for claim approvals to prevent the mental and financial distress caused to patients due to a lack of coordination between hospitals and insurers. Currently, around 7,000 to 8,000 hospitals in the state offer insurance-linked services. Following reports of malpractices, the Minister directed authorities to take action under the Bombay Nursing Home Registration Act.
“Large hospitals will be required to display a mandatory price list for various treatments. To address the issue of varying costs for the same ailment across different hospitals, the government is considering standardised treatment protocols. The government is exploring a unified empanelment system for both insurance companies and hospitals,” he said.
The Health Department has requested regular data on approved claims, rejected claims and pending complaints. Notably, Maharashtra is set to become the first state in India to actively obtain and analyse Maharashtra-specific complaint data from IRDAI to implement corrective measures, the Minister said.
“Increasing the credibility of the medical profession is the government’s priority. We are committed to ensuring that no patient faces hurdles in receiving treatment or settling insurance claims,” he added.
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