Ban on mediclaim patients in private hospitals with less than 15 beds lifted

Following a petition filed in the Bombay High Court by the Association of Medical Consultants (AMC) on June 18 challenging the Insurance Regulatory and Development Authority’s (IRDA) blanket ban on mediclaim patients undergoing treatment in private hospitals and clinics with lesser than 15 beds, a fresh circular was issued in Mumbai by the IRDA.

Speaking to SUNDAY MiD DAY, Dr Sudhir Naik, chairperson of AMC said, “The IRDA issued a fresh circular after we put forward the problems that patients would face owing to lack of adequate beds in hospitals. Sixty per cent of hospitals have less than 15 beds. In the fresh circular, it is mentioned that any nursing home registered with local authorities or in areas where there are no registering authorities, can use the mediclaim facility for patients undergoing treatment in hospitals/clinics,” added Dr Naik.

However, the AMC has not yet withdrawn their petition as the implications of the circular are yet being discussed with their advocates Avinash Jalisatgi and Robin Fernandes. In the fresh circular, the word “or” has been restored instead of “and”.

In the city, 684 out of the 1,200 nursing homes have a capacity of less than 15 beds. Doctors had raised concerns as the rule would not only make patients opt for tertiary hospitals which are not only more expensive, but also affect the business of smaller medical set-ups.

Jalisatgi said, “The new circular was issued on July 3. It is now immaterial if hospitals or nursing home have 15 beds. But they have to be registered under the Clinical Establishment Act or various acts scheduled to this act.” 

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