Prakash Abitkar was speaking at a meeting in Mantralaya with representatives of the Insurance Regulatory and Development Authority of India (IRDAI), private insurance companies, and hospitals to discuss issues related to delays in claim approvals and allegedly excessive medical billing by hospitals
Minister Prakash Abitkar holds a meeting with stakeholders in Mantralaya on Wednesday. PIC/BY SPECIAL ARRANGEMENT
Maharashtra Health Minister Prakash Abitkar on Tuesday directed health insurance companies and hospitals to keep policyholders at the centre of their services, while assuring that the state government will examine complaints received from insured patients. He was speaking at a joint meeting held at Mantralaya in Mumbai with representatives of the Insurance Regulatory and Development Authority of India (IRDAI), private insurance companies, and private hospitals to discuss issues related to delays in claim approvals and allegedly excessive medical billing by hospitals.
Abitkar said the government had received several complaints from policyholders regarding difficulties in obtaining claim approvals from insurance companies and the high medical bills charged by private hospitals. The meeting was convened to establish a standard mechanism to address these concerns and ensure smoother coordination between insurers and hospitals.
Representatives from major insurance companies, including Reliance, Tata, SBI, Star Health, HDFC and AIG attended the meeting, along with representatives from leading hospitals such as Vockhardt, Lilavati, Jaslok and Reliance.
“Even though insurance companies and hospitals operate on commercial lines, the patient must remain the central focus,” the minister said.
Representatives from insurance firms, private hospitals, IRDAI, and the state health department discussed the possibility of evolving a standard operating framework to safeguard patient welfare.
Abitkar noted that the number of people opting for health insurance is steadily increasing, and providing satisfactory services to policyholders is the responsibility of both hospitals and insurance companies. He warned that if irregularities are found, the government will initiate appropriate action.
Maharashtra minister calls for time-bound claim approvals, transparency in hospital billing
Highlighting Maharashtra’s potential for medical tourism, Abitkar said cities such as Mumbai, Pune and Nagpur offer advanced medical facilities, specialist doctors and robust healthcare infrastructure. He urged hospitals to improve services and enhance public trust in the healthcare system.
The minister also directed hospitals across the state to register on the IRDAI portal and keep their information updated. He stressed the need to fix a definite time limit for approving insurance claims, noting that lack of coordination between hospitals and insurance companies often leads to mental and financial stress for patients.
“The government will take necessary decisions to ensure that patients receive timely treatment and that the claim process becomes more transparent and easier,” he said.
At present, around 7,000 to 8,000 hospitals in the state provide insurance-linked medical services. The government has received complaints of irregularities in some cases, and Abitkar said action will be taken under the Bombay Nursing Act wherever necessary.
He also emphasised the need to make it mandatory for major hospitals to display clear rate charts for treatments. With different hospitals charging varying rates for the same illness, the meeting discussed the need to develop standard treatment protocols.
The minister further said the government is considering the creation of a common empanelment mechanism for insurance companies and hospitals.
Hospitals and insurers were also asked to regularly submit data on approved and rejected claims, along with details of complaints, to the health department.
Complaints received from Maharashtra will be shared by IRDAI for study and corrective measures, and the state is likely to become the first in the country to initiate such a process.
Abitkar said improving trust in the medical profession remains a priority for the government and reiterated that no patient should face difficulties in receiving treatment or insurance claim benefits.
Health Services Commissioner Dr Kadambari Balkawade, Director of Health Services Dr Nitin Ambadekar, Joint Director Dr Sunita Golhait, and other senior officials of the public health department were also present at the meeting.
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