Overview

• Cashless services were suspended effective August 16 and Max Hospitals were removed from Niva Bupa’s network listing by September 1.
• Policyholders can continue treatment at Max on a reimbursement basis, with a priority reimbursement process in place and cashless access available at 10,000-plus partner hospitals.
• Max Healthcare says it kept cashless services running after the May contract expiry but calls Niva Bupa’s requested tariff cuts, already tied to 2022 rates, unviable and risky for care quality.
• A Max spokesperson says the hospital group has set up an express desk to help patients process reimbursement claims without upfront payments at its facilities.
• Niva Bupa rebutted a viral post alleging denial of a large cashless claim, saying it approved Rs 25 lakh pre-authorisation and rejected a requested hike to Rs 61 lakh as costs escalated, while insurer and hospital bodies trade barbs over the wider cashless disruptions and IRDAI pushes cashless expansion.