Health insurance companies in India have started getting a bad reputation. The amounts they charge as a premium are rising year on year . However , while the policies are becoming more expensive, the companies are also increasingly being seen as being customer unfriendly, because of their high rates of claim rejection.
While the insurance company needs to audit every claim submitted to it to verify that it is genuine, doctors believe that insurance companies are now interfering with their autonomy . They have started to send-guess the doctor's medical decisions , by refusing to pay for the care which the doctor feels is best for his patient. Thus, it is the insurance company which decides which intraocular lens the doctor is allowed to fit into his patient's eye after cataract surgery , based on the premium the patient has paid !
Even worse, insurance companies are rejecting ‘genuine’ claims, just because they are submitted beyond 7 days from the date of discharge. Thus, instead of the patient trying to heal and recover after his hospitalisation, insurance companies expect him to collect and collate all his hospital medical records and bills and submit them promptly to the insurance company. When a patient has just been discharged, the last thing he wants to worry about is paperwork and documents. Rather than trying to help him heal, the insurance companies are pressuring customers to comply with stupid paperwork requirements.
It looks like health insurance companies are soon going to join the ranks of the other bad boys of the healthcare ecosystem - the pharma companies !
Insurance companies should be rational the same way as the hospitals and doctors.
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