NEW DELHI: Excessive profiteering by private hospitals for treatment of COVID-19 patients has forced the statutory body of insurance companies to seek Supreme Court's intervention. It said that this unchecked practice will raise the medical premium cost in India.
In an affidavit filed in the court in an ongoing case seeking capping of COVID-19 treatment costs in private hospitals, the General Insurance Council has said that so far its members have received over 1 lakh COVID-19 treatment claims.
The council, which has government as well private insurers as its members, has also highlighted that private hospitals are arbitrarily charging extra — much more from insurance holders than those uninsured.
While the overcharging by private hospitals in the pandemic has been reported widely, this is the first time an insurance association has articulated these concerns and has even warned that this could cause the health premiums to go up in near future.
The need to file the impleadment application, that has now been accepted by the court, was felt as the council wanted to be heard, in the wake of the court making some observation related to insurance companies. "It is respectfully submitted that in order to bring confidence and to have clarity on the billing structure with the common man before he gets admitted in the hospital for COVID-19 treatment, there is need for proper monitoring of the treatment costs by the private hospitals and take suitable action against the violators," the affidavit said.
The plea also cites several examples where hospitals charged much higher costs to insured patients than those uninsured and even brought down final bills when confronted by insurers and patients. One such example, with proof, is from Sooriya hospital in Chennai where a patient with insurance cover was charged over Rs 14 lakh for hospitalisation lasting about 35 days.
When objected by the insurance company, the final cost, however, was brought down to less than Rs 4.5 lakhs.The council has also argued that private hospitals are charging for consumables such as PPE kits and gloves and drugs at much higher rates and in several cases, the same PPE kit is used for several patients but each one them is charged the full cost.
Several states have fixed hospitalisation charges across different categories but the same does not apply for insured patients. There are also allegations which underline the ways in which hospitals are circumventing COVID-19 price caps imposed by the states.
Girdhar Gyani, director general of the Association of Healthcare Providers of India, a body of private hospitals, meanwhile said that these issues have been discussed between the two industry bodies in recent times. "With reduced PPE kit price and manpower costs coming down as the quarantine period of healthcare workers has been reduced from two weeks to one week, we are hoping that treatment cost of even insured patients will go down snow," he said.