KOCHI: Over-billing by private hospitals is also contributing to the increase in rejection of claims by insurance companies. Some hospitals allegedly subject people with insurance coverage to unnecessary tests and unnecessary drugs to increase bills.

Complaints against rejection of claims by members of health care schemes have increased with the Insurance Ombudsman and Consumer Disputes Redressal Courts. Insurance companies have been ordered to pay huge compensations by consumer courts for denying claims including Covid cover.

Private hospitals bill different rates for those with and without insurance. There are hospitals that charge people with insurance more than twice as much as those without. Unnecessary tests, surgeries, additional hospitalizations, and medications are added to the bill. This leads to insurance companies rejecting even reasonable claims. Those who work in the consumer sector say that even if they get a claim, private hospitals charge a large amount from the patients additionally.

Liability and loss to patients

If you claim more than the amount stated in the insurance cover, the premium amount will be increased when the insurance is renewed in the next year. Those who can't afford it often have to drop out of insurance coverage. This will be a big loss for those who have joined the scheme years back.

Regulatory board is essential

There is a strong suggestion that a hospital regulatory board should be formed to control the financial exploitation of hospitals. Establishing common standards can prevent over-billing and exploitation of the insured.