In India, Is there any disputes happened between Hospital and Insurance company due to cashless facility?

Yes, disputes between hospitals and insurance companies over cashless facility are not uncommon in India. There have been instances where hospitals have accused insurance companies of delaying payments, rejecting claims unfairly, and imposing arbitrary deductions on claim amounts. Similarly, insurance companies have also complained about hospitals inflating bills and overcharging for services.

One of the major sources of disputes is the lack of clarity and transparency in the cashless facility process. Both hospitals and insurance companies have complained about the lack of clear guidelines and standard operating procedures for cashless facility, which can lead to confusion and disagreements. Hospitals have also raised concerns about the long delays in receiving payments from insurance companies, which can put a strain on their financial resources.

In some cases, disputes over cashless facility have escalated to legal proceedings, with hospitals and insurance companies filing cases against each other. The disputes can be time-consuming and costly, and can also damage the reputation of both parties.

To address these issues, the insurance regulatory authority of India, the Insurance Regulatory and Development Authority of India (IRDAI), has issued guidelines for cashless facility that aim to promote transparency and standardization in the process. However, disputes over cashless facility continue to occur, highlighting the need for greater collaboration and communication between hospitals and insurance companies.