Niva Bupa Health Insurance has suspended its cashless treatment facility at Max Hospitals across India, affecting thousands of policyholders. This means patients insured by Niva Bupa will now have to pay hospital bills upfront at Max Hospitals and later file for reimbursement.
Dr. Bhabhtosh Mishra, Director and COO of Niva Bupa, explained that the company’s agreement with Max Hospitals expired in May 2025. Negotiations over premium revisions failed to reach a consensus, leading to the suspension of cashless services. Mishra also noted that other insurers like Star Health and Care Health face similar issues with Max Hospitals.
Niva Bupa stated that the decision came after exhausting all options and cited administrative and process-related challenges in its arrangement with Max Group of Hospitals. While cashless services at Max Hospitals are currently unavailable, policyholders can still access cashless treatment at over 10,000 other partner hospitals nationwide. Treatments at Max Hospitals will continue on a reimbursement basis.
Max Hospitals has not yet responded to the situation.
This issue extends beyond Niva Bupa. Policyholders of Bajaj Allianz General Insurance and Care Health Insurance may also lose cashless access at several hospitals starting September 1, following concerns raised by the Association of Healthcare Providers (India) (AHPI) regarding the suspension of cashless services.
Although reports suggest AHPI issued an advisory to revoke the suspension, no official confirmation has been made. The General Insurance Council (GI Council) criticized AHPI’s move as sudden and unilateral, warning that such disruptions cause confusion, undermine public trust in health insurance, and force patients to make heavy upfront payments, potentially endangering lives in critical cases.
These developments come amid efforts by the insurance regulator IRDAI to promote 100% cashless treatment across India. However, while insurers are regulated by IRDAI, hospitals are not, limiting regulatory intervention in such disputes.
With hospital treatment costs rising sharply, these conflicts risk making quality healthcare less accessible for ordinary citizens.
