Patients Trapped Between Hospitals and Insurance Companies
Patients today are being mercilessly sandwiched between two profit-driven giants: private hospitals and medical insurance companies. What was once meant to be a safety net—Mediclaim insurance—has now become a question mark. Instead of providing relief in times of medical crisis, it often leaves families drained, humiliated, and financially burdened.
Take my wife’s case as a glaring example. She is 67 years old and covered under a Mediclaim policy with Star Health Insurance. On the night of 10th January 2026, she suffered profuse bleeding from her nose and blood in her cough. In panic, we rushed her to Manipal Hospitals, Mukundapur, Kolkata (formerly AMRI) at midnight. Emergency treatment was given, the bleeding was stopped, and doctors advised keeping her under observation for a few days. We agreed, and she was admitted at 12:20 a.m.
The hospital began conducting multiple tests. Most reports came back normal, and by the next day, doctors agreed she could be discharged. An estimate was sent to Star Health Insurance for approval. Shockingly, the claim was rejected twice. The reason? “All reports are normal, so hospitalization was unnecessary.”
I personally spoke to the claim settlement department. Their representative bluntly told me that since the reports were normal, treatment could have been done at home or in OPD. I argued that IV injections were administered, which cannot be done at home. The response was astonishing: “Oral doses would have worked.” How can someone sitting in a call centre decide what treatment a patient requires, overruling the attending doctors?
Finally, after sending the actual bill and hospital summary, Star Health approved only ₹34,000 out of the ₹58,000 bill, deducting ₹24,000. The justification? The hospital had conducted “unnecessary tests” and charged exorbitantly. For example, a Vitamin D test was billed at over ₹6,000, while the average cost in Kolkata is around ₹1,800. Similar inflated charges were cited for other tests.
But here lies the cruel irony: patients have no control over hospital billing practices. If hospitals charge exorbitantly, why should patients be punished? Insurance companies conveniently wash their hands of responsibility, leaving families to bear the financial brunt.
Despite paying substantial premiums for Mediclaim coverage, patients are not assured of protection when they need it most. Instead, they are crushed between hospitals that treat health as a business and insurance companies that cut claims to protect their profits.
This is not healthcare—it is exploitation. Families in crisis are forced to fight battles they never signed up for.
The only way forward is collective action. A mass consumer forum under government authority must intervene to regulate hospital billing and hold insurance companies accountable. Otherwise, patients will continue to suffer helplessly, paying premiums without security and bills without justice.
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