Insurance firms told not to blacklist hospitals arbitrarily
By IANSFriday, May 14, 2010
GANDHINAGAR - The Gujarat High Court Friday directed insurance companies that they cannot blacklist any hospital and refuse passing mediclaims without giving them the opportunity of being heard.
The petitioner hospitals - Life Care Institute of Medical Science and Research, Karnavati Super-Speciality Hospital, May Flower Women’s Hospital, Hetvi Hospital, Aditya Multi-Speciality Hospital, Sanjeevani Heart And Medical Hospital, and Polyclinic - approached the high court challenging insurance companies’ decision to blacklist them.
United India Insurance Co. Ltd, New India Assurance Co. Ltd, National Assurance Co. Ltd and Oriental Insurance Co. Ltd had blacklisted these hospitals for their alleged irregularities in mediclaim billing.
The insurance companies alleged that the hospitals indulged in corrupt practices and these were revealed during the inspection at these hospitals. Due to these malafide mediclaims, these medical facilities were blacklisted.
However, the hospitals claimed they were not given an opportunity of being heard and the insurance companies stopped passing claims of patients from these hospitals without any notice to them.
A division bench of Chief Justice S.J. Mukhopadhaya and Justice Akil Kureshi said the respondents cannot refuse mediclaims of patients from these hospitals without giving them any show cause notice or without following procedure.
The bench ordered the insurance companies to hear the hospitals and then decide whether or not to blacklist them after issuing necessary notices before Aug 15.
