New Delhi, Sep 2: Niva Bupa Health Insurance on Tuesday clarified that the viral social media post regarding the cashless denial of a Mumbai-based policyholder is ‘baseless’.

The viral post on professional networking site LinkedIn detailed the case of Chandra Kumar Jain, battling Myeloid Leukaemia and urgently needing a Bone Marrow Transplant (BMT) at Sir HN Reliance Foundation Hospital in Mumbai.

The LinkedIn post, from health insurance and investments advisor Avigyan Mitra, stated that the patient with a Rs 2.40 crore policy was allegedly denied a Rs 61 lakh cashless claim for the life-saving procedure.

Stating the allegation being made against Niva Bupa "baseless”, the company, in a statement, called out against the “fear-mongering narratives around the case”.

The company said that Jain, a policyholder since November 18, 2021, availed the claim for the third time in 2025.

“In the last two instances, an amount of 22.72 lacs has already been paid,” the health insurance company said.

In the current instance, it stated that the company "approved 25 lakh pre-authorisation cashless requests," as well as “an additional charge of Rs 77,000".

However, it did not approve the hospital's request for an “increase in pre-authorisation from initially approved Rs 25 lakh to Rs 61 lakh, basis an interim bill and stated that the treatment cost is escalating, which as on September 1 swelled to 80 lakh”.

"Contrary to what is being alleged, the originally approved Rs 25 lakhs pre-authorisation still stands valid,” the health insurer said.

"Those labelling the health insurance sector as a 'scam' are highly irresponsible and misleading. Health insurance plays a vital role in protecting families against unforeseen medical expenses, and if anything, this unfortunate case should tell us all the importance of Health Insurance,” the company said.

The post comes as Niva Bupa on Monday said it has suspended the cashless treatment facility at Max Hospitals across India.

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In a statement to IANS, Dr. Bhabhtosh Mishra, Director and COO of Niva Bupa Health Insurance, said the company’s agreement with Max expired in May 2025. Talks over premium revisions did not reach an agreement, leading to the suspension of cashless services.

Meanwhile, Max Hospitals, in a statement, clarified that it continued cashless services long after ending the contract and that "any further reduction is unviable".

“Max Healthcare has continued to provide cashless services to Niva Bupa policyholders even though the contract expired in May 2025. Niva Bupa has asked Max Healthcare to further reduce tariffs, which are already pegged at 2022 levels,” said the statement from the company's spokesperson.

"Max Healthcare believes that any further reduction is unviable and could compromise patient safety and the quality of care. To support patients, Max Healthcare has set up an express desk to help them claim reimbursements from insurers without having to make upfront payments at Max Hospitals," the spokesperson added.

(IANS)

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