Imagine being rushed to the hospital after a medical emergency, only to be stuck in a maze of paperwork, delays, and frustrating negotiations with your insurer. Now, contrast that with Bollywood actor Saif Ali Khan, who had his ₹25 lakh cashless insurance claim approved within hours of hospitalization.

Does this sound unfair? That’s exactly what the Association of Medical Consultants (AMC) is pointing out.

Preferential Treatment?

After being attacked by an intruder at his Bandra residence on January 16, Saif Ali Khan was hospitalized at Mumbai’s Lilavati Hospital. He underwent surgery and was discharged soon after.

The very next day, his insurance provider, Niva Bupa, approved ₹25 lakh for his treatment under a cashless claim process, the details of which were leaked on social media platform X. This rapid approval raised eyebrows, especially among doctors who see patients struggle with delayed or denied claims every day.

The AMC, a body representing over 14,000 doctors in India, has officially written to the Insurance Regulatory and Development Authority of India (IRDAI), questioning the fairness of this process.

Their concern – Ordinary policyholders often face lengthy claim processing times, coverage disputes, and lower cashless treatment limits, while celebrities and VIPs seem to get fast-tracked approvals.

How does Health Insurance work for common people?

If you’ve ever filed a health insurance claim, you know how this works:

• Hospitalization occurs.
• A cashless claim request is raised with the insurer.
• The insurer evaluates the claim (may take days).
• Claim may be fully approved, partially approved, or rejected.

Policyholders are often asked to submit additional paperwork, making the process painfully slow.

Meanwhile, many insured individuals struggle to get approvals for even ₹5-10 lakh, with pre-approvals taking days, if not weeks. Some hospitals even insist on upfront payments from non-celebrity patients due to the uncertainty of claim approvals.

The argument?

The AMC argues that preferential treatment for high-profile individuals undermines the principle of fair and equal healthcare access. When celebrities receive priority processing and higher cashless treatment limits, it raises some serious questions:

• Are insurers more responsive to high-profile clients because they fear bad PR?
• Why do common policyholders face extensive scrutiny, but celebrities get instant approvals?
• Are policy benefits the same for everyone, or do VIPs have hidden perks?

These concerns highlight the urgent need for greater transparency in the insurance industry.

What can the IRDAI do?

The insurance regulator must step in to ensure:

• Fair claim processing for all – No fast-tracking based on celebrity status.
• Transparent claim approval criteria – Insurers should disclose how they determine cashless treatment limits.
• Stronger consumer protection – Delays and arbitrary denials should be penalized.

Health insurance should be a reliable lifeline for everyone, not just for celebrities. If we’re all paying premiums, we should all get equal and fair treatment—no exceptions!

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