The cashless facility for Niva Bupa policyholders has been suspended across all Max Hospitals in India, and this move could significantly disrupt plans of thousands of policyholders who are set to undergo or are undergoing some treatment at Max network hospitals.
According to a report by Economic Times, the insurer had informed its partners regarding the removal of all Max Hospitals from its network list with effect from 16 August, 2025. While the company has cited "administrative, process and practice-related challenges" and an unresolved tariff negotiation as reasons, the development was not explicitly communicated to customers on its official website or social media channels.
Dr. Bhabhtosh Mishra, Director and Chief Operating Officer at Niva Bupa, told ET Wealth Online: "Our agreement with Max expired in May 2025, and while discussions on tariff revision, an annual process, have been ongoing, we were unable to reach a mutual agreement. As a result, cashless services at Max Hospitals are temporarily suspended."
Max Healthcare, however, has pushed back. A company spokesperson told ET that Niva Bupa asked for further tariff reductions, even though rates are already pegged at 2022 levels. "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 said.
What does this mean for policyholders?
For now, if you are a Niva Bipa policyholder, you can continue the treatment at Max Hospital but only through the route of 'reimbursement claims'. This means that patients will need to pay the medical bills upfront (from their own pockets) and later they can submit claims to Niva Bupa for repayment.
The insurer has activated a "priority reimbursement" process to fast-track claims from customers undergoing treatment at Max facilities, though details on timelines are unclear.
However, those who prefer cashless treatment will need to use one of the other 10,000+ partner or network hospitals of the insurer located across India. In these network hospitals the facility continues as usual.
The issue is not unique to Niva Bupa. Earlier this year, CARE Health Insurance also suspended cashless tie-ups with Max Hospitals, although its suspension was limited to Delhi-NCR.
For policyholders, this situation highlights a reality that has become frequent practice recently. Even large hospital chains and insurers can have conflicts and part ways over pricing issues, leaving patients caught in between.
Till the time new agreements are made, policyholders insured by Niva Bupa, who are seeking treatment at Max Hospitals should go prepared to pay bills upfront or keep their documentation (like discharge summary, medical bills, policy doc, etc.,) ready for reimbursement claims later.
