ET Wealth Online saw a copy of the notification informing its partners of this development. However, even though all Max hospitals have been removed from their list of network hospitals on their website as of September 1, 2025, no official information has been explicitly made available to policyholders via Niva Bupa’s official website or other social media handles.
Said Dr. Bhabhtosh Mishra, Director & Chief Operating Officer at Niva Bupa Health Insurance, “ We would like to inform you that our cashless services at Max Hospitals are currently unavailable. 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”.
According to Mishra, cashless treatment is unavailable at Max Hospitals for Star Health and Care Health, too, for a variety of reasons.
A Max Healthcare spokesperson, responding to ET Wealth Online’s request for comments on this matter, explained that “we had 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. 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.”
As per Niva Bupa’s notification, “With great consideration, and only after exhausting all other options, we are constrained to take the difficult decision of suspending the cashless facility at Max Group of Hospitals effective 16 August 2025 across India. This step has been taken due to certain administrative, process and practice-related challenges in our existing arrangement with Max Group of Hospitals”.
What does this mean for Niva Bupa’s policyholders?
The notification highlights that while the cashless facility is currently unavailable at Max Group of Hospitals across India, “they have put in place alternative arrangements to ensure customers’ treatment continues smoothly”.
Niva Bupa policyholders can continue their ongoing treatments at any of the 22 hospitals spread across India, which come under the Max Group of Hospitals, but only on a reimbursement basis. This means that while Niva Bupa policyholders can avail of treatments at Max Hospitals, they will have to first pay the bills out of their pockets, and then file for reimbursement with Niva Bupa.
“However, if you prefer the convenience of cashless services, you may wish to consider one of our 10,000+ partner hospitals, where the cashless facility remains fully available”, the notification adds.
Niva Bupa has reportedly enabled a priority reimbursement process for its customers who are currently undergoing or seeking treatment at Max Hospitals. “In this process, your customers may make payments directly to the hospital and then raise a reimbursement request with us. We will endeavour to process your customers’ claim quickly to ensure they receive the eligible amount hassle-free”, the notification added. However, no further details regarding this process are available as yet.
Niva Bupa has also asked its partners to “inform customers with chronic conditions who are continuing treatment at the Max Group of Hospitals about the Priority-Reimbursement process”.
However, the notification also stated that “wherever possible, guide your customers to an appropriate choice of hospital from our network list of 10,000+ hospitals where the cashless facilities are available”.
As per IRDAI’s Handbook on Indian Insurance Statistics, for the year 2023-24, Niva Bupa recorded a claim settlement ratio of 92.02%. This percentage indicates the number of times an insurer has honoured or paid the claims, out of every 100 claims they have received.
However, their incurred claims ratio, which refers to the total claim amount paid by an insurer, as compared to their total health insurance premium collection in a financial year, remains alarmingly low at 59.92%. This means that out of every Rs 100 that a policyholder filed as a claim with Niva Bupa in 2023-24, they only paid around Rs 60, on average.
Niva Bupa also ranks amongst the top 5 health insurers, against whom the Council of Insurance Ombudsman (CIO) has received the maximum policyholder complaints (1,770) in FY2023-24, when it comes to complete or partial repudiation or rejection of claims.
CARE Health also on list for cashless claim processing suspension with Max Hospitals
Earlier this year, CARE Health Insurance had also suspended the cashless facility with Max Hospitals. However, this cashless treatment suspension was restricted only to Delhi-NCR.
Also Read: No cashless claim in Max Hospitals in Delhi NCR for policyholders of CARE Health Insurance
As mentioned on their website, “We are committed to providing access to quality healthcare at affordable premiums. With immediate effect, we have ceased cashless claim services at all Max Hospitals – NCR due to unsustainable demands from a customer’s perspective. We continue to provide the said services at alternative equivalent facilities among our comprehensive network of over 21,600 healthcare providers”.