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A post shared by an investment advisor on LinkedIn -- which sought to highlight the plight of a Myeloid Leukaemia patient saying that his Rs 61 lakh cashless claim was rejected by Niva Bupa -- evoked some sharp reactions on social media platforms, nudging the firm to come out with a clarification that it was still considering the claim and hasn’t turned it down.
The controversy began when Avigyan Mitra, a health insurance and investment advisor, wrote on LinkedIn that Chandra Kumar Jain, a patient admitted at Sir HN Reliance Foundation Hospital, Mumbai, was battling Myeloid Leukaemia and urgently required a bone marrow transplant.
According to Mitra, despite Jain holding a Rs 2.40 crore health cover (Rs 1 crore base plus Rs 1.4 crore no-claim bonus), the insurer suddenly refused cashless approval for bills of over Rs 61 lakh, citing that “liability cannot be established.”
Mitra called this a “systemic betrayal,” arguing that families pay premiums for years for protection during such crises, not to be forced to arrange cash at short notice.
Company’s clarification
Responding to a viral LinkedIn post that accused the insurer of abandoning a cancer patient during a life-threatening emergency, Nimish Agrawal, chief marketing officer at Niva Bupa, said, “The patient, admitted on 27 June, was approved an initial pre-authorisation of Rs 25 lakh for a bone marrow transplant.”
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Treatment costs have since escalated beyond Rs 70 lakh, which Agrawal said was “not usual.”
Since the patient has not yet been discharged, the company has neither denied nor approved the final claim.
Agrawal added that health insurance requires coordination with hospitals to ensure treatment costs are justified and said the company remains committed to supporting the family.
Public outrage
The post quickly went viral, drawing sharp reactions. Angel investor Udit Goenka shared it on X, describing insurance as the “biggest scam business in India.” Several others questioned whether policyholders can truly rely on health cover in medical emergencies.
The broader issue
While the patient’s claim status remains open until discharge, the incident has spotlighted key concerns in India’s health insurance sector:
Clarity of cashless approvals: Pre-authorisations are often mistaken for final settlement.
Policyholder awareness: Families may not fully understand that approvals are subject to change until discharge.
Trust gap: Cases of high-value claims often spark friction between insurers, hospitals, and patients.
The episode highlights the growing need for transparency and simpler communication in health insurance, particularly for critical illnesses involving large sums.
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