The Association of Medical Consultants (AMC), representing over 14,000 medical professionals, has raised concerns over the swift sanctioning of a ₹25 lakh cashless treatment claim for Bollywood actor Saif Ali Khan following his hospitalisation at Lilavati Hospital in Bandra. The claim, which was approved within hours of submission, has sparked accusations of preferential treatment for celebrities, prompting the AMC to call for an investigation by the Insurance Regulatory and Development Authority of India (IRDAI).
AMC expressed its disapproval in a letter to the IRDAI, criticising the speed at which the claim was processed. The association pointed out that such prompt approvals are rare for ordinary policyholders and suggested that celebrities and high-profile individuals benefit from preferential terms and treatment. This, they argue, leads to systemic inequality in the healthcare insurance system.
Health insurance expert Nikhil Jha echoed these concerns on X (formerly Twitter), emphasizing the unequal nature of the claim approval process. Jha highlighted that, in the case of a typical policyholder, the insurer would have required additional documentation - such as an FIR copy in medicolegal cases - before approving the claim. However, the insurance provider waived this requirement in Khan’s case and approved ₹25 lakh for his treatment without delay.
"The Insurance company sanctioned ₹25 lakh within a few hours to Lilavati Hospital for the treatment of Saif Ali Khan. The normal process is to ask for an FIR copy in medicolegal cases. The insurance company waived this requirement and immediately approved the cashless request," Jha wrote in an X post.
{{/usCountry}}"The Insurance company sanctioned ₹25 lakh within a few hours to Lilavati Hospital for the treatment of Saif Ali Khan. The normal process is to ask for an FIR copy in medicolegal cases. The insurance company waived this requirement and immediately approved the cashless request," Jha wrote in an X post.
{{/usCountry}}The controversy intensified when details of Khan's insurance claim were leaked on social media, revealing that his family had initially filed a claim for ₹35.95 lakh for his five-day stay at the hospital. The insurer, Niva Bupa, confirmed that the claim was being processed, with ₹25 lakh already approved.
In its letter to IRDAI, the AMC expressed concern that the treatment of high-profile individuals like Khan could lead to an unfair disparity in healthcare access. "This instance highlights a troubling trend where celebrities and patients with corporate policies receive favorable terms and higher cashless treatment limits, while ordinary citizens struggle with insufficient coverage and low reimbursement rates," the letter read.
Dr Sudhir Naik, who heads AMC's medico-legal cell, reiterated that the association was not against corporate hospitals or celebrities but advocated for equitable treatment for all patients, regardless of their social status. "We want the same treatment for ordinary patients who go to nursing homes," he said.
Saif Ali Khan attack
Saif Ali Khan was hospitalised after a robber broke into his Bandra home on January 16 and stabbed him. The incident occurred when the intruder allegedly confronted the actor's maid at his residence. As Saif attempted to intervene, the situation escalated into a violent altercation, resulting in the actor sustaining several stab wounds.
The attacker, Mohammad Shariful Islam Shehzad, was arrested three days later after a manhunt. Khan underwent surgery for injuries to his back, neck, and arm, with doctors reporting that one of his wounds was dangerously close to his spinal cord.
Insurer's response
A Niva Bupa spokesperson said that the cost of treatment depends on multiple factors, including the disease, severity of the patient’s condition, procedure or treatment undertaken, the city and the hospital where the treatment is availed. “The same treatment would cost different in different hospitals. Moreover, even in the same hospital, the treatment cost would vary depending on the type of room that the customer has opted for.”