Niva Bupa ₹61 Lakh Claim Row: Cancer Patient Had ₹2.40 Crore Cover, So Why Was ₹61 Lakh Pre-Approval Disputed?

A dispute emerged in September 2025, when Mr. Chandra Kumar Jain was hospitalized at Sir HN Reliance Hospital in Mumbai undergoing cancer treatment. According to the family, Niva Bupa did not approve a Rs 61 lakh health insurance claim during Mr. Jain’s treatment, and it caused distress to the patient as well as the family.

​According to the reports, Mr. Jain had an insurance cover of 2.40 crores.

​Niva Bupa Insurance said that they had initially approved a claim of 25 lakhs and sought a clarification from the hospital regarding the rising treatment costs.

The case came into focus when Aviyan Mitra, the investment  advisor for Mr. Jain’s family, posted on his LinkedIn alleging that Niva Bupa Insurance denied a cashless approval during Mr. Jain’s treatment based on "liability cannot be established.”

According to the reports, Mitra said that his client held a health policy with a good sum of money. He mentioned that the insurance included Rs 1 crore in base cover and an additional Rs 1.4 crore no-claim bonus. He alleged that even after

​The company had already issued a written approval for a Rs 25 lakh BMT package before backtracking. Mitra called the move a “systematic betrayal”, and he mentioned that the family was left to arrange a large sum of money during a medical emergency, even though the patient, treatment and the policy remained unchanged.

​The LinkedIn post said, "Health insurance cannot become a game of wordplay and escape clauses. When lives are at stake, dignity, compassion, and fairness must come first. This fight is not just for Mr. Jain. It's about ensuring that no family in India ever has to beg their insurer during the darkest hour of their life."

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A cashless health insurance claim is a service provided by an insurance company where a patient can get treatment in a hospital, and the bill is paid by the insurance company directly to the hospital.

​However, a patient needs to check whether the hospital where he/she plans to receive treatment is included in the network of the health insurance policy.

Niva Bupa said that Mr. Jain was admitted to the hospital in June 2025, and that the insurance company had approved a claim of Rs 25 lakh on pre-authorisation for a stay of 27 days after a discussion with the hospital.

​According to the reports, the hospital sent an additional charge of Rs 77,000 on July 9, 2025, which was also approved by Niva Bupa Insurance Company.

​However, a few days later, the hospital requested an increase of the pre-authorisation amount to Rs. 61 lakh from Rs 25 lakh, based on interim fees and rising treatment costs.

​Niva Bupa told Mint that the final amount was increased to 80 lakh. They said they couldn’t approve the amount since it was much more than what was approved initially.

​They also mentioned that they asked the Hospital to give viable proofs for the increase in the price of treatment.

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Niva Bupa refused the denial of Rs. 61 lakh through a post on Twitter. The company’s representative Aarav said that they were aware of Mr Jain’s case and that the company had provided a pre-authorisation of Rs 25 lakh to the family.

They claimed that the sudden increase in the treatment fees had escalated the matter. They added that the final amount of cashless claims is approved with the hospital at the time of discharge, and since Mr. Jain was not discharged at the time, they could not process the final request in the required time.

No public details are available regarding the final claim settlement.

(Rh/ARC/MSM)