Service Tax on Cashless Medical Insurance
The Union government has introduced on July 01, 2010 a service tax of 10.3% on every claim made using the cashless facility. On the same day insurance companies have curtailed the cashless mediclaim facility by drastically reducing the number of eligible hospitals which move has already had the instant impact of bringing cashless mediclaim transactions to a virtual standstill in metros. But the Central Government’s move to introduce service tax on every cashless mediclaim settled has paradoxically gone unnoticed.
According to Jaslok Hospital CEO Colonel M Masand, the head of the Association of Hospitals, ‘the service charge component would not be visible to consumers as it was a sum that would be paid by TPAs to hospitals after every cashless transaction.’ If that be so, for an approval of cashless facility for a particular patient for treatment costing one lakh rupees, they have to pay Rs.10,300/- as service tax to the hospital. But will the TPAs shell out such a huge amount on service tax from its kitty without burdening the policyholders, particularly when they are already feeling the heat due to heavy outflow of cash under cashless mediclaim settlement due to which reason the insurers have curtailed the number of hospitals eligible for cashless mediclaim facility?
So, as is their wont, they may opt for the easiest route to cushion this shock by passing on this ‘extra burden’ on to the shoulders of the policyholders. For doing this, they may examine three options. One, they may incorporate a rider in the policy conditions by specifying cashless facility as ‘a facility that excludes service tax.’ But incorporating a rider after issuing a policy may not stand the legal scrutiny. Nevertheless, by taking a leaf out of Bhopal Gas Tragedy case which is still dragging on even after twenty six years, some may approve of this option as a temporary measure to overcome the burden before finding a permanent solution.
If there are no takers for the first option, as a second one, they may increase the premium for the mediclaim policy with cashless facility. As mentioned earlier, the service tax payable for a treatment costing one lakh rupees is Rs.10,300/-. For a mediclaim policy worth of one lakh rupees, they may charge an additional premium for this additional amount of Rs.10,300/- to cover the extra burden. But this again will invite public wrath and a possible danger of people opting out of cashless facility for their mediclaim policy. Still, with such people form only a motley group, companies may not mind the outcry and carry on with increasing the premium.
If they do not want to attract any public anger and avoid litigations, they may resort to try the third and silent option which may be termed as ‘compressor or squeezer method.’ By opting to this method they need neither to increase the premium nor to pass on the burden on to the shoulders of the policyholders, but instead they can silently club together the service tax and the treatment cost into a single liability and thereby reducing the actual treatment coverage of the policy by 10.3%. In other words, a policyholder who holds a mediclaim policy with an option of cashless facility for a sum assured of one lakh, can actually avail cashless treatment for only up to Rs.90662/- and the balance of Rs.9338/- will be adjusted towards service tax and thereby the entire sum assured will be exhausted. In all likelihood the companies may prefer this silent method as most of the policyholders may not even come to know of this hidden cost unless it is explained by others or studied by themselves or observed from the hospital bill after treatment.
Above all these, there is another danger also lying ahead. The Central Government’s present move to widen the Service Tax net is aimed only at the mediclaim policies with cashless facility alone leaving the other regular mediclaim policyholders who go in for reimbursement after treatment, which may be viewed as discriminatory and opposed and may even be challenged. When the shouts of opposition grow louder, the Government may be left with only two options, either to withdraw its move or bring in all mediclaim policies under the service tax net. Knowing from our past experiences with this government, which cares more about corporate and big businesses than the Aam Aadmi, - as in the case of petro-product price rise and decontrol of petrol to help the oil companies and as in the case of budgetary write-offs of tax for the benefit of super-rich and the corporate sector - the Central Government may not go back on its decision but instead may bring in all the mediclaim policies, be it with cashless facility or with reimbursement option, under the service tax net.
Whatever is happened following the government’s move to bring in the mediclaim policies with cashless facility under the service tax net, the ultimate losers are only the policyholders. Like the decision to decontrol of petrol and petro product price hike, which is claimed to reduce government’s financial burden and to reduce deficit, the government’s current move to widen the service tax net, perhaps is to garner more revenue and to reduce deficit. But insurance and health care are the most important and essential basic needs of any society and it should be the top priority of any government. In our country the cost of treatment and hospitalisation are almost out of reach of common people and health insurance is the only source for them to think of a specialised treatment when in need. Instead of providing free health care or making health insurance cheaper, to consider it as a source to milk money to increase the income and reduce the deficit by the government is nothing but abandonment of its social duty. Considering the social importance of cashless medical insurance, the central government should come forward to withdraw its decision to bring it under tax net immediately without standing on prestige.