# Health insurers cut claims using ‘reasonable and customary’ charges 2026-08-16T08:04:01+00:00 | Business & Economy | Indian Opinion Desk Corroboration: 1 independent outlet (2 source reports) Health insurance claim settlement letters often contain deductions that can leave policyholders confused. Livemint reports that understanding terms like 'reasonable and customary' (R&C) charges, MoU discounts, and 'no active line of treatment' can help consumers challenge unfair cuts. In one case cited by Livemint, Chennai resident Vijaya Kawar had a Rs 2.11 crore hospital bill but her insurer approved only Rs 85 lakh. The Rs 1.26 crore in deductions included Rs 28.39 lakh under R&C charges and Rs 87.50 lakh on the grounds there was no active line of treatment. Kawar could not approach the Insurance Ombudsman because the disputed amount exceeded the Rs 50 lakh limit. R&C charges mean the insurer pays only what it considers standard for a treatment in a given area. MoU discounts are contractual reductions between hospital and insurer. Deductions for 'no active line of treatment' occur when an insurer believes hospitalisation was not medically necessary. Policyholders should obtain itemised bills and ask insurers to explain the data behind deductions. Livemint notes these disputes may end up in consumer court. ## Coverage - livemint.com - livemint.com (2) This story was synthesised by AI from the 2 sources linked above. Updated: this story now draws on 2 sources. Last updated 2026-08-16T12:53:42+00:00. Tags: Chennai, consumer court, Punit Kochar, Vijaya Kawar Canonical: https://indianopinion.org/health-insurance-claims-decoding-settlement-letters-after-deductions/ License: Summary and commentary (c) Indian Opinion, reusable with attribution. Facts belong to the linked sources. Cite: https://indianopinion.org/health-insurance-claims-decoding-settlement-letters-after-deductions/#story-in-brief How this brief was made: an AI model read the reports linked above and wrote this summary and analysis, which were published automatically. Published briefs are sampled every hour by an automated quality check; the editor verifies its findings and approves corrections, and corrected briefs carry a dated correction line. Stance labels are editorial classifications of how each outlet framed this story, assigned by the same model, not ratings of the outlets. We do no original reporting. Methodology: https://indianopinion.org/ai-use-policy/