49.6m Dubai claims make Bathwal's hospital rate argument relevant for UAE insurers

Mayank Bathwal, chief executive officer of Aditya Birla Health Insurance, said in a Financial Express interview updated on 7 September 2026 that predictable hospital rates can reduce friction in claims, a point Dubai operators should read against 49.6 million health insurance claims in 2025.

The Indian debate is relevant to the UAE because the same tension sits inside every payer-provider contract. CFOs want fewer rejected claims. COOs want faster pre-authorisation and discharge clearance. CIOs need cleaner data exchange between hospital systems, third-party administrators and insurers. Dubai is the first market to watch because the Dubai Health Authority (DHA) regulates a large compulsory insurance market through ISAHD and eClaimLink.

Why Dubai should watch the Indian debate

Bathwal told the Financial Express that about 70% of insurer cost in India is healthcare cost. His argument was commercial, rather than a call for blunt price cuts. Hospitals, he said, should use medical protocols, common empanelment and the National Health Claims Exchange to make rates easier to compare and claims easier to process.

"They should create efficiency in cost by following standard treatment protocols." Mayank Bathwal, CEO, Aditya Birla Health Insurance

Dubai has already built part of that operating base. DHA's insurance rules sit on ISAHD, and DHA price-list and emergency coverage directives are published through the ISAHD law and regulations portal. The practical issue is the gap between rules and daily contracting. A hospital may have several tariff files, several payer portals and several interpretations of documentation before a claim is paid.

The volume now matters. Dubai's health insurance system recorded 49.6 million claims in 2025, up from 43.69 million in 2024, according to WAM. That is a 13.5% increase in one year. For a mid-sized clinic group, even a small denial rate can turn into a working-capital problem when claim volumes rise.

What changes for clinics and insurers

Predictable rates do three things in a UAE setting. They make patient estimates more credible before treatment. They reduce payer-provider disputes after discharge. They give finance teams a cleaner basis for network negotiations with insurers such as Daman, Thiqa and Sukoon, where the product and geography apply.

• Dubai: Check whether every high-volume procedure has one current tariff file by payer, network and facility code.
• Abu Dhabi and Al Ain: Map payer rules against Department of Health Abu Dhabi (DOH) requirements before renewing Daman or Thiqa contracts.
• Northern Emirates: Review Ministry of Health and Prevention (MOHAP) licences and network inclusion before quoting cash prices to insured patients.
• IT teams: Audit rejected claims by denial code, payer, doctor and diagnosis-related group where the system supports DRG reporting.

Patients also have a price signal. Dubai's Essential Benefits Plan is designed for Dubai residents earning AED 4,000 or less per month; DHA's updated benefit table set the premium band at AED 550-750 per member per year for the EBP in 2024. The federal basic health insurance scheme for private-sector workers and domestic workers in the Northern Emirates is priced at AED 320 per year, according to the UAE Government portal. These numbers do not set hospital procedure prices, but they show how narrow the funding base can be for entry-level cover.

What operators should do next

The UAE question is implementation, rather than ideology. Fixed or predictable episode rates can work for repeatable services such as diagnostics, day surgery and maternity packages. They are harder for tertiary cases, complications and imported consumables whose costs move faster than annual payer negotiations.

Hospital COOs should start with the 20 procedures that produce the highest denial value, not the longest tariff book. CFOs should separate tariff leakage from utilisation growth in monthly reporting. CIOs should treat payer integration as a revenue-cycle project, with a named owner for claims data quality, pre-authorisation timestamps and discharge document completeness.

The next UAE signal will come from regulators. DHA is the primary reference for Dubai facilities, DOH for Abu Dhabi and Al Ain, and MOHAP for Sharjah, Ajman, Umm Al Quwain, Ras Al Khaimah and Fujairah. Operators comparing provider networks or checking licences should use the UAE Open Healthcare Directory, which lists 12,386+ licensed providers and anchors facility records to DHA, DOH and MOHAP registers.