On Universal Health Coverage Day, leading surgeon associations in India have highlighted the growing mismatch between the rapid clinical advancement of robotic-assisted surgery and the insurance systems responsible for enabling timely patient access. Robotic platforms are now established across major metropolitan centres and increasingly in tier 2 and tier 3 cities, yet utilisation remains constrained by insurer-level variations that influence when, how or whether patients can proceed with recommended treatment.
This gap becomes clearer in recent findings from a national survey by the Obesity and Metabolic Surgery Society of India, which reported that over 95% of surgeons see patients postponing indicated procedures while waiting for insurance approvals. Such delays often push patients into more advanced stages of disease, resulting in more complex surgical pathways and higher long-term expenditure. With robotic-assisted surgery now available across more regions, these interruptions prevent patients from fully benefiting from a technology designed to improve precision and overall quality of surgical outcomes.
These access challenges stand in contrast to a growing body of clinical evidence, which insurers typically rely on to assess the value of surgical approaches. “Emerging India-specific data is consistently demonstrating the advantages of robotic-assisted surgery in achieving safer, more predictable results for patients,” said Dr. Vivek Bindal, Head of Department, Institute of Minimal Access, Bariatric and Robotic Surgery, Max Super Speciality Hospital, New Delhi, and Chairman, Clinical Robotic Surgery Association (India Chapter). “For example, I contributed to a multicentre study published this year comparing robotic-assisted surgery by using da Vinci and conventional ventral hernia repair. The robotic group demonstrated lower pain levels at all postoperative intervals, fewer complications, reduced analgesic use, and better health perception scores among patients. These outcomes show the importance of ensuring that patients can access robotic-assisted care without unnecessary delays.”
The growing clinical evidence base is also reshaping expectations around how advanced surgical technologies should be supported within India’s broader health financing ecosystem. “The gap between what modern surgical care can deliver and how insurance systems are currently structured is affecting when patients receive the treatment they need, and in some cases even leading them to abandon procedures that could have helped,” said Dr. Randeep Wadhawan, Chairman, Surgical Gastroenterology, Bariatric & Robotic Surgery, Max Hospital, Dwarka, New Delhi, and President, Obesity and Metabolic Surgery Society of India. “As robotic-assisted surgery becomes part of routine practice across both public and private hospitals, coverage mechanisms must evolve to reflect its role in contemporary surgical care.”
Surgeon associations emphasise that the core issues lie not in clinical appropriateness, where evidence is steadily expanding, but in administrative inefficiencies. These include variation in insurer requirements, frequent requests for clarification, extended assessment timelines and heavy documentation demands. “Patients increasingly recognise the value of minimally invasive care, but many struggle to proceed because the approval process is not consistent across insurers,” said Prof. Dr. Atul Peters, Principal Director, Department of Bariatric, Minimal Access and Robotic Surgery, Max Smart Super Speciality Hospital, Saket, New Delhi and Founding Member, Asia-Pacific Chapter of the International Federation for the Surgery of Obesity and Metabolic Disorders (ACMOMS). “With robotic-assisted surgery now included under IRDAI’s guidelines in the Master Circular on Health Insurance Business, which states that modern treatments like robotic-assisted surgery should not be excluded from base policies, many private insurers have started aligning with the IRDAI directive, and several state government schemes have also started incorporating robotics into their benefit packages. However, inconsistencies in claim approvals, sub-limits and coverage caps still limit access. Clear, standardised coverage guidelines would give clinicians greater freedom to recommend the most suitable technique without administrative constraints shaping the choice.”
Reinforcing a collaborative intent, surgeon associations stressed that surgeons and payers share a common objective of ensuring safe, high-quality care for patients. “It is encouraging to see several insurers taking proactive steps through IRDAI circulars, broader coverage language and the inclusion of robotics in state schemes, and we see these developments as a strong foundation for further progress. Predictable access to robotic-assisted surgery can significantly strengthen India’s universal health coverage goals by improving clinical outcomes, reducing complications that increase long-term expenditure and protecting families from avoidable out-of-pocket costs,” Dr. Vivek Bindal added.
To move forward, surgeons associations stress the need for streamlined approval pathways with timely pre-authorisations, uniform documentation templates and fewer repeated clarifications, supported by harmonised coverage norms and reimbursement frameworks that fully accommodate robotic-assisted surgery. They believe that these measures are essential to ensure that patients across all regions and income groups receive equitable access to advanced surgical care.