The District Consumer Disputes Redressal Commission of Chandigarh has ordered Max Super Speciality Hospital to compensate VK Agarwal, a 76-year-old man from Chandigarh, with Rs 1.20 lakh for inflating his COVID-19 treatment bill.
Agarwal filed a complaint stating he was admitted to Max Super Speciality Hospital on January 23, 2021, for COVID treatment and discharged on February 12, 2021. The hospital billed him Rs 7,62,445, with Rs 1,11,851 charged directly to him and the remainder to his insurance.
Agarwal discovered discrepancies in the bill, including unjustified charges for a dietician visit not covered by insurance and erroneous physiotherapy fees. He noted that the dietician advised him to consume milk at night, despite his ulcerative colitis, and that the physiotherapist only demonstrated exercises once.
The hospital defended the charges, stating they were in line with their tariff and agreement with the insurance company, and insisted that all billed services were provided. Oriental Insurance, represented by Raksha Health Insurance, claimed they processed and paid the claim according to policy terms, dismissing other allegations.
The Commission concluded that the hospital improperly billed for a dietician visit that provided inappropriate advice to a colitis patient, charged for physiotherapy not performed as stated, and included excessive fees for items like surgical gloves.
“The advice of the dietician to take milk at night to the patient/ consumer, who is suffering from ulcerative colitis is a wrong advice which could lead to serious consequences on the health of the patient/ consumer, which is a clear-cut negligence on the part of the dietician and amounts to deficiency in service,” the commission noted.
“Further the hospital failed to lead any cogent and convincing documentary evidence to justify the said charges billed from the complainant. Therefore, it is held that the Max Super Speciality Hospital, Mohali has illegally exaggerated the medical bill of the complainant by adding wrong charges for the services, which were never provided to the complainant, and this (behavior) amounts to deficiency in service as well as adoption of unfair trade practice on the parts of the hospital,” held the commission.
It directed Max Super Speciality Hospital to compensate the complainant by paying an amount of Rs 1,20,000 for “causing loss, harassment and mental agony due to its deficient services” as well as “indulgence into unfair trade practice”, which also includes litigation expenses.