Panipat Hospital wrongly charges Ayushman Card holder, Consumer Court orders refund, compensation to patient

The order was announced in open court on February 12, 2024, by Dr. R.K. Dogra, President, and Dr. Rekha Chaudhary, Member, District Consumer Disputes Redressal Commission, Panipat.

The case involved Singh, who filed a complaint against Oscar Super Speciality Hospital & Trauma Centre, Panipat, for alleged deficiency in service and unfair trade practices.

The complainant holds an Aayushman card, making him eligible for medical treatment across various hospitals. Following an accident on June 18, 2023, the complainant sought treatment at the hospital operated by Oscar Super Speciality Hospital & Trauma Center, purportedly enlisted on the government's panel.

However, the hospital officials allegedly demanded monetary compensation for the treatment, even though the complainant presented his Aayushman card. The complaint contends that the hospital officials unlawfully insisted on payments amounting to Rs.15,000/-, Rs.2000/-, Rs.1665.85/-, Rs.800/-, and Rs.4000/- for services such as X-ray and blood tests. He was later treated at Virk Hospital free of cost under the Aayushman card.

Aggrieved, Singh filed a complaint with the District Commission seeking a refund of Rs. 25,000, Rs. 1,00,000 as compensation for mental pain, and Rs. 22,000 as litigation expenses. The hospital was proceeded against ex-parte as they did not appear despite notice.

Upon examination of the complainant's arguments and documents, two main issues were noted by the Commission. Firstly, determining the legitimacy of the complainant's claim for Rs.25,000/-, including interest and other related factors; and secondly, defining the appropriate relief to be awarded to the complainant.

The Commission observed that the terms and conditions of the Aayushman Card indicated that the complainant should have received free treatment. However, the hospital, despite explanations, wrongly and illegally collected Rs.20,615/-. Numerous oral requests for a refund were unsuccessful, and the hospital refused any repayment. The circumstances strongly indicate that the hospital incorrectly charged the complainant for treatment, and the complainant is rightfully entitled to reclaim the amount. The hospital, having remained absent, was proceeded against ex parte on September 29, 2023, leaving the complainant's evidence unchallenged. It noted;

"..as per the terms and conditions of the Aayushman Card free of cost treatment should have been given to the complainant but despite explaining all positions to the respondent, they recovered Rs.20,615/- wrongly and illegally. Despite so many oral requests, the money was demanded back from the respondent but all in vain and lastly refused to make payment of even a single penny. All the circumstances are proving that the respondent has wrongly received the treatment charges from the complainant and complainant is certainly entitled for taking the same back from the respondent."

Subsequently, the Commission, after considering the arguments presented by the complainant's counsel and thoroughly reviewing the available records and unrebutted evidence, favoured the complainant and directed Oscar Super Specialty Hospital and Trauma Centre to pay Rs.20,615/- to the complainant within 45 days of the order, along with interest at the rate of 9% per annum from the date of filing the complaint until actual realization. It held;

"...it is ordered the opposite party i.e. Oscar Super Specialty Hospital and Trauma Centre be directed to make the payment of Rs.20,615/- to the complainant within 45 days of this order along-with interest @ 9% per annum from the date of filing of this complaint till its actual realization. Opposite party is further directed to pay Rs.5,000/- as compensation and Rs.5500/- as litigation expenses failing which the complainant will be entitled to recover the whole amount with interest @12% from the date of order till its actual realization."

"In case, opposite party fails to do so, then the complainant can file the execution petition under section 71 of Consumer Protection Act, 2019 and in that eventuality, the opposite party may also be liable for prosecution under Section 72 of the said Act. Copies of this order be sent to the party free of costs, as per C.C. No. 296-2023 Dariya Singh Versus Oscar Super Speciality Hospital & Trauma Centre 6 rules, and this order be promptly uploaded on the website of this Commission. File be consigned to the record room after due compliance."

To view the original order, click on the link below: