Hospital Fails to Furnish Medical Bills: Consumer Court slaps Rs 1 Lakh Compensation
Mahabubnagar: Observing that due to the failure on the part of the hospital in providing the patient's son with medical bills and other necessary documents of treatment, he could not claim reimbursement, the District Consumer Disputes Redressal Commission has directed a Mahabubnagar-based hospital to pay Rs 1 lakh as compensation.
The crux of the case is that the complainant could not claim the reimbursement due to non-supply of required medical bills for Rs.1,50,000/- and other expenditures and due to lack of other test reports, admission card and discharge sheet etc., whatever necessary for reimbursement of the medical expenses.
The Commission noted that "It is observed that in failure to provide the said papers, the complainant could not avail reimbursement facility for his mother during the hospitalization life time of her. The complainant has lost his opportunity to avail such facility due to lack of requisite medical bills/ papers/reports etc."
The case concerns the complainant who took his mother to the treating hospital for treatment due to chest pain and she was accordingly admitted in the hospital on December 27, 2016. Following this, tests were conducted and the treating doctor informed that the patient (complainant's mother) was required to be treated on an emergency basis as she was diagnosed with cardiac problem. The complainant had paid Rs 1,50,000 for the treatment.
However, three days later, the doctor had informed the complainant that his mother's condition was serious and for this the complainant needed to pay Rs 3,00,000 for further treatment. As the complainant couldn't pay the amount, the hospital refused to continue the treatment. Compelled, the complainant issued a post-dated cheque and after the receipt of the same, the hospital informed him that his mother had already died.
Shocked, the complainant allegedly asked the hospital for providing the details of the cause of death which the hospital denied. The complainant has further stated that the hospital had not given the admission card and the test reports for the reimbursement of medical bills from the Government as the deceased was a family pensioner. As a result, the complainant couldn't avail the reimbursement facility for the amount incurred at the hospital and all the monetary benefits were lost.
As the post-dated cheque bounced, the hospital issued a legal notice to the complainant under the N.I.Act for an amount of Rs.3,00,000. Responding to the notice, the complainant had stated in a notice that the cheque was issued under coercive condition and it was not viable debt.
Thus the complainant pleaded that the hospital did not give any medical treatment details or bills, the admission details and test reports, due to which the complainant could not make reimbursement for the payment made to the treating hospital for an amount of Rs 1,50,000 besides the loss of his mother.
Alleging that the acts and deeds of the treating hospital amount to deficiency of service and unfair trade practice, the complainant pleaded that the said amount has to be repaid by the hospital besides compensation.
Thus, the complainant in his complaint filed under section 12 of Consumer Protection Act, 1986, sought a direction upon the treating hospital for a refund of Rs 1,50,000 with interest and pay Rs 2,00,000 towards compensation for mental agony, harassment, and loss of his mother's life.
The Complainant had cited some judgments including the Regulations 2002 of the Indian Medical Council, which mentions, "If any request is made for medical records either by the patient or the authorised attendant or local authorities involved, the same may be duly acknowledged and documents shall be issued within a period of 72 hours".
Denying all the pleadings, the treating hospital contended that the complainant did not inform about the facility of reimbursement. The hospital further submitted before the commission that the patient had cardiac problem and the treatment had been initiated on an emergency basis. While undergoing treatment, the patient had died due to low B.P, uncontrolled sugar levels, and heart attack despite the best possible efforts, treatment, care and attention, further stated the hospital.
Further the hospital also denied that they did not provide any receipts, test reports, medical treatment details, or even admission details of the deceased patient. The hospital also submitted that they had already issued bills for Rs.1,50,000/- which was paid by the complainant as an advance amount.
It was also pointed out by the hospital that the complaint was not for any negligence in treatment but for the allegation of non-supply of requisite papers. The hospital further submitted that it had never insisted the opposite party for issuing post dated cheque.
After listening to the contentions, the Commission noted that the husband of the deceased patient is a pensioner under Government of Telangana and the patient was a family pensioner beneficiary.
The commission noted that even if the amount incurred for treatment in Rs 1,50,000 + Rs 3,00,000, the hospital is "under obligation to issue the bills raised against the said amount with full particulars of medicines and description of the treatment charged by him and he is responsible to show the same by raising bills on such and such occasions and dates. But, there is no evidence placed in the record to show the amount spent by the OP doctor while providing the treatment and medicines on credit basis for the complainant's mother."
"The Ex.A-3, receipt placed by the complainant shows that Rs.1,00,000/- by way of cheque was received by the OP hospital towards PTCA + two stents. The another bill for Rs.50,000/- and Rs.3,00,000/- have not placed in the record by either party. It is not the case of deciding cheque bounce, but the right of the consumer to collect the bills in advance from the hospital to avail reimbursement facility along with copies of receipts if paid, test reports, admission card or if any other document necessary for reimbursement from the hospital," further observed the Commission.
"It is observed that in failure to provide the said papers, the complainant could not avail reimbursement facility for his mother during the hospitalization life time of her. The complainant has lost his opportunity to avail such facility due to lack of requisite medical bills/ papers/reports etc." read the consumer court order.
Further mentioning that it was unfair on the part of the hospital to say that the required medical bills would have been furnished only after the payment of total fees, the Commission noted,
"It is the duty of every doctor or hospital to furnish all the medical bills, test reports, admission card etc., to the patient or to the persons relating to the patient. No doubt, it is required to furnish the same to the complainant for any legal necessity."
Finally noting that the hospital has filed the documents including attested copy of case sheet, original C.D., and other papers, the consumer court mentioned,
"The submission of the above papers before the Commission has no use to the complainant because he already lost his opportunity besides her mother and as such his right of getting the bills within the time has been denied by the OP."
However, noting that the complainant has not placed any piece of evidence on record to arrive the correct amount of reimbursement that he is entitled out of the amount of Rs.1,50,000/- incurred in the hospital, the commission clarified that it was not possible to order for refund of the said amount by the hospital.
At this outset, the Commission granted Rs 1 lakh as compensation to the complainant and mentioned,
"The Commission conclude that there is a deficiency in services on the part of the OP doctor in providing the required medical bills, admission card, treatment done, discharge sheet, medical reports etc., to the complainant within time. Hence, the OP is liable to pay an amount of Rs.1,00,000/- towards compensation for the loss sustained by the complainant by all means. It is therefore, we the Commission hold that a consolidated compensation of Rs.1,00,000/- is reasonable to be granted to the complainant."
To read the court order, click on the link below.
