Surgery Patient Overcharged- Consumer Court Holds Max Hospital Guilty of unfair trade practice
Chandigarh: The District Consumer Disputes Redressal Commission-I, Chandigarh, recently directed the Max Hospital to pay Rs 15,000 compensation to a patient for charging him an excess amount of Rs 90,000 for the treatment of oncology and consequent robotics surgery.
Apart from the compensation, the Commission also asked the hospital to pay Rs 10,000 as litigation cost to the complainant and refund the excess amount i.e. Rs 90,000.
The history of the case goes back to 2023 when the patient was admitted to the treating hospital for treatment of oncology and based on the advice of the doctors, he underwent the surgery and was cured consequently. At the time of discharge, he was billed for Rs 4,44,435 and out of this, an amount of Rs 2.10 lakh was deposited by him and Rs 3,24,432 was paid by the Central Government Health Scheme (CGHS). Therefore, a total of Rs 5,34,435 was deposited to the hospital's account, when the invoice was for Rs 4,44,435.
As per the complainant, after the discharge, an invoice receipt dated 20.11.2023 was generated including the information regarding a cheque reimbursement of Rs 90,000. However, when the complainant enquired about it, the hospital declined to reimburse Rs 90,000 and provided another invoice receipt for surgery expenses of Rs 90,000.
The complainant claimed that as per an invoice receipt dated 20.11.2023, the amount of Rs 90,450 had already been claimed by the hospital from CGHS and resultantly, the hospital could not have received the double amount from the complainant.
Therefore, the complainant argued that the hospital received Rs 5,34,435 against the invoice of Rs 4,44,435 and did not refund Rs 90,000 to the complainant, which amounts to a deficiency in service and unfair trade practice.
On the other hand, the hospital after successful surgery raised the invoice and accordingly, the complainant deposited Rs 2,10,000 on 15.11.2023 along with Rs 3,24,435 and in the bill, a sum of Rs 89,999.99 was refunded to the complainant and accordingly total bill of Rs 4,44,435 was raised.
Further, the hospital alleged that the complainant and the CGHS made the total payment of Rs 2,10,000 plus Rs 3,24,435 i.e. a total of Rs 5,34,435 and in the final bill a sum of Rs 89,999.99 was deduced and the total became Rs 4,44,435 which was the final bill. Therefore, there was no question of overcharging.
While considering the matter, the District Commission observed that it was an admitted case that the complainant had undergone robotics surgery for oncology in the Hospital on 12.11.2023 and was discharged on 20.11.2023. The hospital raised the invoice dated 20.11.2023 for ₹4,44,435/-, out of which the complainant had paid an amount of ₹2,10,000/- and an amount of ₹3,24,435/- was deposited by the CGHS and while issuing the settlement receipt available at page 15 of the paper book, the hospital has further raised the invoice of ₹90,000/- in addition to the earlier invoice of ₹4,44,435/-
"In the back drop of the foregoing admitted and disputed facts on record, one thing is clear that the entire case of the parties is revolving around the invoice dated 20.11.2023 (Ex.C-2) and for that purpose the same are required to be scanned carefully," observed the Consumer Court.
Perusing the case, the Commission noted that the hospital raised the Invoice No.MHIC234158 dated 20.11.2023 for ₹4,44,435/- and out of the aforesaid amount a sum of ₹2,10,000/- has already been deposited by the complainant on 15.11.2023. Further, it observed that it was mentioned that CGHS had already credited an amount of Rs 3,24,435 to the hospital and thereafter an amount of ₹89,999.99 has been refunded to the patient as mentioned in the settlement receipt.
"Thus one thing is clear on record that in fact the OP has accepted total amount of ₹5,34,435/- against the invoice of ₹4,44,435/- and as per its record had refunded the amount of ₹90,000/- to the complainant at that very moment by giving reference in the invoice. Now, the only dispute between the parties is if the OP has already refunded an amount of ₹90,000/- to the complainant or not?" Commission noted.
The complainant's counsel submitted that even though the hospital made a reference of the net amount refunded to the patient, the same was not refunded to the complainant till date. Therefore, he argued that the hospital's act amounts to deficiency in service and unfair trade practice on the part of the hospital as it charged Rs 90,000 in excess from the complainant and also made false reference in Ex.C.2 regarding the refund of the same.
Meanwhile, the hospital's counsel submitted that after the scrutiny of the record by the hospital, it was found that inadvertently, the amount could not be refunded to the complainant and the hospital was ready to refund the same.
"As in Ex.C-2, the OP has made a reference that it has already refunded net amount of ₹89,999.99 to the patient and the same defence has also been taken by the OP in its written version led before the Commission, it stands proved on record that the OP has not only mis-stated the facts to the complainant about the refund of the aforesaid amount but has also misled this Commission regarding the same and the said act of the OP amounts to deficiency in service and unfair trade practice on its part," opined the consumer court.
Accordingly, the consumer court declared that the consumer complaint succeeded and directed the hospital to-
i. to pay ₹90,000/- to the complainant alongwith interest @ 9% per annum (simple) from the invoice date i.e. 20.11.2023 (Ex.C-2) onwards.
ii. to pay ₹15,000/- to the complainant as compensation for causing mental agony and harassment;
iii. to pay ₹10,000/- to the complainant as costs of litigation.
To view the order, click on the link below:
https://medicaldialogues.in/pdf_upload/chandigarh-dcdrc-i-262470.pdf
