Key facts
- A Gujarat consumer commission ordered a hospital and doctor to refund Rs 1.64 lakh to a patient.
- The patient was billed under a Covid-19 treatment package despite testing negative for the virus.
- The hospital issued a total bill of Rs 3.71 lakh for treatment received between July 22 and July 29, 2020.
- The insurance company had approved Rs 1.78 lakh of the claim, rejecting Rs 1.64 lakh.
- The commission awarded an additional Rs 10,000 for mental harassment and litigation expenses.
A consumer commission in Gujarat has directed a private hospital and its doctor to refund Rs 1.64 lakh to a patient who was wrongly billed under a Covid-19 treatment package despite testing negative for the virus. The Surat Consumer Disputes Redressal Commission (CDRC) also awarded Rs 10,000 for mental harassment and litigation expenses.
The dispute began when a 58-year-old Surat resident, who had a Rs 7 lakh mediclaim policy, was admitted to a hospital for treatment between July 22 and July 29, 2020. Following his discharge, the hospital issued a bill of Rs 3.71 lakh. Upon submitting the claim to his insurance company, only Rs 1.78 lakh was approved, with Rs 1.64 lakh rejected.
The patient subsequently approached the consumer forum. During the proceedings, the insurer argued that the patient was diagnosed with 'viral pneumonia, Covid-negative'. However, the hospital had allegedly billed him using the Covid-19 treatment package rates prescribed by the Surat Municipal Corporation (SMC).
The commission found that neither the hospital nor the doctor could satisfactorily explain why Covid-19 package rates were applied to a Covid-negative patient. Consequently, the forum held them responsible for the deducted amount. The commission ordered the hospital and doctor to jointly refund Rs 1.64 lakh with 8% annual interest from July 31, 2021, the date the complaint was filed, along with Rs 10,000 for compensation and costs.