A consumer court in Kerala has directed a private hospital to pay Rs 1.14 lakh to a former patient after finding the healthcare facility guilty of service deficiency for submitting an inflated treatment bill and a disputed insurance document.
The Kollam District Consumer Commission, comprising President S K Sreela and Member Stanly H, ordered the hospital to refund Rs 79,000 collected in excess of legitimate treatment costs, alongside Rs 25,000 in compensation for mental agony and hardship. The hospital was additionally instructed to pay Rs 10,000 toward litigation expenses, with all payments required within 45 days.
Discrepancy In Medical Estimates
The case stemmed from the complainant’s admission on October 30, 2025, at around 1:45 pm with acute gastric pain. After spending approximately 12 hours in the intensive care unit, he was shifted to an inpatient room the following day and discharged on November 3. Prior to discharge, hospital representatives informed the patient that his overall medical expenses would come to approximately Rs 40,000.
The patient, who held an active health insurance policy covering up to Rs 2.50 lakh, agreed to settle the expenses through his insurer while committing to clear any out-of-pocket balance himself.
Disputed Signature And Insurance Claims
Contrary to the initial estimate, the hospital subsequently submitted a claim of roughly Rs 1.30 lakh to the insurance provider, which went on to approve Rs 1.19 lakh. When the patient challenged the sharp increase, hospital staff asserted that higher inpatient service rates accounted for the difference.
The patient then discovered that the signature attributed to his name on the billing documentation dispatched to the insurer was not his. Alleging that the hospital had extracted roughly Rs 79,000 beyond actual treatment costs, he approached the consumer commission seeking a refund along with Rs 4 lakh in compensation for unfair trade practices.
Hospital Fails To Contest Allegations
The hospital chose not to appear before the commission or submit a formal response despite receiving due notice.
In its August 19 ruling, the commission noted that because the hospital retained custody of billing and medical files, the burden rested on the administration to explain the origin of the contested document and justify the charges. In the absence of any rebuttal, counter-evidence, or cross-examination from the hospital, the commission accepted the complainant’s documentation and sworn testimony, ruling that the unexplained billing and unauthorized paperwork constituted a clear deficiency in service.
