Hyderabad: CARE Hospitals asked to pay ₹4.5L for charging from patient, insurance company for same surgical procedure
During the proceedings, no representative of the hospital appeared before the Commission, nor was any written response filed
By Sistla Dakshina Murthy
Representational Image
Hyderabad: The Hyderabad District Consumer Disputes Redressal Commission–III has directed CARE Hospitals to pay Rs 4.5 lakh for failing to refund an advance amount to the patient despite receiving the payment from the insurance company for the surgical procedure.
The commission asked the hospital to refund Rs 3.5 lakh with 12% interest, pay Rs 1 lakh as compensation, and Rs 10,000 towards litigation costs or deficiency in service.
Assurance given, refund withheld
The complainant, Muralidhar Rao (74) of Himayatnagar, was admitted to CARE Hospital, Banjara Hills, on March 1, 2025, for a minimally invasive cardiac surgery. He held a group mediclaim policy with New India Assurance Company and applied for cashless approval.
Hospital staff allegedly informed him that insurance approval might take time and assured him that the amount would be refunded once the claim was settled. Rao deposited Rs 3.5 lakh in advance.
Insurance paid, Hospital silent
The surgery was performed on March 3, and Rao was discharged on March 10. He later learnt that the insurer had already paid the full amount to the hospital. When he sought a refund of the advance payment, the hospital did not respond.
Rao stated that the hospital refused to issue receipts for the advance and ignored repeated follow-ups. He sent a letter by speed post on April 9 and emails on April 18 and May 1, but received no reply, prompting him to approach the consumer forum.
Hospital fails to contest case
During the proceedings, no representative of the hospital appeared before the Commission, nor was any written response filed. The case was therefore heard ex parte.
After examining the evidence submitted by the complainant, including the discharge summary, payment screenshots, correspondence, and emails, the Commission concluded that the hospital’s conduct amounted to a deficiency in service.
Commission’s order
The Hyderabad District Consumer Disputes Redressal Commission–III ordered CARE Hospital to:
Refund Rs 3.5 lakh with 12% interest
Pay Rs 1 lakh as compensation for mental agony
Pay Rs 10,000 towards legal costs
Pay the amounts within 45 days; otherwise, further consequences may follow, the commission said.
