Patient detained overnight at Fortis Hospital due to delayed bill clearance; commission finds deficiency in service
TNR News Network
Dharamshala In a significant ruling, the District Consumer Disputes Redressal Commission has held Tata AIG General Insurance Company liable for deficiency in service and directed it to pay ₹80,093 to the complainant along with 9% annual interest.
The case, titled Bal Krishan Sood vs Tata AIG General Insurance Company Limited, was filed by Bal Krishan Sood and his wife Kamini Sood, who had purchased a group health insurance policy (No. 02391572600000) from Tata AIG with a coverage of ₹5 lakh, paying a premium of ₹37,941. The policy was valid from July 26, 2022, to July 25, 2023.
In March 2023, Mr. Sood experienced a urological issue and was admitted to Fortis Hospital, Mohali, on April 8. He underwent surgery and was discharged on April 9. However, due to delays in bill clearance by the insurance company, the hospital detained the patient until 9 PM that night.
Despite pre-authorization approval, Tata AIG raised multiple objections on a ₹50,000 claim and delayed the payment. Aggrieved by the ordeal, the complainant approached the consumer commission.
The commission found clear negligence on the part of the insurance company and ordered it to pay ₹80,093 with 9% annual interest. Additionally, the company must pay ₹10,000 as compensation for mental and physical distress and ₹10,000 towards litigation costs.
