Hyderabad: Hyderabad District Consumer Commission–III has held Care Hospitals guilty of deficiency in service for failing to refund insurance claim money despite assurances given to a patient.
The Commission directed the hospital to refund Rs 3.5 lakh with 12 percent interest, pay Rs 1 lakh as compensation, and Rs 10,000 towards litigation costs.
The case was filed by Muraleedhar Rao, aged 74, a resident of Himayatnagar, who was admitted to Care Hospital at Banjara Hills on March 1, 2025, for a minimally invasive cardiac surgery. Rao held a group mediclaim policy with New India Assurance Company and had applied for cashless insurance coverage.
According to the complaint, hospital staff informed him that health insurance approval would be delayed and assured him that any advance amount paid would be refunded once the claim was settled.
Relying on this assurance, Rao deposited Rs 3.5 lakh in advance.
He also alleged that the hospital refused to issue receipts for the payment.
The surgery was conducted on March 3, and Rao was discharged on March 10. He later discovered that the insurance company had already paid the entire amount to the hospital during his treatment period.
However, despite repeated requests, the hospital failed to refund the advance amount.
Rao stated that he sent a legal notice via speed post on April 9 and followed it up with emails on April 18 and May 1, but received no response. Left with no option, he approached the Consumer Commission.
During the proceedings, no representative from Care Hospital appeared before the Commission, nor was any written reply submitted.
Make payments within 45 days: Commission
The Commission therefore proceeded ex parte and examined the evidence produced by the complainant, including discharge summaries, payment screenshots, correspondence, and email records.
Observing that the hospital’s conduct amounted to a deficiency in service, the Commission directed Care Hospital to make the payments within 45 days.
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