Testing your patience

Pushpa Girimaji

Is there any redress against hospitals overcharging patients? Recently, I got admitted to a private hospital for some investigations. Before admission, I was given an estimate of Rs 42,000 for the stay and investigations. However, at the time of discharge, I was given a bill of Rs 78,000. I protested and demanded an explanation, but the hospital could not explain many of the charges to my satisfaction.

For example, I was told that the consultation charges were Rs 500 per doctor, but the bill put it at Rs 1,000 each. Similarly, the charges for investigations were very different and far higher than what was quoted earlier. The hospital was, however, unwilling to revise the bill and in the end I was forced to pay. Is there any law against this kind of overcharging by hospitals? I want to know if I can force the hospital to refund the excess amounts charged from me.

To your specific question on whether there is any law against overcharging by hospitals, I will have to reply in the negative. There is no law that puts a cap on the maximum amount that a hospital can charge from the patients. However, if the hospital has charged you more than the earlier estimate, and is unable to explain the reasons for it, you can haul up the hospital for unfair trade practice and overcharging . You can file the case before the consumer court constituted under the Consumer Protection Act.

Under the Consumer Protection Act, you can file a complaint against a service provider (hospital in this case) for charging a price in excess of the price (a) fixed under any law (b)displayed or (c) agreed between the parties. In this case since the hospital has charged more than the original estimate or the price agreed upon and is unable to explain the reason for it, you can lodge a complaint for overcharging and seek refund of the excess amount collected and also any other compensation that you would like.

Similarly, misleading a consumer about the price of a particular service constitutes an unfair trade practice and you could complain on this count too.

In the case of The Commissioner, Assam State Housing Board Vs Manoj Kumar Adhikary, the National Consumer Disputes Redressal Commission clarified that “matters relating to pricing may be adjudicated by the consumer fora in cases where price is fixed by law or there is a deliberate or intentional act on the part of the seller of goods (and provider of services) to take advantage of a higher price of the goods or there is a price dispute due to unfair trade practice…”

Similarly, in the case of Om Prakash vs Assistant Engineer, Haryana Agro Industries Corporation, the Supreme Court observed: : “The consumer courts have to examine whether by adopting an unfair conduct or practice, a trader has wronged the consumer and compelled him to pay an excess amount…..”.

Is there any law that mandates that hospitals display the price list for various services so that we can compare prices and choose the hospital that suits our pocket?

Unfortunately, no, not in India. In Singapore, for example, for this very purpose, the ministry of health publishes health care charges in various hospitals in the public and the private sector. If there is misleading or deceptive practices with regard to pricing, consumers have redress under the Consumer Protection (Fair Trading) Act. If there is gross overcharging amounting to unethical and unprofessional practice, consumers can also complain to the Singapore Medical council.

In the US, as many as 30 States mandate that hospitals provide pricing information to the public, so as to ensure transparency in the health care service. In many of the states there, this information is provided by the Hospitals Association on their websites.

I mention these two examples to highlight the need for similar initiatives in India, particularly in view of the large number of hospitals that are coming up in the private sector and the complaints that there is no transparency in their billing. It should become mandatory for every hospital to put out on their websites, their charges for various services provided by them. In fact the National Accreditation Board for Hospitals and Healthcare Providers (NABH) should consider incorporating this requirement as part of its accreditation programme for health care organizations.