Panipat District Commission Holds Oscar Super Specialty Hospital Liable For Charging Patient Despite Applicability Of Aayushman Bharat Scheme

Brief Facts:

Mr. Dariya Singh (“Complainant”) possessed an Aayushman card, making them eligible for medical treatment from various hospitals. The Complainant met with an accident and was admitted to the Oscar Super Speciality Hospital & Trauma Centre (“Hospital”), a facility affiliated with the government. Despite receiving treatment from the hospital's doctor, the Complainant claimed that the care provided by the hospital was inadequate, leading to persistent pain and swelling. Furthermore, the hospital officials allegedly demanded money for the treatment, and when the Complainant mentioned their Aayushman card, the hospital subjected him to illegal pressure. In response, the Complainant paid amounts totalling Rs. 15,000/-, Rs. 2000/-, Rs. 1665.85/-, Rs. 800/-, and Rs. 4000/- for X-rays, blood tests, and other services. Notably, the Complainant received proper treatment only upon admission to Virk Hospital, where treatment was provided free of cost under the Aayushman Card.

Feeling aggrieved, the Complainant approached the District Consumer Disputes Redressal Commission, Panipat (“District Commission”) and filed a consumer complaint against the hospital. The hospital didn't appear before the District Commission for proceedings.

Observations by the District Commission:

The District Commission noted that the Complainant submitted the bills of the hospital and a copy of the Aayushman Card demonstrating that he posed an Aayushman Card and the subsequent treatment received at the hospital. According to the terms and conditions of the Aayushman Card, the District Commission held that the Complainant should have been entitled to free treatment. However, the District Commission held that the hospital wrongly and illegally recovered Rs.20,615/- from the Complainant, despite repeated oral requests for reimbursement by the Complainant. The District Commission held the hospital liable for deficiency in services.

The District Commission directed the hospital to make a payment of Rs. 20,615/- to the Complainant within 45 days of the order. Additionally, the hospital was directed to pay Rs. 5,000/- as compensation and Rs. 5,500/- for the litigation costs incurred by the Complainant.