NEW DELHI: After the surgery is done, 48-year-old Mohammed Umar was being a ‘medical hostage’ for 5 days in Apollo Spectra Hospital in Kailash Colony New Delhi. The hospital denied to let him leave until the bill was paid and proceeded to bill him for the period of his constrained admission.
Patient’s family had made it very clear to the hospital at the outset that they could not bear the cost of surgery. The hospital promised them that it would arrange for approval from his insurance health policy, and Thereafter hospital requested to his insurance company and got initial approval. But after-surgery, the management told to the patient family that the insurance company had declined payment. So they would not let him leave till hospital outstanding clear up.
In April 2017, A Delhi High Court order had said hospitals “cannot keep patient hostage” for any reason for unpaid bills.
Following a “bladder neck incision” surgery on August 11, 2019, Umar (patient) was supposed to be discharged the next day. Nevertheless, he was kept till August 16 by the hospital until the insurance company’s amount of approval came through. Meantime, the hospital extended to add Rs 1,000 daily charges for admission in the general ward.
Who is the Main Culprit?
In reply to queries from media, an Apollo Spectra spokesperson declared the patient was not detained. Since insurer wanted some clarification about the surgery is done, at the time of scheduled discharge. They also wanted to a verification visit the patient in the hospital. The patient was not very literate and he was on the catheter. We practiced the opportunity of this period for greater care of the catheter,” said the spokesperson. Although, Imran (son of the patient) said this was fiction. He added, That insurance investigator had already visited them in the hospital on August 10 to verify documents. Investigator met the doctor and take his father’s signature on documents to justify the case.
Facts Behind of the Case
Mohammad Umar, is a security guard by profession. He had been facing difficulty to pass the urine. On Aug 7, Umar consulted with a laparoscopic surgeon who suggested him to come to Apollo Spectra Hospital where he hospitalized for surgery. Umar’s family had already spent Rs 3,000 on examinations including an ultrasound, which exposed bladder outlet obstruction. The patient was informed of the surgery’ to be done and shared the cost. But Imran told the doctor, they could not manage the cost. Imran also informed him they had an insurance health policy. “I frequently emphasized that we do not have money. But the doctor and hospital staff convinced me that the surgery would be done only after getting claim approval from your insurance company,” said Imran.
Trouble Knock the door
On August 10, they were told the approval had come through and Umar proceded for surgery and hospitalized. The surgery was performed the next day and Imran was told thereafter his father would be discharged on August 12, 2019. However, There were Eid on the 12th. But shocking news was given to Imran that the insurance company had refused payment and asked to clear the bill by the cash. When Imran called the surgeon to get out from this. He said he was going abroad and there was emptiness he could do. He suggested Imran talk to the insurance company. The hospital said the approval process was started and refused to discharge the patient without payment.
Feeling Helpless
At around 10 pm on August 14, 2019, Mohd. Umar and his wife were pushed out of the general ward and made to sit at the reception area. “They were informed they could not sit around in the ward without paying the hospital bill. They were also harassed and insulted a lot” said Imran. Patient’s son rushed back to the hospital billing desk on hearing this. But the hospital staff remained to misbehave, he dialed 100 to seek the Delhi police assistance. The policemen who arrived warned the hospital and secured Umar was taken back to the ward from reception. They recommended the family to discuss with “senior management” the next day so that they can get rid of this.
Another Hurdle
“But the next day was Independence Day and seniors management were on leave,” told Imran. He sought guidance from Malini Aisola of the ‘Campaign for Dignified and Affordable Healthcare’ who entered the hospital on August 16 with a lawyer to see the case. She also was told the patient could not depart till the bill was compensated. After seeing this activity insurance company took a decision quickly and send approval. It has been very shocking that the insurance company was not helpful to his member who paid the premium for health policy. But hospital asked to settle the food bills for August 15 and 16, which they did before dropped”.
Illiterate Hospital or Dictator illegally
The hospital was working advantage of the patient family’s helplessness and distinguished lack of power. In spite of regularly being explained that keeping the patient was illegal. The hospital did not comply and could not be shown humanity even harassment was on a high scale. Patients in such circumstances are often exploited by the insurance company, hospitals, and doctors allying upon them,” stated Aisola.
That was not an end
Umar had asked a copy of his medical record credentials. It was included reports of investigations, operative notes, treatment chart and doctors’ notes. Although, its the patient right to have record copies of their treatment. But sadly, Hospital charged to patient Rs 400 to produce the reports. The patient had also asked for a detailed bill summary of the Rs 61,000 which was born by Insurance company but hospital staff denied to provided. The hospital justified in its response that in an insurance tie-up it had a single line procedure approval inclusive of all expenses. And this was given to the patient forward with the discharge report.
Recommendations to other Patient
This article is present for public awareness so that another patient cannot enter in such trouble. Root India Healthcare Team salute to patient’s son Mr. Imran for taking action and bring insurance company and hospital picture among we all people. Also, Thank you to Ms. Malini Aisola of the ‘Campaign for Dignified and Affordable Healthcare.
Please Note
We strongly recommend to everyone please read the terms and conditions before purchasing health policy, preventive care, health cards, and other wellness programs. If you hold any health card already please read their terms and conditions before using it. Generally, all health plans are having 30 days free look period to surrender the policy.