1. Medical insurance claim repudiated due to alleged alcohol abuse — Hospital raised bill after denial of cashless facility — Dispute concerning differential charges. (Para 2 , 3 )
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2025 Supreme(Online)(SCDRC) 39674
STATE CONSUMER DISPUTES REDRESSAL COMMISSION
Padma Pandey, Presiding Member, Rajesh Kumar Arya, Member
Paras Hospitals – Appellant
Versus
Rony Sharma – Respondent
FIRST APPEAL NO. SC/4/FA/140/2025
Advocates:
For the Appellants/Petitioners: Anirudh Kush
For the Respondents: Naren Pratap Singh, Krishan Kant
For the Appellants/Petitioners: Anirudh Kush
For the Respondents: Naren Pratap Singh, Krishan Kant
Charging higher rates for the same medical treatment when paid in cash versus cashless/TPA rates, without providing valid justification or evidence of industrial norms, constitutes a deficiency in service and an unfair trade practice.
Headnote:(A) Consumer Protection Act, 2019 - Section 41 - Deficiency in service and unfair trade practice - Medical billing - Disparity between cashless and cash charges - The treating hospital initially raised a bill of Rs. 2,64,335.83 for cashless treatment, but upon rejection of the cashless facility by the insurance company, raised a higher final cash bill of Rs. 2,95,577 - Appellant hospital claimed that cash tariffs are higher according to industrial norms - No evidence or written norms were placed on record to prove competence to charge different rates for the same treatment - Raising a higher bill without justification for the same treatment amounts to deficiency in service and unfair trade practice. (Para 9)
Facts of the case:
The complainants sought relief after the son of complainant No. 2 was treated at Paras Hospital. Initially, the hospital provided a bill for Rs. 2,64,335.83 for a cashless claim. However, when the insurance company rejected the cashless facility alleging alcohol abuse, the hospital raised a revised cash bill of Rs. 3,09,313.73, finally settling at Rs. 2,95,577 after a courtesy discount. The complainants alleged that the hospital overcharged them by switching to a higher cash tariff without justification.
Findings of Court:
The court found that the appellant hospital failed to provide any evidence of industrial laws or norms that justify charging different rates for the same treatment based on the mode of payment (cash vs. TPA). The act of increasing the bill simply because the cashless facility was denied was held to be an unfair trade practice.
Issues: Whether charging different rates for the same medical treatment based on the payment method (cash versus cashless/TPA) without providing a valid justification constitutes a deficiency in service and unfair trade practice.
Ratio Decidendi: The court ruled that raising a higher bill for cash payments compared to the initial bill generated for cashless facilities, in the absence of any documented justification or industrial norms, constitutes a deficiency in service and an unfair trade practice.
Result: Appeal dismissed.
Legal Category Hierarchy
Table of Contents
2. Hospital argued bill varied per industrial norms; complainants contended no justification for differential charges. (Para 3 , 8 )
3. Hospital failed to justify charging higher rates for same treatment after denial of cashless facility — This amounts to deficiency. (Para 9 , 10 )
4. A hospital cannot charge different rates for same treatment without justification when cashless facility is denied — Constitutes deficiency and unfair trade practice. (Para 10 )
5. Appeal dismissed — Order requiring hospital to pay excess amount upheld. (Para 11 )
6. Can a hospital charge higher rates for same treatment after denial of cashless facility?
No, unless the hospital justifies the differential pricing; otherwise it amounts to deficiency in service and unfair trade practice. (Para 9 , 10 )
7. What constitutes deficiency in service by a hospital under the Consumer Protection Act?
Raising a revised bill without justification after cashless facility is denied, resulting in higher charges for the same treatment. (Para 9 , 10 )
8. Is a hospital required to maintain uniform tariffs for cash and cashless patients?
Yes, any difference must be explained and supported by industrial norms; otherwise it is unlawful. (Para 9 , 10 )
CHANDIGARH
FIRST APPEAL NO. SC/4/FA/140/2025
(Against the Order dated 3rd February 2025 in Complaint DC/44/CC/317/2024 of the District
Consumer Disputes Redressal Commission Chandigarh district commission)
PARAS HOSPITALS
PRESENT ADDRESS - NEAR NADA SAHIB GURUDWARA, PANCHKULA, HARYANA,
THROUGH ITS AUTHORISED SIGNATORY.NEAR NADA SAHIB GURUDWARA, PANCHKULA,
HARYANA, THROUGH ITS AUTHORISED SIGNA , PANCHKULA,HARYANA.
SANJEEV SHARMA S/O LATE K.L. SHARMA Late K.L. Sharma
PRESENT ADDRESS - SHOP/OFFICE AT SCF-25, SECTOR 18-D,
CHANDIGARH.SHOP/OFFICE AT SCF-25, SECTOR 18-D, CHANDIGARH. ,
CHANDIGARH,CHANDIGARH.
.......Appellant(s)
Versus
RONY SHARMA RONAK
PRESENT ADDRESS - S/O SH. SANJEEV SHARMA SHOP/OFFICE AT SCF-25, SECTOR 18-D,
CHANDIGARH.S/O SH. SANJEEV SHARMA SHOP/OFFICE AT SCF-25, SECTOR 18-D,
CHANDIGARH. , CHANDIGARH,CHANDIGARH.
THE NEW INDIA ASSURANCE COMPANY LIMITED
PRESENT ADDRESS - SCO-36-37, GROUND FLOOR, SECTOR 17-A, CHANDIGARH -160017,
THROUGH ITS AUTHORISED SIGNATORY.SCO-36-37, GROUND FLOOR, SECTOR 17-A,
CHANDIGARH -160017, THROUGH ITS AUTHO , CHANDIGARH,CHANDIGARH.
VIDAL MEDCORP TPA
PRESENT ADDRESS - PLOT NO- 98, INDUSTRIAL AREA, PHASE 2, RAM DARBAR,
CHANDIGARH, THROUGH ITS AUTHORISED SIGNATORY.PLOT NO- 98, INDUSTRIAL AREA,
PHASE 2, RAM DARBAR, CHANDIGARH, THROUGH ITS , CHANDIGARH,CHANDIGARH.
.......Respondent(s)
BEFORE:
HON'BLE MRS. PADMA PANDEY , PRESIDING MEMBER
HON'BLE MR. RAJESH KUMAR ARYA , MEMBER
FOR THE APPELLANT:
ANIRUDH KUSH (Advocate)
DATED: 31/12/2025
ORDER
STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
U.T., CHANDIGARH
(Additional Bench)
First Appeal No. : 140 of 2025
Date of Institution : 26.03.2025
Date of Decision : 31.12.2025
Paras Hospitals, Near Nada Sahib Gurudwara, Panchkula, Haryana, through its
Authorized Signatory Rahul Kumar.
…Appellant
V e r s u s
1. Rony Sharma S/o Sh. Sanjeev Sharma
2. Sanjeev Sharma S/o Late K. L. Sharma
Both having Shop at SCF No.25, Sector-18 D, Chandigarh
3. The New India Assurance Company Limited, SCO 36-37, Ground Floor, Sector-17-A,
Chandigarh–160017 through its Authorized Signatory.
4. Vidal Medcorp TPA, Plot No.98, Industrial Area, Phase-2, Ram Darbar,
Chandigarh, through its Authorized Signatory.
…..Respondents
Appeal under Section 41 of the Consumer Protection Act, 2019 against order
dated 03.02.2025 passed by District Consumer Disputes Redressal Commission-
I, U.T. Chandigarh in Consumer Complaint No.317/2024.
BEFORE: MRS. PADMA PANDEY, PRESIDING MEMBER
MR.RAJESH K.ARYA,MEMBER
For the appellant : Sh. Anirudh Kush, Advocate
For respondents No.1&2 : Sh.Naren Pratap Singh, Advocate
For respondent No.3 : Sh.Krishan Kant, Advocate
Respondent No.4 Ex-parte vide order dated 22.08.2025
PER PADMA PANDEY, PRESIDING MEMBER
This appeal is directed against the order dated 03.02.2025, rendered by the
District Consumer Disputes Redressal Commission-I, U.T. Chandigarh (hereinafter to be
referred as “the Ld. District Commission”), vide which, it partly allowed the complaint bearing
No.CC/317/2024 in the following terms ;
“In the light of the aforesaid discussion, the present consumer complaint
succeeds, the same is hereby partly allowed in the following terms:-
OPs No.1 and 2 are directed to pay Rs.2,64,335.83/- to the complainants
(i)
alongwith interest @ 9% per annum (simple) from 15.12.2023 i.e. final bill
(Annexure C-11) onwards as well as Rs.20,000/- as compensation for
causing mental agony and harassment to the complainants;
OP No.3 is directed to pay the excess amount of Rs.31,241/- (i.e.
(ii)
Rs.2,95,577/- minus Rs. 2,64,335.83/-) to the complainants alongwith
interest @ 9% per annum (simple) from 15.12.2023 i.e. final bill (Annexure
C-11) onwards as well as Rs.10,000/- as compensation for causing
mental agony and harassment to the complainants;
OPs are directed to pay 10,000/- to the complainants as costs of litigation
(iii)
in equal share.
This order be complied with by the OPs within a period of 45 days from
the date of receipt of certified copy thereof, failing which the amount(s)
mentioned at Sr.No.(i) & (ii) above shall carry penal interest @ 12% per
a
