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by Admin
14 December 2025 5:24 PM
“Delays in Medical Billing or Insurance Clearance May Cause Harassment, But Are Not Criminal Offences” - Delhi High Court dismissed a petition under Section 482 CrPC that sought to revive criminal proceedings against Max Super Speciality Hospital and its officers, alleging wrongful confinement, misappropriation of money, cheating, and conspiracy. The petitioner, an advocate by profession, claimed he was harassed by hospital staff during discharge, despite being a policyholder under a cashless insurance scheme.
However, Justice Neena Bansal Krishna ruled that the alleged facts, though unpleasant, did not attract the ingredients of a criminal offence. The Court observed: “This harassment and mental trauma… may be a ground for seeking compensation for mental harassment, but does not tantamount to any criminal offence.”
The petitioner, Shashank Garg, was diagnosed with cysticercosis and admitted to Max Hospital, Saket on 7 October 2013 for surgery. He was covered under a Max Bupa cashless insurance policy, with an initial pre-authorisation for ₹75,000. The hospital demanded a pre-deposit of ₹1,45,000, which the petitioner alleged was done under coercion. He underwent surgery on 8 October, but was allegedly not discharged on time and detained until late evening on 9 October 2013, despite full clearance being received from the insurer.
He claimed: “Despite approval of the entire amount by the Insurance Company, a sum of ₹57,332/- was unauthorizedly debited by the Hospital from his advance deposit… causing wrongful loss.”
He further alleged: “I was wrongfully confined in the Hospital despite being under a valid cashless policy… and all payments already made.”
A complaint under Sections 342, 406, 420, 120B IPC was filed. The Magistrate initially summoned three hospital officials, but the Revisional Court set aside the summoning order, which led to the present challenge.
Court’s Observations on Medical Billing and Cashless Policy
Justice Krishna acknowledged the petitioner’s frustration but held that the facts did not establish criminal intent. The Court noted: “There was neither any fraudulent or dishonest intention on the part of Max Hospital in making the petitioner deposit the charges… It may seem to be an onerous condition, but definitely cannot be stated to be extraction of money.”
Regarding the allegation of wrongful restraint, the Court held: “Though there was a palpable delay of few hours in drawing the discharge papers… the final approval from the Insurance Company came at 7:10 p.m. and the petitioner finally left at 9:15 p.m. These circumstances do not establish any intentional wrongful restraint.”
The Court also found no merit in the claim of misappropriation: “Whatever was the amount deposited… was understood to be adjusted at the time of final bill, which had been done. There is no misappropriation of funds by the Max Hospital.”
Rejecting the conspiracy charge under Section 120B IPC, the Court noted: “The respondents have wilfully and intentionally aided each other in their acts… is not borne out from any credible evidence. No concerted action to defraud the complainant has been prima facie established.”
In a significant aside, the Court acknowledged systemic issues in medical billing and insurance coordination: “Such incidents of alleged harassment felt by patients in settling their final bills… are frequently suffered. Though much angst has been expressed… no final redressal has been worked out till date.”
Justice Krishna suggested that regulatory reform is overdue, remarking: “It is a matter which must be taken up at the level of State Government/Central Government in consultation with IRDA and the Medical Councils… to smoothen the discharge process and settling of the medical bills.”
Dismissing the petition, the Delhi High Court concluded: “There is no merit in the petition… no criminal offence under Section 342/420/406/34/120B IPC is made out.”
While empathizing with the petitioner’s ordeal, the Court firmly reiterated that “every grievance cannot be elevated into a crime.” The ruling clarifies the boundaries between contractual/consumer issues and criminal liability in the context of hospital administration.
Date of Decision: 17 April 2025