In Shashank Garg v/s State & Others., a patient's complaint alleging cheating, criminal breach of trust, and wrongful confinement against a private hospital and its staff has been dismissed by the Delhi High Court, underscoring the distinction between a civil grievance and a criminal offense. The court's decision highlights that while procedural delays and perceived harassment during hospital discharge are regrettable, they do not automatically constitute criminal acts.
The Case: Allegations of Deception and Unjust Enrichment
The petitioner, an advocate, sought surgery at Max Super Speciality Hospital, Saket, under a cashless health insurance policy. Despite having pre-authorization for Rs. 75,000, the hospital allegedly insisted on a full advance payment of Rs. 1,45,000 before proceeding with the surgery. The petitioner claimed he was then wrongfully confined in the hospital until the full payment was received from the insurance company.
Upon discharge, the petitioner alleged discrepancies in the final bill, including an unadjusted discount and an unauthorized debit of Rs. 57,332, despite the insurance company approving the entire amount. He accused the hospital and its staff of cheating (Section 420 IPC), criminal breach of trust (Section 406 IPC), wrongful confinement (Section 342 IPC), and criminal conspiracy (Section 120B IPC).
Lower Courts' Rulings and the High Court's Affirmation:
Initially, a Metropolitan Magistrate summoned the accused individuals based on the petitioner's pre-summoning evidence. However, this summoning order was challenged and subsequently set aside by the Additional Sessions Judge, who found no prima facie illegality or infirmity.
The Delhi High Court, reviewing the petition, meticulously examined the facts presented by both sides. The hospital clarified that the initial partial pre-authorization necessitated the advance deposit. They also explained that the alleged differential amount of Rs. 57,332 was due to the petitioner opting for a higher category "Deluxe Room" while his insurance policy covered only a "Standard Room." The delay in discharge was attributed to the time taken for the insurance company's final approval.
Beyond Harassment: Delineating Civil from Criminal
The High Court concurred with the lower court's reasoning, emphasizing that the circumstances did not reveal any fraudulent or dishonest intention on the part of the hospital. The advance deposit was a clear consequence of the partial insurance approval, and the billing adjustments were explained. The court stated that a procedural delay in discharge, while inconvenient, does not amount to wrongful confinement in the absence of malicious intent.
Crucially, the judgment underscored that while patients often face harassment and mental trauma due to cumbersome billing and insurance claim procedures, such experiences, however unfortunate, do not automatically translate into criminal offenses. The court acknowledged the frequent grievances of patients regarding the complexities of cashless policies and the delays caused by insurance companies. It even suggested the need for regulatory policies and a "Charter of Patients' Rights" to streamline discharge processes and bill settlements.
The Verdict: No Criminal Offense Found
Ultimately, the High Court concluded that no criminal offense under Sections 342, 420, 406, 34, or 120B of the IPC was made out against the hospital or its staff. The petition was dismissed, upholding the lower court's decision.
This ruling serves as an important reminder that for criminal charges to stick, there must be clear evidence of a criminal intent and the fulfillment of the elements of the alleged offense. While the petitioner's experience may have been frustrating and caused distress, the court found it to be a matter best addressed through avenues for compensation for mental harassment rather than criminal prosecution.
Section 120B., Indian Penal Code - 1860
Section 342., Indian Penal Code - 1860
Section 406., Indian Penal Code - 1860
Section 420., Indian Penal Code - 1860
Indian Penal Code, 1860
