[Resolved] Fortis Healthcare — Fraud and extortion

+91 12 4492 1033
+91 12 4492 1071
+91 12 4492 1021
Tower A, Unitech Business Park, Block – F, South City 1, Sector – 41, Gurgaon, Haryana, India – 122001

Dear sir,
I am writing to let you know the pathetic customer service i received at your "world class" hospital. I was admitted to fortis hospital shalimar bagh on 3/5/17 for a back surgery. I applied for a claim (Claim no.[protected] through the tpa office against the bill (No. 1003/17/i/cr/0000884) raised by your hospital. Following are the horrific counts of harassment i faced while being admitted at your hospital:

1. The claim amount which was passed was nowhere near the amount which was promised by the counsellor while making an estimate prior to patient admission. The counsellor advised us that the total bill would be around 51, 000inr of which the policy would pay about 40, 000inr, while, we would have to bear around 10, 000-11, 000inr. This was agreeable to us. However, the actual billed amount was 55, 794/- out of which the insurance company only passed a claim of 21, 885/-!! I asked repeatedly for the bifurcation of the passed amount, but no one, neither from the hospital, nor from the insurance company were able or willing to provide it. On what basis do you give the false and misleading counselling to the patient?? Why even indulge in estimation if you can not estimate any amount correctly??

2. Out of the 21, 885/- which was passed, the hospital charged me an excess of 5, 187/- for no reason and forced me to pay up that amount. When asked about the details of these excess amount for, i was told that this is the amount which the insurance company would give to the hospital. They call it mou discount and i came to know that this is an agreement between fortis hospitals and e-meditek.
How is that my problem?? My insurance company passed a claim of 21, 885/- and writes in black and white that the complete amount (21, 885/-) is to be set-off against settling the bill. After arguing for more than 3 hours with your tpa head dr. Raza haider, and urging him repeatedly to do what is right and legally binding, i felt a total sense of helplessness over the complete lack of empathy on hospital's part. Even though the matter of your hospital's deal with e-meditek does not concern me, i was forced to pay up the amount for obtaining discharge permission.

3. I tried reaching out to the so called "patient welfare" only to find all relevant persons on leave and the two so-called "welfare executives" just sitting there passing their time on the pc and totally unable to help a harassed patient. They tried to avoid the situation by hiding behind their powerlessness instead of helping in any sort. Moreover, they did not share any contact details to me for talking to any senior management. I was shocked by this lack of transparency, which in today's time, is not even present in govt. Hospitals, let alone a brand like fortis!!
Noting the numbers from the cash counter, i tried calling everyone from the duty manager to the medical director. No one picked up their phone inspite of me calling their mobiles at least 15 times!!! I wonder if the hospital just puts out dummy numbers.

This is an absolute rubbish of a customer service with zero regards to patient welfare. This is also a pure case of extortion and patient harassment and i would be happy to take up the issue legally.

Warmest regards,
Sunil kumar goel

1. Final bill.
2. Insurance approval

Fraud and extortion
Fraud and extortion

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