The hospital can enter into MOU with the Insurance company to provide discount or lower rates to patients of insurance company on services but this doesnot mean any irregularity can be done by hospital as if any mishap or contravention by hospital than it is liable and has to pay damages.

Also if there is deficiency in service.by hospital than a consumer complaint can be made.

The point you are raising is valid but still the agreed price cannot be challanged on just assumption that they will provide bad service on the contrary if there is deficiency in service on case to case or if there is any practice which is against india medical laws than the hospital.can be sued irrespective who pay under criminal law for negligence, under civil for damages.

Sir, I respect your concern but there is no locus standii on court to the fact that if you ask less charges so hardware will be of bad quaility, it can be due to number of patients insurance company provode.(assumption, there defence)

if we have evidence to effect that low quaility material is used and life is at risk we can challange same. So if you come.across any such thing that can be produced as evidence before court than same can be challanged. Also the person under going treatment if doesnot.recieve service agreed upon can sue insurance company.

Or if negligence on part of hospital they have to pay exemplary damages.

To answer your follow up questions.

1. the doctor should use the hardware to insure full safety payment shall be made according to the terms and agreement of Insurance company.

2. No the insurance company just does the mou for discount or lower rate he cannot make an agreement to effect that the specific essentials hardware should not be used. Anything that risk the life or is not of quality for treatment cannot be used and no agreement on that effect can be made.

3.He don't have to absorb the cost.

4.That is unethical for a doctor to do.

Sir this issue of great concert if you find anything evidencary to the effect you can challange same also a PIL can filed to restrict such MOU but the low quality service and effects to be proved. Court cannot take decision on mere assumption it need evidence to some extent to reach on conclusion.

It is moral responsibility of every professional to provide best service and follow code so is the code of doctor they need to follow regulations in medical field strictly for safe and better treatment.

The patient and doctor needs to insure that such MOU doesnot.effect services and compromise safety and treatment standards. The payment is then on hospital and insurance company to decide.

This is really important issue raised by you and I would be.more than happy to.provide my.further assistance if you find any evidence to.effect of such practices being followed.

1) capping is done so that hospitals dont charge exhorbitant amount for surgeries

2)if you have evidence that cheapest materials are being used that compromise patient health you can sue the insurance company and hospital for endangering your health

if doctor uses special hard ware to ensure safe completion of procedure he can charge it on patient

2) if it is not covered by insurance policy then patient has to pay

3) under no circumstances should hospital take risk with patients life

Regarding your first question these types of agreements are entered so that hospital does not charge excessive amount from insurance companies giving false bills. Secondly you being policy holder if you have enough evidence that cheap material are used you can sue the concerned hospital And insurance company in consumer forum. There will be specific terms and conditions in insurance clauses which you enter if some procedures are outside purview of insurance policy the patient will be made to pay the excessive amount since it will not be covered by policy. Hospitals would never try to use cheapest material since many people who are not covered with insurance also get treatment in same equipment. If you have concerns you can approach the jurisdiction high court filing PIL with sufficient proof to show the nexus between hospital and insurance company as alleged by you.

Dear Doctor,

Your concern for the patient is appreciable. Such behind the screen agreements between hospitals and insurance companies is really unknown to most of the patients. They just believe the hospitals and doctors therein and surrender for any operation which the doctors suggest under the risk of more complications. During such periods the patient and his relatives unable to work out or discuss anything about the materials being used by the doctors during course of operation. It seems it is a big scam which has to be unearthed with the help of honest doctors like you.

I feel such supporting documents cannot be found and the only course open for us to approach High Court by way of Public Interest Litigation petition, with some prima-facie evidence to convince the Court. Once the Court is convinced, a sweeping order will be issued directing investigation agencies like CBI to probe into such illegal agreements. Please go ahead with your proposal and try to find out a honest lawyer to file PIL.

This is very common practice and a lucrative business in medical industry and known to all. But unfortunately all the influencial and big names are behind the same. If you have clinching evidence against them you can file a PIL against such persons and HC can issue directions to the centre for effective implementation of the same.

Success in litigation depends upon pleadings abd evidence on record

2) if you engage solicitor firm and pay only Rs 1 lakh fees per year firm woukd engage juniour counsel to fight your case

3) if you pay Rs 10 lakh fees then solicitor firm would engage senior counsel to argue your case

4) lawyers do not engage detective agency in gathering evidence . It is fir client to engage his services

Your concern in general is an appreciable effort

However what do you think you can do about it especially without any evidence about it.

You can file a PIL on this to get the things cleared, but even then it may be stopped for time being and would emerge in another form.

Can you keep approaching court frequently with such PILs ?

Even for this what you say, it is required to prove before the court with substantial evidence , especially in the event of fighting two mighty and mammoth organisations i.e., the insurance company and the hospital.

Everyone knows that what they do is illegal but who cares?

It is a novel idea, but who will bell the cat?

If you are forced to use the hardware or equipment that were already used, there are chances for infections which may lead to failure of treatment etc resulting into medico legal case.

But if you are employed as a doctor then you may not have anything to say or object to it owing to your employment obligations.

You may have to safeguard your own interests because your agitation should not hamper your own welfare or employment prospects.

Your enthusiasm should not become fatal to your own employment.

Your subsequent question do not throw light on any thing which you are so much anxious about.

The profession of a lawyer and a doctor cannot be compared on the same lines

There is a difference between a lawyer losing his client's case in a court of law and the failure of a doctor's operation/surgery to his patient.

No doubt your concern about the public in general and insured in particular is appreciable but who will bell the cat, will you.

You can collect the evidence as file writ petition or PIL.