Dear Fortis Healthcare Team,
I am writing formally to express dissatisfaction with the care and the handling of the billing and insurance claim process. This email addresses the recent hospitalization of my younger brother Prashant Khurana at your facility on 22nd July 2025 through the emergency department and expected a grievance regarding the same. The reason for admission was chest pain and accelerated hypertension.
The patient was admitted to the emergency department between 11:00 PM to 11:45 PM on 22nd July 2025 . Admission was advised for cardiac enzyme tests and observation. The patient was placed in the ICU, though it's unclear if this was necessary. Standard ICU procedures did not appear to be followed.
The main concern is misleading information from your staff regarding the health insurance claim process. The Third-Party Administrator (TPA) process was started for a claim of ₹51, 423, even though the patient had not been hospitalized for 24 hours. The claim was rejected, and the final cash payment increased to ₹56, 383. This discrepancy and the attempt to process a claim prematurely, knowing the standard insurance guidelines, constitutes a serious lapse in ethical conduct and transparency on the part of your experienced staff.
The discharge process was lengthy, taking about six hours, which caused distress to the patient and family.
A detailed explanation and justification is requested for the following:
1. The decision to admit the patient to the ICU and the necessity of this placement though none of the ICU procedures have been followed.
2. The initiation of the TPA process for a claim that did not meet the criteria, leading to its rejection.
3. The difference in the billed amount (initial ₹51, 423 vs. final cash payment of ₹56, 383) and a clear breakdown of all charges. The reason for the increased amount as its payment mode changes from Insurance to Cash.
4. The prolonged discharge process and the harassment experienced by the patient and family.
Attached are the supporting documents received from the hospital and Rejection email from insurance.
This situation demonstrates negligence and a lack of transparency in patient care and financial practices. A prompt and satisfactory resolution is expected, including a refund of the excess amount and appropriate action against those responsible.
We hope to resolve this matter amicably and expect a satisfactory response within 5-7 business days, If not addressed we will be compelled to escalate this issue to consumer forums.
Immediate attention to this matter is expected.
Sincerely,
Nishant Khurana
email: nishantkhurana.[protected]@gmail.com, mr.[protected]@gmail.com
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