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undisclosed experimental surgery resulted in insurance loss
11-Feb-2025 (In Consumer Court Law)
Undisclosed experimental surgery resulted in insurance loss and inconvenience. Loss of Rs 1.5 lakhs.
hi first need to see the nature of the surgery caused and the loss caused by you and if the insurance company failed to refund the amount then you could file consumer complaint in forum seeking compensation by sending legal notice
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Adv. Baddam Aravind Reddy
Secunderabad | 1000+ Answers
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how you can come to a conclusion that it's an experimental surgery. before proceeding for a surgery and when you are going for cashless surgery then as per procedure approval for surgery as per your health policy. so I suggest you to approach an advocate of ur choice with all material papers and discuss and come to a conclusion
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Adv. Dwara Pallavi
Hyderabad | 200+ Answers
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You can take legal action against the hospital or doctor for undisclosed experimental surgery that caused financial loss and inconvenience. Here’s what you can do:
1. File a Consumer Complaint for Medical Negligence
Since you suffered a financial loss of ₹1.5 lakhs, you can file a case in the Consumer Commission under:
Medical Negligence – For not informing you properly about the procedure.
Deficiency in Service – If they failed to provide proper information, resulting in insurance denial.
Unfair Trade Practice – If they misrepresented the surgery as a standard one.
✅ File the complaint in the District Consumer Commission (for claims under ₹50 lakhs).
✅ Demand compensation for financial loss, inconvenience, and mental agony.
2. File a Complaint with the Medical Council
You can file a complaint with the State Medical Council against the doctor/hospital for:
Performing an undisclosed experimental procedure.
Violating patient consent and ethical guidelines.
Causing financial harm due to insurance rejection.
3. File a Civil Suit for Damages
If the amount is significant, file a civil suit for:
₹1.5 lakh reimbursement for the financial loss.
Additional compensation for mental distress and inconvenience.
4. If There Was Fraud or Malpractice
If you suspect fraud, you can file a criminal complaint under:
Section 420 IPC (Cheating)
Section 337/338 IPC (Causing harm by a negligent act)
Would you like help in drafting a Consumer Complaint or a Legal Notice to the hospital?
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Adv. Mrudhula Jahnavi
Serilingampally | 200+ Answers
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