Indian Patient’s Hernia Surgery Bill Includes Cancer-Related Procedure

Regi Abraham entered Criticare Hospital in Malad, Mumbai, on 1 September for hernia repair surgery. Prior to admission, he secured pre-authorization from his insurance provider for a non-cash treatment coverage amounting to 95,500 Indian rupees.

Bill jumps from 95,000 to 202,000 rupees

On 2 September, during discharge formalities, hospital staff handling insurance claims informed Abraham’s family that his final bill had increased to 202,000 rupees. The increase was attributed to an additional procedure coded as cancer-related. Abraham stated he was asked to pay the outstanding balance out of pocket after the insurer declined to cover the extra item.

“Thyroidectomy” classified under cancer care

According to Abraham, the billing records listed both the hernia repair and a procedure identified as “thyroidectomy”, categorized under cancer treatment. He emphasized he had never been diagnosed with cancer nor consulted the hospital for any cancer-related evaluation or therapy.

Why the classification matters

The core issue lies not in whether a separate cancer surgery occurred—but in how the procedure was classified and billed. While thyroidectomy is sometimes used in certain cancer treatments, it is also performed in complex hernia cases. The dispute therefore centers on coding accuracy and billing methodology, not on the performance of an independent oncological intervention.

Hospital attributes incident to human error

Criticare Hospital attributed the incident to an “unintentional human error”. It clarified that a non-clinical administrative staff member selected an incorrect classification while entering procedure details into the hospital’s billing and insurance system.

Deepak Namjoshi, the hospital’s founder, confirmed the error had been corrected and stated the facility did not receive any advance payment corresponding to the disputed amount. The final amount paid by Abraham stood at 75,000 rupees.

Disagreement over when and how the error was identified

Abraham said the correction followed his formal objection to the bill. In contrast, the hospital asserted it independently detected and rectified the issue without needing patient notification—a point where the two accounts diverge.

Surgeon revises description from “negligence” to “confusion”

The operating surgeon described the episode in a letter dated 3 September as “negligence”. After media inquiries, however, he clarified he preferred the term “confusion” instead of “negligence”, stressing the incident was not fraudulent and affirming it caused distress to the patient.

Regulatory complaints filed

Abraham did not limit his response to bill correction. He lodged formal complaints with the Maharashtra Medical Council, the Insurance Regulatory and Development Authority of India, the Brihanmumbai Municipal Corporation, and public health authorities at both state and city levels—requesting official review of the incident.