Under Section 2 (a) of the Indian Contract Act, 1872, any package/estimate/quotation given by a doctor/hospital to a patient would be a ‘proposal’. In case this ‘proposal’ is accepted by the patient before its revocation by the doctor/hospital, it becomes a ‘promise’, an ‘agreement’, a ‘contract’ under Sections 2 (b), 2 (e), and 10 of the Contract Act.
Hence, every doctor/hospital must be extra cautious in giving package/estimate/quotation to any patient because if the patient indicates his/her acceptance, it will become a ‘contract’ legally binding the doctor/hospital.
While giving a package / estimate / quotation, the following aspects must be taken into consideration and the inclusions and exclusion must be clearly spelt out:
- Type of room/bed – how many days in ICU/ordinary room. Extra charges on transfer from lower class to higher class and rebate on transfer from higher class to lower class.
- Fees for initial pre-operative consultations with specialists and investigations.
- OT charges, equipments, OT medications, anesthetic agents, anesthetic drugs.
- Fees of surgery/procedure team including anesthetist – both for surgery and inpatient visits.
- Post-operative investigations.
- Inpatient medications
- Fees of dietician, physiotherapist, etc.
- Physiotherapy/rehabilitation services – during/after hospitalization.
- Nursing care.
- Meals/laundry for patient/attendant.
- Items of personal nature such as in-room soft drinks, telephone charges, guest meals, etc.
- Take home medications and supplies.
- Fees for post-discharge consultations with specialists and investigations.
- Add-on charges, if any.
- Ambulance charges.
- Medical insurance.
- Cashless hospitalization/managed care.
- Amount required to be deposited and how many days/h before admission. On non-deposit of the specified amount what would be the fate of the scheduled surgery/procedure.
- Modalities for canceling a scheduled surgery/procedure. Refund – amount and time frame.
- In case of foreign patients, express conditions must be incorporated to take care of international
- currency fluctuations and translators (where requisitioned).
In case of packages, it would also be advisable to include the following clauses in the publicity material, brochures, website, etc:
- Specify the list of diseases/disorders whose patients would be considered high risk and hence ineligible for the particular package or would be charged more.
- It is advisable to specify that – ‘final estimate will be given only after the patient has been thoroughly examined by the concerned doctor’.
- It is advisable to specify that – ‘prices subject to change without any prior intimation. Patients are advised to take individual estimates’.
