Introduction
Some cases don’t come with warning signs. That’s exactly what happened on March 7, 2025, when a hospital, a respected institution in Jaipur, found itself surrounded by hundreds of angry people after a patient died hours after surgery. The family demanded ₹50 lakh. The crowd vandalized hospital property, and the doctor admitted a mistake. The situation was spiraling, but Coveryou didn’t step back; we stepped in.
Case Background
The patient, aged 43, had undergone hernia surgery two days earlier. The operation went smoothly, and he was discharged on March 7 at 11 a.m. But just a few hours later, he returned in distress and died of a cardiac arrest en route to another hospital.
Upon investigation, it was found that his hemoglobin level was low (8.5 g/dL) and had not been optimized before surgery. Not only this, but no ECHO or heart evaluation was done before the operation. Informed consent was also incomplete and didn’t mention cardiac risks. The surgery, though elective, was done without waiting for proper stabilization.
Soon after his death, a mob of over 400 people gathered outside the hospital. They demanded ₹50 lakh. After hours of negotiation and intense pressure, the matter was settled for ₹11 lakh on the same night.
Challenges Faced:
- No Prior Approval Possible: The OCS was done at 10 PM there was no time to get ICICI’s approval in advance.
- Partial Cash Payment: ₹3 lakh of the settlement was paid in cash, which is normally not allowed under insurance rules.
- Policy Not Available Immediately: The policy document couldn’t be accessed at 10:30 PM during the chaos, delaying formal intimation.
Support from CoverYou:
Despite the chaos, our in-house legal expert took complete control. He guided the doctor on calling the police and the SDM office immediately. He also helped in drafting a clear settlement letter, explaining the ₹3 lakh cash and ₹8 lakh cheque payments.
After gathering and submitting all patient records, treatment documents, and invoices,
Our claim expert emailed ICICI Lombard the same night, detailing why prior approval wasn’t possible. Collected video evidence of the mob attack, which even appeared in the media. The expert prepared a full merits/demerits report justifying the ₹11 lakh settlement. He kept the hospital informed at every stage, and no step was taken without consent.
Final Outcome:
The claim status was approved smoothly and immediately, before the situation worsened, and the paid amount was ₹10,50,000 (₹50,000 deducted as compulsory excess). The settlement of the case was on 29 March 2025.
Impact
What started as a tragedy could’ve ended in total loss, no support, no approval, and no cover. But thanks to fast thinking, a calm mind, and real-time guidance, the doctor and hospital not only avoided further damage, they also received justice and support under the CoverYou policy terms.
At CoverYou, we don’t just step in when the claim is filed; we stand by when your world is burning, literally or legally.
Disclaimer:
Some names and identifying information have been altered or anonymised to maintain privacy.
