The Punjab and Haryana High Court has deferred hearing on a petition filed by a 64-year-old farmer alleging that Fortis Hospital, Mohali, and an ophthalmologist fraudulently claimed Rs 2.86 lakh from his Mediclaim policy. The matter was adjourned after counsel for the Punjab Government sought time to apprise the court of the status of an inquiry committee constituted in the case.
The petition by Janmeja Singh alleges that what was meant to be a routine cataract surgery costing around Rs 50,000 to Rs 60,000 resulted in inflated and fabricated bills amounting to Rs 2,85,990 under his Rs 10-lakh mediclaim cover.
When the matter came up before Justice Suvir Sehgal, the petitioner’s counsel, Vivek Salathia, submitted that two detailed complaints, placed on record, had led to the constitution of an inquiry committee on August 26, 2025. Despite the petitioner appearing before the panel, its proceedings have remained inconclusive for nearly six months, the court was informed.
Counsel appearing for the Central Bureau of Investigation represented one of the respondents. The assistant advocate-general, appearing for the state, sought time to inform the court about the status of the inquiry. The court allowed the request and posted the matter for March 20.
According to the petition, Singh first approached the doctor in December 2024 for a cataract in his right eye. He has alleged that upon learning of his Mediclaim policy, the doctor advised treatment at Fortis Hospital under the pretext of advanced laser treatment.
Hospital records, the petition states, reflect three visits between December 2024 and January 2025. Singh has alleged that OPD entries were shown for dates on which he did not visit, and that he was falsely diagnosed with macular oedema and corneal issues. The petition further alleges that expensive Ozurdex and Accentrix injections were billed without proper batch traceability or supporting diagnostic evidence.
Singh has claimed that during the first two visits, he was only prescribed eye drops and that cataract surgery was performed on the third visit. Despite this, nearly Rs 2.86 lakh was allegedly claimed from his insurer. He has also alleged that he was made to sign blank insurance forms, which were later used to process the claims.
No FIR on June 2025 complaint
A criminal complaint was filed on June 21, 2025, alleging cheating, forgery, and criminal conspiracy. However, no FIR has been registered so far. The petition states that the police treated the matter as one of medical negligence and referred it to a senior medical officer in Mohali.
Advocate Slathia strongly criticised this approach as contrary to the Supreme Court’s mandate in Lalita Kumari v. State of UP (2014) 2 SCC 1, which requires the registration of an FIR for cognisable offences like cheating and forgery. He said that this was not a negligence case but a premeditated insurance fraud involving fake OPD entries, fabricated diagnoses, and billing for injections never administered.
In the writ petition, Singh has prayed that the court issue a mandamus directing the state to constitute a special investigation team headed by a senior IPS officer, with senior officials of the Insurance Regulatory and Development Authority of India, to probe the alleged medical insurance fraud and cheating by the hospital and the doctor.
He has also sought a forensic audit of the hospital’s electronic medical records, insurance billing systems, and pharmacy inventory between December 2024 and February 2025 to track the flow of insurance payments in his case. In addition, he has asked the court to direct the hospital to preserve and produce original medical/insurance records or, alternatively, to hand over the investigation to the CBI for a fair probe.
The case will now be taken up on March 20.
The Punjab and Haryana High Court will now take up the case on March 20. (Express photo) 
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