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‘Fake OPD entries, fabricated diagnoses, injections never given’: Punjab Govt seeks time on fraud probe against Fortis

The Punjab and Haryana High Court defers a petition by a farmer who alleged that Fortis Hospital in Mohali and an ophthalmologist claimed Rs 2.86 lakh from his insurer for a routine cataract surgery.

Punjab and haryana high courtThe Punjab and Haryana High Court will now take up the case on March 20. (Express photo)

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

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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.

Manraj Grewal Sharma is a senior journalist and the Resident Editor of The Indian Express in Chandigarh, where she leads the newspaper’s coverage of north India’s most politically and institutionally significant regions. From Punjab and Haryana to Himachal Pradesh and the Union Territory of Chandigarh, she oversees reporting at the intersection of governance, law, politics and society. She also reports on the diaspora, especially in Canada and the US. With a career spanning journalism across several countries, academia and international development, Manraj brings a rare depth of perspective to regional reporting. She is widely regarded as a leading chronicler of Punjab’s contemporary history and socio-political evolution, particularly its long shadow of militancy, federal tensions and identity politics. Her book, Dreams after Darkness, remains a definitive account of the militancy years and their enduring aftermath. Professional Background & Expertise A gold medalist in mass communication and a post-graduate in English literature, Manraj has a multifaceted career spanning journalism, academia, and international development. She was also awarded a fellowship by National Foundation of India and did several in-depth pieces on Manipur. Internationally, she has reported from Israel, US, UK, Myanmar, and Mauritius Her key focus areas include: Regional Politics, History, Agriculture, Diaspora, and Security. Of late, she has started focusing on Legal & Judicial Affairs: Much of her recent work involves reporting on high-stakes cases in the Punjab and Haryana High Court, ranging from environmental policy to civil rights. International Consulting: She previously served as a consulting editor for the Asia Pacific Adaptation Network and a publishing consultant for the Asian Development Bank (ADB) in Manila. Academia: For five years, she was the managing editor of Gender, Technology and Development, a peer-reviewed international journal at the Asian Institute of Technology, Bangkok. Recent Notable Articles (Late 2025) Her recent reportage focuses heavily on judicial interventions and regional governance: 1. Environment & Governance "‘NGT can’t test legality of policy’: HC hears challenge to Punjab’s ‘Green Habitat’ plan" (Dec 22, 2025): Covering a critical legal battle over whether the National Green Tribunal has the authority to strike down a state policy regularizing farmhouses on delisted forest land. "High court pulls up Punjab poll panel over audio clip probe" (Dec 10, 2025): Reporting on judicial concerns regarding the transparency and fairness of local body elections. 2. Legal Rights & Social Welfare "HC issues notice to Punjab, Haryana over delay in building old age homes" (Dec 22, 2025): Reporting on a contempt petition against top officials for failing to establish government-run homes for the elderly as promised in 2019. "Victims can appeal acquittals in sessions court without seeking special leave" (Dec 19, 2025): Highlighting a significant procedural shift in criminal law following a Supreme Court ruling. "HC upholds benefits for Punjab FCI officer acquitted in 20-year-old bribery case" (Dec 19, 2025): A report on the concept of "honourable acquittal" and its impact on employee benefits. 3. Human Rights & Identity "As Punjab denies parole to MP Amritpal Singh, HC asks it to submit ‘foundational material’" (Dec 1, 2025): Covering the legal proceedings regarding the radical preacher and sitting MP's request to attend Parliament. "Protecting life paramount: HC backs Muslim woman in live-in after verbal divorce" (Nov 6, 2025): Analyzing judicial protections for personal liberty in the context of traditional practices. Signature Beats Manraj is recognized for her ability to decode complex judicial rulings and relate them to the everyday lives of citizens. Whether it is a 30-year-old land battle in Fazilka or the political implications of Kangana Ranaut’s candidacy in Mandi, her writing provides deep historical and regional context. Contact @grewal_sharma on X manrajgrewalsharma on Instagram ... Read More

 

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