[ Everyday Law ]
A swab, a surgical mop, a pair of forceps or a length of gauze left inside the body when the wound is closed is one of the few medical injuries the law treats as nearly self-proving. The standard of care for a surgeon is the protective Bolam standard — the ordinary skill of an ordinarily competent practitioner — accepted for India in Indian Medical Association v V P Shantha and elaborated in Jacob Mathew v State of Punjab , and a mere error of judgment is not negligence. But a foreign body sealed inside a patient is different in kind. In Achutrao Haribhau Khodwa v State of Maharashtra , (1996) 2 SCC 634, a mop was left inside a woman's abdomen during an operation; peritonitis developed, a second surgery followed, and she did not survive. The Supreme Court fixed liability on the institution because no valid explanation was forthcoming for the swab having been left behind, and held the doctrine of res ipsa loquitur applicable to such a case. This guide sets out the standard of care, why a retained foreign body shifts the evidential burden, the hospital's vicarious liability, the consumer-commission route, and the criminal threshold.
2026-05-15 · 16 min read
[ Everyday Law ]
A cashless authorisation under a health-insurance policy is a contractual entitlement, not a discretionary favour. It is mediated by the IRDAI (Health Insurance) Regulations, 2016, the IRDAI (Protection of Policyholders' Interests) Regulations, 2017, the IRDAI Master Circular on Standardisation in Health Insurance Business dated 22 July 2020 and the IRDAI Health Insurance (Standardisation) Guidelines, 2022, supplemented by the IRDAI Circular on "Cashless Everywhere" dated 31 January 2024. The regulator has prescribed turn-around-times for pre-authorisation and for final discharge, identified the third-party administrator's contractual role, and laid down the empanelment architecture of network hospitals. A refusal that breaches these turn-around-times — or a denial founded on a clause the insurer has waived through prior conduct — is reviewable through the IRDAI grievance route, the Insurance Ombudsman under the Insurance Ombudsman Rules, 1998 as superseded by the IRDAI Integrated Insurance Ombudsman Scheme, 2017 (amended 2021), the District Consumer Disputes Redressal Commission under the Consumer Protection Act, 2019 and the civil court. The Supreme Court in National Insurance Co. Ltd. v Hindustan Safety Glass Works Ltd. , (2017) 5 SCC 776 and in Galada Continental Pvt. Ltd. v Union of India , (2016) 12 SCC 152 has refused to allow insurers to retreat behind technical clauses where conduct shows waiver or acquiescence. This guide sets out the framework and the denial routes as they now operate.
2026-05-15 · 18 min read
