IRDAI Non-Payable Items: Charges That Should Not Be on Your Bill

List I — Personal comfort items (~68 items)

Baby food, TV, visitor meals, laundry — things that have nothing to do with treating your condition. If it is for personal comfort rather than medical need, it belongs here.

None of these should appear under "treatment charges" or "consumables." If you see them there, the label is wrong.

List II — Already inside your room charge (~37 items)

You are paying ₹3,000–₹15,000 per day for the room. That rate already covers basic supplies like gloves, gowns, bed linen, and tissues. When these show up again as separate ₹50–₹200 lines in the consumables section, you are paying for them twice.

Scan the "consumables" or "nursing" section of your bill. If you see bed sheets, shoe covers, or cotton balls listed as separate charges — and you are also paying a daily room rate — one of those is the duplicate.

List III — Already inside your surgery fee (~23 items)

Surgical blades, OT drapes, spirit swabs, cautery pencils — the surgeon uses these during the procedure. Their cost is built into the surgery fee you already paid. Listing them again as separate charges is unbundling: splitting one fee into extra line items.

If you paid a surgery or procedure fee, check whether these same OT consumables appear again under "consumables" or "OT charges." The fee should already cover them.

List IV — Running costs the hospital already built into its rates (~18 items)

Registration, housekeeping, medical record maintenance, discharge procedure — these are the cost of running a hospital. They are already factored into every other rate on the bill. Charging for them on top is like a restaurant adding a line for "use of plates."

What this means for your bill

If you have insurance

The insurer spots these items and deducts them. Good — except the deducted amount lands on you. The hospital still collects the money; it just comes from your pocket instead of the insurer's. And your sum insured shrinks for the next claim.

If you are paying cash

Nobody is filtering your bill. Dozens of small entries — ₹50 here, ₹200 there — survive because nobody argues over a single pair of gloves. But 60 such lines over 10 days? That is ₹10,000–₹30,000 in charges you already paid for inside the room and procedure fees.

How to check

1. Get the itemized bill (your right under theClinical Establishments Act).
2. Look at the "consumables" and "miscellaneous" sections.
3. For each item, ask: does this belong in my room rate (List II), my procedure fee (List III), or hospital overhead (List IV)?
4. If yes, note the item, amount, and list number.
5. Total the amount and raise it in yourdispute letter.

When regulators caught it

The ₹16 lakh dengue bill — Fortis, Gurgaon (2017)

A 7-year-old was treated for dengue for 15 days. The family received a bill of roughly ₹16 lakh. NPPA investigated and found the hospital procured gloves at ₹9.86 a pair and charged ₹75. Overall consumable markup: 1,737%. Many of the inflated items — gloves, masks, kits — were non-payables from Lists II and III billed as separate entries rather than absorbed into room and procedure rates.

NPPA investigation; Economic Times, December 2017

PPE kits on top of packages — Nanavati, Mumbai (2020)

The BMC audited COVID billing and found Nanavati billing PPE kits and N95 masks separately — even though the treatment package already included them. Paracetamol appeared as a separate charge too, despite being in the package. Tests ran between 1 AM and 3 AM. An FIR was registered.

BMC audit; Mumbai Mirror, July 2020; Times of India

A 20% surcharge hidden in the OT — Bombay Hospital, Mumbai

A consumer forum found that a store near the OT sold medicines at a 20% markup above the hospital's own pharmacy price. Same hospital, same drug, two prices depending on which counter dispensed it. The forum called it unfair and ordered a refund.

South Mumbai District Consumer Forum; Moneylife

Frequently asked questions

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