Abu Dhabi Court Mandates Hospital Payment from Couple
An Abu Dhabi court has ruled that a couple must cover a substantial portion of their medical bills after their insurance coverage fell short. The decision by the Abu Dhabi Commercial Court of First Instance requires the couple to pay a remaining balance of Dh180,782, following an insurance payout of Dh250,000 for emergency medical services provided to the woman and her newborn twins.
Hospital’s Legal Battle for Compensation
The hospital initiated legal proceedings against the couple and their insurance company, seeking a total of Dh430,782 for the medical care delivered to the mother and her infants, who were treated in the intensive care unit. Additionally, the hospital pursued compensation for purported material and moral damages, claiming a total of Dh1 million in losses and lost profits. The hospital sought legal interest at a rate of 12% from the lawsuit’s filing date until the full payment.
Arguments from the Defendants
The couple contested the lawsuit, arguing that it was prematurely filed due to an ongoing investigation of a potential medical error by medical liability committees. They requested a suspension of the lawsuit pending the outcome of this investigation, which, they argued, might negate any claims regarding medical expenses. Furthermore, they contended that the lawsuit violated the Medical Liability Law and called for the appointment of a specialized medical expert to assess the actual treatment costs.
Insurance Company’s Position
The insurance company, involved as a third defendant, also sought dismissal of the lawsuit, asserting that it bore no liability. The company emphasized that the insurance coverage was capped at Dh250,000 per year, a limit that had already been met, thus fulfilling its obligations under the Health Insurance Law of the Emirate of Abu Dhabi.
Court’s Analysis and Decision
The court’s ruling was based on the acknowledgment signed by the husband, which guaranteed payment for the medical services received. The court noted that the insurance policy clearly stipulated a maximum coverage limit, which had been reached. Consequently, the financial responsibility for the excess amount rested with the couple. The court found the hospital’s claims valid, citing evidentiary support from submitted invoices detailing services amounting to Dh430,782.
Judgment and Financial Implications
The court dismissed the couple’s argument about the pending medical error investigation, stating that the financial obligations arising from the medical services contract were distinct from any potential liability for negligence. Consequently, the court ordered the couple to pay Dh180,782 to the hospital, with an additional legal interest rate of 5% per annum until full payment is made. The couple was also required to cover court expenses and attorney fees totaling Dh200.
While the hospital’s request for additional compensation was rejected, the court deemed the awarded legal interest sufficient to address any damages incurred by the delay in payment.