Liability for Unpaid Hospital Bills When Post-Dated Checks Bounce
(Philippine Law, updated 24 April 2025)

1 The source of the obligation

Hospital-patient (or guarantor) contract. Admission sheets, promissory notes and other papers you sign on confinement are ordinary contracts; they create a civil obligation to pay under Articles 1157–1158 of the Civil Code. A spouse or relative who signs as “responsible party” becomes personally (and usually solidarily) bound because the contract clearly shows an intention to be directly liable. citeturn0search2
Necessaries & family support. Medical expenses of a spouse, ascendant, descendant or minor child are “necessaries”; they bind the conjugal/community property (Family Code arts. 94 & 121) and may be claimed as legal support (art. 194) even if only one spouse actually signed. citeturn0search1

2 Paying by post-dated check (PDC)

Key rule	Practical meaning
Art. 1249, Civil Code – A check is not legal tender and “produces the effect of payment only when it has been cashed.” citeturn11search3	Merely handing a PDC never extinguishes the debt; if it later bounces, the original obligation “revives” in full.
Negotiable Instruments Law (Act 2031)	A PDC is a bill of exchange payable on a future date; the drawer promises that sufficient funds will exist on presentment.
Hospital practice	Hospitals accept PDCs only as conditional payment or a form of security; most add a clause that dishonor makes the whole balance immediately due. citeturn0search2

3 When the PDC is dishonored

3.1 Civil liability

Principal + interest. The patient/guarantor remains liable for the entire Statement of Account. Current jurisprudence imposes 6 % legal interest from finality of judgment until full payment. citeturn9search8
Damages. Bad-faith refusal to pay can justify temperate, moral, or exemplary damages and attorney’s fees under Arts. 19-21 & 2208 Civil Code.

3.2 Criminal exposure

Statute	Elements that matter for hospital bills	Penalties / notes
Batas Pambansa 22 (Bouncing Checks Law) citeturn10search0	1) Making/issuing the check for value; 2) Knowledge of insufficient funds; 3) Dishonor and failure to pay within 5 banking days after notice.	• Alternative penalty regime: jail (30 days–1 yr), or fine (up to ₱200k, double the check), or both, at the court’s discretion—re-emphasised by the Supreme Court in 2023. citeturn0search0
Estafa – Art. 315 (2)(d) RPC	Requires deceit (intent to defraud when the check was issued) and actual damage. A hospital may file estafa in addition to BP 22 because the two offenses protect different interests. citeturn0search3

Landmark case. Ty v. People (G.R. 149275, 27 Sept 2004) affirmed a BP 22 conviction for seven worthless checks issued to Manila Doctors Hospital totaling ₱210,000. The Court rejected the defense that the checks were issued under “fear or duress,” stressing that hospital bills are “for value” and that payment within 5 days would have averted criminal liability. citeturn8search2

Professionals beware. The Supreme Court has also disciplined lawyers who repeatedly issue worthless checks as “gross misconduct.” citeturn9search9

4 Hospital remedies after dishonor

Extra-judicial demand. A written demand with a bank certificate of dishonor satisfies BP 22’s notice requirement and starts running interest.
Civil suit for collection, usually with a prayer for damages:

Small Claims—now up to ₱1 million (2023 Rules on Expedited Procedures). citeturn9search0
Regular action—Regional Trial Court if the claim exceeds ₱1 million.

Criminal complaint for BP 22 (Metropolitan/Municipal Trial Court), estafa (Regional Trial Court), or both.
Reporting to professional regulators if the issuer is a physician, lawyer, etc.

Hospitals cannot detain the patient to compel payment (see §5), but they may withhold death certificates and discharge summaries only until a promissory note or equivalent security is signed, per DOH A.O. 2008-0001. citeturn0search4

5 Patient protections

Statute	What it does	How it interacts with PDCs
Republic Act 9439 (Stop Hospital Detention Law) + DOH A.O. 2008-0001	Prohibits hospitals and clinics from detaining recovered or deceased patients solely for non-payment. Allows them to require a promissory note with one solidary guarantor and to retain death certificates or results until that note is signed. citeturn0search4turn0search1	Signing the note does not waive or novate the original obligation; it merely creates an additional written acknowledgment the hospital can sue on.
R.A. 10932 (2017 Anti-Hospital Deposit Law) & IRR, DOH A.O. 2018-0012	Criminalises refusal to treat emergency cases for lack of advance payment or deposit; increases fines and imposes closure for repeated violations. citeturn0search5turn0search10	The statute does not cancel the debt; once stabilised, the patient must still settle the bill, and issuance of a PDC follows the same rules above.

6 Defences & mitigation for the drawer

Pay within 5 banking days after notice. This extinguishes criminal—but not civil—liability under BP 22.
Question the notice. Without proof that the statutory notice of dishonor reached the drawer, conviction fails.
Lack of consideration. Rare in hospital cases because treatment is obvious value; Ty rejected this defence.
Force majeure / impossibility. Only affects civil liability if the patient can prove the obligation was extinguished (very rare).
Compromise or novation. A new agreement expressly extinguishing the old debt (e.g., approved PhilHealth benefit fully covering the bill) bars further collection.

7 Interest, costs & enforcement

Interest rate. Courts routinely impose 6 % p.a. legal interest on the unpaid balance from date of finality of judgment until full payment. citeturn9search8
Costs & fees. Attorney’s fees are generally awarded when the debtor acted in bad faith or forced the hospital to litigate.
Execution. Hospitals may levy on the debtor’s bank accounts, salary (up to the exempt portion), or other non-exempt assets once the judgment becomes final.

8 Practical checklist

For hospitals	For patients / guarantors
▢ Verify identity & capacity of signer. ▢ Keep originals of admission contract, PDC & SOA. ▢ Send written notice of dishonor immediately with bank memo. ▢ Offer settlement plans compliant with RA 9439 & 10932. ▢ Choose forum (small-claims, regular, BP 22, estafa) strategically.	▢ Never issue a PDC you are unsure you can fund. ▢ If the check may bounce, fund or replace it within 5 days of notice. ▢ Retain all PhilHealth/HMO benefit proofs; they reduce the collectible balance. ▢ Negotiate a restructuring or promissory note before dishonor. ▢ Keep proof of all payments to show good faith.

9 Key takeaways

A PDC does not pay a hospital bill until actually encashed; if it bounces the debt remains in full.
Dishonor triggers civil collection and may expose the drawer to BP 22 and even estafa.
Patients cannot be physically detained (RA 9439) nor refused emergency care (RA 10932), but their liability to pay survives.
Paying within five banking days of notice is the single most effective way to avoid jail time under BP 22.
Hospitals should use the small-claims track for balances up to ₱1 million; it is quick, document-driven, and lawyer-optional.

Properly understood, post-dated checks are a convenient bridge—not a shield—between urgent medical needs and the obligation to settle the cost of care.