A Person Suffering From A Genetic Disorder Needs Medical Insurance As Much As Others: Delhi HC

| February 26 , 2018 , 19:08 IST

In a landmark judgement, the Delhi High Court on Monday held that the Right to avail health insurance is an integral part of Right to Healthcare and Right to Health. Justice Pratibha Singh ruled it was unconstitutional to rule out health insurance because of Genetic disposition in absence of appropriate testing.

Hearing a dispute between petitioner Jay Parkash Tayal and United India Insurance Company Limited, Justice Singh delivered the judgement upholding the trial court verdict that a person, suffering from a genetic disorder, needs medical insurance as much as others.

Several of the prevalent medical conditions that affect a large mass of the population, including cardiac conditions, high blood pressure, diabetes in all forms, could be classified as genetic disorders.

She decreed the suit for a sum of Rs.5 lakhs along with interest @12% from the date of filing of the claim with the Appellant Insurance Company till the date of payment.

Delivering the judgement Justice Singh also highlighted the problems faced by people in getting medical reimbursed. She said, “Medical insurance is primarily obtained for the purpose of unforeseen medical conditions that may affect a person and so long as there has been no fraud, concealment or suppression, at the time of obtaining insurance, policies ought to be honoured. It is usual to see claimants running from pillar to post in order to get medical reimbursement from insurance companies”

Highlights of the judgement delivered by Justice Singh:

  • Right to avail health insurance is an integral part of the Right to Healthcare and the Right to Health, as recognised in Art. 21 of the Constitution.
  • Discrimination in health insurance against individuals based on their genetic disposition or genetic heritage, in the absence of appropriate genetic testing and laying down of intelligible differentia, is Unconstitutional.
  • The broad exclusion of genetic disorders is not merely a contractual issue between the insurance company and the insured but spills into the broader canvas of Right to Health.
  • There appears to be an urgent need to frame a proper framework to prevent against genetic discrimination as also to protect collection, preservation and confidentiality of genetic data.
  • Insurance companies are free to structure their contracts based on reasonable and intelligible factors that should not be arbitrary and in any case cannot be ‘exclusionary’. Such contracts have to be based on empirical testing and data and cannot be simply on the basis of subjective or vague factors. It is for lawmakers to take the necessary steps in this regard.

Read the complete judgement here