Delhi High Court: Prathiba M. Singh, J. told Delhi government to exempt the employees dealing with medical and health insurance services from curfew restrictions. The Bench stated,
“Medical insurance and health insurance services are essential services during the COVID-19 pandemic situation. Thus, the employees who are dealing with medical and health insurance services; ought to be permitted to move freely between hospitals and their own offices, in order to expedite the processing of medical insurance claims.”
The Petitioner, in the present petition, is a leading insurance company which is engaged in the business of health insurance plans and mediclaim policies. The case of the Petitioner was that it has branches all over Delhi, with approximately 256 employees, however only around 30 to 35 officials are required to attend offices, in order to process the claim documents of various patients who are primarily suffering from COVID-19 and are admitted in various hospitals. The present petition had been necessitated due to the rejection of e-pass for movement during lockdown by the Delhi Government, to the employees of the Petitioner, who are required to move from place to place for clearance of the insurance claims etc. Reliance was placed on the decision of this Court in Vinay Jaidka v. Chief Secretary, WP(C) 5026/2021 wherein it had been directed that, “all insurance companies ought to process the insurance claims within a period of 30 to 60 minutes, so that the discharge of patients is not delayed and hospitals beds are not blocked due to the said delay in processing the claims.”
The petitioner contended that the Govt. of NCT of Delhi through the Delhi Disaster Management Authority in its order dated 19-04-2021 had classified insurance companies under category 4 (l) and persons in the said categories require an e-pass in order to be able to move freely during the lockdown. The employees of the company, pursuant to the said requirement, applied to the GNCTD for an e-pass. However, all their applications had been ‘rejected’ without any reasons. As the website displayed:
“ePass for NGLS7BW NOT Generated/Approved yet Current Status: Rejected”
The Bench opined that medical insurance and health insurance services are essential services during the COVID-19 pandemic situation. The employees of insurance companies could not be restrained in this manner from free movement, as their movement is essential during the situation of a pandemic where many are dependent on the clearance of health insurance claims for discharge from the hospitals. Thus, these employees ought to be permitted to move freely between hospitals and their own offices, in order to expedite the processing of medical insurance claims. The Bench further observed that the abovementioned message of rejection was extremely ambiguous as it does not reflect the reason for rejection. The Bench expressed,
“During the pandemic, if issuance of e-pass can be made a complex process for persons dealing with health insurance policies and claims thereunder, it would result in enormous delays.”
Accordingly, the following directions were issued:
(i) The employees of the Petitioner, who are dealing with health insurance claims, as also mediclaims etc., shall be considered as rendering essential services, and thus, be exempt from curfew restrictions.
(ii) The Petitioner company shall provide a proper record of the required employees, and shall give a complete list of the employees along with their Aadhar Card/ID numbers, and one common certificate, certifying that all the said employees would be dealing with processing and clearance of claims relating to health insurance or mediclaim policies.
(iii) By return email, the official concerned of the GNCTD shall acknowledge the receipt of the said documents. In accordance with this order, the said employees, after the documents having been submitted to the official concerned, shall be exempted from the curfew restrictions,
In the light of above, the petition was disposed of.
[Max Bupa Health Insurance Co. Ltd. v. NCT of Delhi, 2021 SCC OnLine Del 1996, decided on 06-05-2021]
Kamini Sharma, Editorial Assistant has put this report together
Appearance before the Court by:
For the Petitioner: Adv. Gurmeet Bindra
For the Respondents: SC Santosh Kumar Tripathi with Adv. Aditya P Khanna
