Delhi High Court: In a case wherein the petitioners approached this Court challenging the denial of a health insurance policy for their minor son who was suffering Bi-Lateral Hearing Loss, which was a hearing disability, a Single Judge Bench of Prathiba M. Singh, J. held that this would be contrary to the provisions in favour of Persons with Disabilities under the Rights of Persons with Disabilities Act, 2016 and directed the IRDAI to consider the way products could be designed for persons with hearing disabilities and persons with implants.
Background
The petitioner had approached this Court challenging the denial of a health insurance policy for his minor son who was suffering Bi-Lateral Hearing Loss, which was a hearing disability. The minor son of the petitioners was prescribed Cochler Implant and the petitioners got the same implant done for their son in 2020, at their own expense. Since the petitioners had a family insurance policy which included their elder daughter at that stage, renewal was sought by them, with the inclusion of their minor son as a co-insured after disclosing the said pre-existing condition. The Respondent 1, TATA AIG General Insurance Co. Ltd. however, refused to issue a policy on the ground that such a disability would not be covered by their underwriting policy. The case of the petitioner was that this would be completely discriminatory of disabled persons including disabled children.
Submissions on behalf of the Petitioners
Counsel for the petitioner relied upon the ‘Guidelines on Standardization of Exclusions in Health Insurance Contracts’ issued by the IRDAI and stated that the insurance company could have certain exclusions but the same would have to be only on the condition that there could be no insurance given after levying further loading charges on the policy.
Submissions on behalf of the Respondents
It was submitted that the policy did permit exclusion in Chapter II of the ‘Guidelines on Standardization of Exclusions in Health Insurance Contracts’.
Analysis, Law, and Decision
The Court noted that the counter affidavit of TATA AIG General Insurance Co. Ltd. showed that there was a categorical stand of the company that the company was able to issue a policy but by permanently excluding the pre-existing condition of the minor child. Thus, the Court opined that this would in effect mean that the child of the petitioners would be unable to obtain a health insurance policy at all in respect of his Bi-Lateral Hearing Loss and any health issues arising out of the same from the Respondent 1.
Thus, the Could held that this would be contrary to the provisions in favour of Persons with Disabilities under the Rights of Persons with Disabilities Act, 2016 and considering TATA AIG General Insurance Company Ltd. was part of a responsible and respected corporate group, it was expected that persons with disabilities would be treated compassionately. Further, the Court held that society in general also had a duty towards persons with disabilities and there was a need to consider and provide specific products covering disabilities for such people.
The Court after considering the directions given in Saurabh Shukla v. Max Bupa Health Insurance Co. Ltd., 2022 SCC OnLine Del 4471 and after considering the facts of the present case, directed as follows:
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The IRDAI in its meeting of insurance companies should also consider the facts of the present case and consider the way products could be designed for persons with hearing disabilities and persons with implants. Moreover, the IRDAI, while submitting its position to the Court should consider the existing Policies and Guidelines as may be applicable to persons with disabilities.
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The present case should also be escalated to the higher management of Tata AIG General Insurance Company Ltd. including, if required, to the Board of Directors to also consider this matter as to how persons with disabilities ought to be accommodated by insurance companies.
The matter would next be listed on 17-3-2023.
[Neeraj Mehta v. TATA AIG General Insurance Co. Ltd., 2023 SCC OnLine Del 487, decided on 25-1-2023]
Advocates who appeared in this case:
For the Petitioners: Advocate Shyam D. Nandan;
For the Respondents: CGSC Subhash Tanwar;
Advocate Ashish Choudhary;
Advocate Abhishek Nanda.
*Judgment authored by: Justice Prathiba M. Singh.
*Simranjeet Kaur, Editorial Assistant has reported this brief.
