oppn parties Mediclaim Cannot Be Denied for Genetic Disorders, Rules Delhi HC

News Snippets

  • Crude prices fall sharply as Saudi Arabia assures normal production in a few weeks. Prices fall by 5.4% to $65.30 per barrel
  • Sensex tumbles 700 points over fears that rising crude prices will deal a body blow to the tottering Indian economy
  • As Rajeev Kumar fails to appear before the CBI despite several notices, the agency forms a special team to locate and apprehend him
  • S Jaishankar says Pakistan is not a normal neighbour and its behaviour is a "set of aberrations"
  • External Affairs Minister S Jaishankar says PoK in Indian territory and the country hopes to have physical jurisdiction over it one day
  • Barasat Sessions court near Kolkata rejects Rajeev Kumar anticipatory bail application citing lack of jurisdiction as the reason
  • PM Modi celebrates his birthday with Narmada aarti and later has lunch with his mother.
  • All 6 Bahujan Samaj Party MLAs merge with the Congress in Rajasthan
  • Bengal CM Mamata Banerjee to meet PM Modi on Wednesday, state issues on the agenda
  • Pakistan to open Kartarpur corridor on Nov 9
  • Rajeev Kumar, ex-police commissioner of Kolkata and wanted for questioning in the Sarada scam does not appear before the CBI despite the state administration requesting him to do so
  • Supreme Court asks the Centre to restore normalcy in J&K but keeping national interest in mind
  • As Trump accepts the invitation to attend a programme in Houston with PM Modi, India rushes to settle trade issues with US
  • After drone attack on Aramco's Suadi Arabia facility, oil prices jump 19% in intra-day trading causing worries for India
  • Imran Khan raises nuclear war bogey again, says if Pakistan loses a conventional war, it might fight till the end with its nuclear arsenal
Sunni Wakf Board and Nirvani Akhara write to the Supreme Court for a negotiated settlement to the Ayodhya dispute
oppn parties
Mediclaim Cannot Be Denied for Genetic Disorders, Rules Delhi HC

By Sunil Garodia

About the Author

Sunil Garodia Editor-in-Chief of indiacommentary.com. Current Affairs analyst and political commentator. Writes for a number of publications.
The Delhi High Court has ordered that insurance companies cannot deny mediclaim just by saying that the disease for which coverage is demanded is due to “genetic disorder.” Saying that the term “genetic disorder” is all-encompassing and not clearly defined, the court ruled that any broad exclusion of genetic disorders from either insurance contracts or claims is illegal and unconstitutional. It also took the insurance regulator IRDA to task by saying that it “ought to have supervised the manner in which the term genetic disorders are being misused by insurance companies to reject genuine claims. Obviously the IRDA turned a blind eye to the functioning of insurance companies.”

The case under consideration was that of one Jay Prakash Tayal who had a mediclaim policy with United India Assurance Company, a state insurer. Tayal was diagnosed with Hypertrophic Obstructive Cardiomyopathy , a condition that thickens portions of the heart reducing its capacity to pump blood. The insurer refused to entertain the claim by saying that it was a genetic disorder and was hence excluded under the general exclusions clause. Tayal approached the trial court in 2016 which ruled in his favour. Terming exclusion of genetic disorders “arbitrary, discriminatory and unfair”, Judge Kamini Lau had said in her order that "no person can be discriminated or deprived of state protection in case of an ailment, be it genetic or acquired. The courts of law are required to interpret the provisions of the private contracts in the light of these constitutional obligations.”

Aggrieved with this order, United Insurance appealed to the Delhi HC which has again ruled in Tayal’s favour. It has to be recognized that in the absence of proper investigations, terming any disease to have arisen due to genetic disorder is blatantly wrong. It is both medically and legally unfair to attribute something to any other thing without irrefutable proof. Apart from some proven conditions, even the medical community is divided over what other conditions can irrefutably be said to have happened due to genetic disorder. Hence, insurance companies cannot shirk their responsibility by hiding behind this loophole.