The Bench of Justice Prathiba M. Singh was listening to the plea of 1 Subhash Khandelwal who submitted earlier than the Courtroom that he had bought an insurance coverage coverage from Max Bupa Well being Insurance coverage Firm Restricted and that he additionally paid the insurance coverage premium for the sum assured of Rs.35 lakhs on common foundation.

Importantly, he submitted that when he raised a declare with the insurance coverage firm in respect of his psychological sickness, he realized that there was a clause within the coverage limiting the sum assured to Rs.50,000/-, with a few situations, in case of psychological diseases.

Courtroom’s observations

Having perused Part 21 (4)A of the Psychological Healthcare Act, 2017, the Courtroom famous that there might be no discrimination between psychological diseases and bodily diseases and the insurance coverage offered in respect thereof.

Part 21 (4) A of the Psychological Healthcare Act, 2017 reads as follows:-

Part 21. Proper to equality and non-discrimination –

XXXX

(4) Each insurer shall make provision for medical insurance coverage for remedy of psychological sickness on the identical foundation as is on the market for remedy of bodily sickness.”

The Courtroom noticed,

“The clauses identified within the coverage clearly present {that a} giant variety of psychological situations are excluded from full protection of the coverage and solely a sum of Rs.50,000/- is reimbursable for these psychological situations.“

Importantly, the Courtroom additionally remarked,

“This matter requires consideration, inasmuch because the Insurance coverage Regulatory and Improvement Authority of India ought to position on file the premise on which approval has been granted for such insurance coverage insurance policies.”

Lastly, noting that a lot of insured individuals would be affected by such an insurance coverage coverage, the Courtroom directed that counter affidavit shall be positioned on file inside two weeks.

The matter has now been posted for additional listening to on June 2, 2021.

In associated information, final 12 months the Supreme Courtroom had issued discover to the Centre and the Insurance coverage Regulatory Improvement Authority of India (IRDAI) in a plea searching for instructions with respect to violation of Part 21(4) of the Psychological Healthcare Act, 2017 whereby insurers are certain to supply medical insurance coverage for the remedy of psychological sickness.

Advocate Mrinal Kanwar represented the Petitioner.

Case title – Subhash Khandelwal v. Max Bupa Well being Insurance coverage Firm Restricted & Anr. [W.P.(C) 4010/2021]