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“Can Mental Illness Be Treated Differently From Physical Illness For Medical Insurance Purposes?” [READ ORDER]

In the case of Shikha Nischal Vs. National Insurance Company Limited & Anr., the petition raises an important issue relating to insurance coverage for mental illnesses and the provision of non-discrimination qua such illnesses as enshrined in Sections 21(1)(a) and 21(4) of the Mental Healthcare Act, 2017 (hereinafter, ‘MHA, 2017’).

By: Gurleen Kaur Anand, Amity University, Mumbai.

In the present case, the petitioner was diagnosed with Schizoaffective Disorder and sought for reimbursement of the expenses incurred in her treatment. But, National Insurance Company Limited (NICL) rejected her claim on the ground that the Healthcare Policy did not cover psychiatric disorders.

Mr. Shahrukh Ejaz, ld. Counsel appearing for the Petitioner, submits that the Petitioner is clearly covered under Section 21(4) of the MHA, 2017 which provides specifically that insurance companies would not make any distinction between mental illnesses and physical illnesses.

The present petition raises issues of grave public importance. In the modern world, mental health is as important as physical health. It was in recognition of this fact that the United Nations Convention on Rights of People with Disabilities prohibited any form of discrimination in respect of mental illnesses or any other disabilities. This Convention was ratified by India on 1st October, 2007.

The Convention recognises mental disabilities as a form of disability and enshrines the principle of ‘non-discrimination’ towards such disabilities. It not only recognises the need for non-discrimination qua disabilities in general, but also specifically refers to medical insurance, under Article 25, in particular.

The said Article reads as under:

“Article 25: Health States Parties recognize that persons with disabilities have the right to the enjoyment of the highest attainable standard of health without discrimination on the basis of disability. States Parties shall take all appropriate measures to ensure access for persons with disabilities to health services that are gender sensitive, including health related rehabilitation. In particular, States Parties shall…. (e) Prohibit discrimination against persons with disabilities in the provision of health insurance, and life insurance where such insurance is permitted by national law, which shall be provided in a fair and reasonable manner.”

The crux of the above provisions clearly is that mental illnesses cannot be treated differently from physical illnesses. Insurance policies also cannot discriminate between these two types of W.P.(C) 3190/2021 Page 17 of 20 illnesses. The reasons for the non-discriminatory provisions between mental and physical illnesses are not far to seek. While physical illnesses are manifested in the human body in some form, mental illnesses do not always have visible physical manifestations. However, mental illnesses can also be debilitating and destructive.

The Court stated that it was the duty of the Insurance Regulatory and Development Authority of India (IRDAI) to fully supervise and ensure that the provision of the Mental Health Act, 2017 are implemented by all the insurance companies for the benefit of the persons who obtain Mediclaim policies.

The recent pandemic also highlights this beyond any doubt. Circumstances leading to patients requiring isolation, healthy persons being subjected to lock-downs, work from home conditions, loss of employment leading to lack of confidence for long durations have led to several mental problems. Such mental conditions need to be dealt with immediately. Availability of insurance for mental disabilities or conditions is, therefore, not only important but is an essential need.

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