Insurancecan’texclude genetic disorders: Court

WHAT THE COURT SAID

Right to avail health insurance is integral part of right to health, as recognised in Article 21 of the Constitution Discrimination based on genetic disposition in the absence of appropriate genetic testing is unconstitutional Exclusionary clause of ‘genetic disorders’ in insurance policy is discriminatory, violates right to equality under Article 14 Regulator has to review exclusionary clause and ensure insurers do not reject claims on basis of genetic disorders

The court directed IRDA to ensure that no claims were rejected by companies on the basis of exclusionary clauses pertaining to genetic disorders, and to “re-look” into the exclusionary clauses in insurance contracts.

“Typically, any health insurance policy excludes latent, unknown diseases and pre-existing disorders. As a result of the judgment, pre-existing medical conditions are excluded except genetic disorders. Only thing, probably, (for the insurance companies to do) is to align with the judgement and continue to make pre-existing conditions as an exclusion..within that exclusion you make an exclusion for genetic disorders. That means you are opening yourself to any kind of genetic disorder... and the kind of hospitalisation costs that follow genetic disorder are extraordinary,” said K Ramchandran, an industry expert.

Justice Pratibha M Singh delivered the 47-page judgment in a plea brought by Jai Prakash Tayal, who suffered from Hypertrophic Obstructive Cardiomyopathy, seeking damages from United India Insurance Co. Ltd.