All insurance companies must offer mental health insurance, says Delhi High Court

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In India, mental health is a subject that comes with a set of stigmas, because of which many people avoid taking medical treatment. It was for this reason mental illnesses did not come under insurance purview until April 7, 2017, after which the Mental Healthcare Act (2017) was passed.  Due to growing cases of mental illness including depression, finally, it came into force on July 7, 2018, with Section 21(4) of the Act stating that “every insurer shall make provision for medical insurance for treatment of mental illness on the same basis as is available for the treatment of physical illness.” We have come a long way but still, not all insurers are covering the mental health of the insured.

Following the lag in implementation, Delhi High Court on April 19  held that all insurance companies are liable to give effect to the Mental Healthcare Act 2017 in their policies from the time it came into force in 2018 and any delay in doing so would be “contrary to the letter and spirit of the law”.

Justice Prathiba M Singh said insurance regulator IRDAI is duty-bound to supervise the insurance companies and ensure that they comply with the Act and it “cannot turn a blind eye” to non-implementation of the same.

India does not have many mental health professionals in tune with its estimated needs. According to rough estimates, there are only 0.3 psychiatrists per 100,000 people in India.

Earlier Irdai had issued a ‘negative list of exclusions stating that a person suffering from mental illness or psychological disorders or types of neurodegenerative ailments or puberty or menopause-related illness can’t be denied health insurance.

IRDAI guidelines came into effect from October 2020 widening the scope of the cover including conditions such as age-related macular degeneration, HIV, mental illnesses, enteral feedings, internal congenital, genetic diseases. Health insurance premium rates also got increased following this standardisation and widening of cover but still, a lot needs to be done from the insurers’ side to cover the gap.

The court’s directions came on a woman’s plea whose claim for reimbursement of costs for treatment of schizophrenia were rejected by the National Insurance Company Ltd on the ground that psychiatric disorders were excluded from medical cover.  The court held that her claim for Rs 6.67 lakh was reimbursable and that she was entitled to the same. The court also imposed a cost of Rs 25,000 on the insurance company to be paid to the woman for forcing her to opt for litigation to claim.

(With inputs from PTI)