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Will Supreme Court take Action?
Insurance Firms Continue to go Against the SC Ruling on Pre-Existing Diseases

In May 2008, the Supreme Court had ruled that “public sector insurance companies cannot refuse to provide medical cover policies to those suffering from pre-existing diseases,” and said such an action was “arbitrary, illegal and unconstitutional.” The court also stated that the elderly can’t be denied medical insurance on the pretext of frequent hospitalization and higher reimbursement claims.

Unfortunately, the Indian health insurance industry has failed on the directives miserably. Cases after cases are coming up of insured patients being denied insurance through either outright or through extended documentation formalities. The industry is estimated to be around Rs.51.25 billion and is expected to become a $280 billion industry by 2020. But around 75% of expenditure on healthcare in India is still being met by the ‘out-of-pocket’ category and merely 10% of the population today has health insurance.

In the French insurance system, “The more ill a person becomes, the less the person pays.” The Commonwealth Fund, in its 2007 survey, “Mirror, Mirror on the Wall”, found that Australia, New Zealand, UK, Germany and Canada have better insurance facilities with universal health insurance coverage. Australia ensures free universal access to hospital treatment and subsidised out-of-hospital medical treatment. UK’s National Health Service (NHS) provides coverage to everyone normally residing in UK.

India, though, refuses to change, despite being an economy with ‘better’ prospects. Last year, Supreme Court found that in spite of the its directive to private hospitals to reserve 33% inhouse beds and 40% of OPD for poor patients, these hospitals were not complying. Delhi HC imposed a fine of Rs.2 lakh on Indraprastha Apollo Hospital. It is time for the Supreme Court to act in a much harsher manner against insurance firms.

By:- Sray Agarwal

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