Skip to main content

Medical Insurance for Mental Treatment: Legal Angle

 Medical Insurance for Mental Treatment: Legal Angle

The whole world is developing a slew of measures to cope up with COVID-19, India is not left untouched with the increasing number of cases day by day with rising death tolls. India as a country has encouraged mass production of PPE kits to achieve self-reliance with the imposition of stricter lockdown regulations in the affected areas.

In these trying times, the Supreme Court in a remarkable judgement has issued notice to Centre and Insurance Regulatory Development Authority of India (IRDAI) for directing insurers to provide medical insurance for treatment of mentally ill patients. IRDAI's dereliction of its duties with violation of Section 24(1) of Mental Healthcare Act, 2017 raises serious questions which are left unanswered. Through this paper, the author intends to provide legal insights upon the SC order with its rationale and pressing need in the prevalent current scenario.

Significance Of This Development
people are left stranded with no family support in these pressing COVID-19 times, they become more prone to depression and anxiety issues. In our conventional society, mental illness is often portrayed as a taboo or form of seclusion from societal relations. People suffering from mental health problems are regarded as neglected part of society which are left to suffer on their own without any helping hands. Without any recourse, medical health insurance proves as a lasting resort for them to cope up with rising medical expenditures.

This proves a progressive step towards considering mental illness at par with the physical illness which will further help in providing better mental health care facilities. India's health care spending stands of 3.6% of total GDP expenditures, the lowest in comparison to other developing countries. With out of the pocket health expenses, people are not being provided with basic health facilities. This move is aimed at widening the scope of facilitating insurance coverage to needy mentally ill patients.

In these trying times of health emergencies, health insurance acts as boon for people suffering from different diseases. According to the National Mental Health Survey, mental illness cases proportionately increase with less income, low education and limited employment which form the part of widespread ramifications of COVID-19 crisis. This move will help in properly temporary relief to mentally ill people who are left stranded without any help. But despite the enactment of relevant statutory provisions, IRDAI has failed to provide directives to different insuring authorities to include mental illness as part of physical illness for a mental health insurance claim.

The cold attitude of IRDAI towards taking legal action against unregulated insurers raised serious objections about the transparency of it. This move will further help in providing insurance cover to mentally ill patients along with the imposition of action against different authorities for non-compliance of the same.

Legal Nuances
According to Section 21(4) of the Mental Health Care Act, all insurers are mandated to provide medical insurance for treatment of mental illness on a similar basis for treating physical illness. This provision was included as a result of ratification of United Nations Convention on Rights of Persons with Disabilities (UNCRPD), Article 25 of UNCRPD deals with health and its sub-clause (e) provides for prohibition of discrimination in relation to Health insurance against Persons with Disabilities.

In the recent case, the petitioner has also filed an RTI application for disseminating information of insurers who conceded to order passed by IRDAI in 2018. But in response, despite the inclusion of Section 21(4) in the Act, its implementation remains a stricter challenge as none of the insurance companies have adhered to the same.

This biased behaviour also violates the fundamental right of equality under Article 14 of the Indian constitution as mentally ill patients are disproportionately affected as the existing laws prove to be ineffective. This violation discriminates mentally ill patients as a lack of appropriate health insurance cover only increases their risks.

Critical Analysis
The IRDAI was established as a central authority to regulate the structure of the evolving insurance industry of India. But due to it the prevalent red-tapism, it has been bypassing its responsibilities for stricter implementation of Section 21(4) of MHCA, 2017. IRDAI had also issued an order in 2018 complying all insurance companies to cover mental illness under the purview of Health insurance but without continual follow up, it failed to achieve the desired purpose.

The reluctance in taking stern action against insurance companies and its casual stance for the inclusion of mental illness under the Health insurance scheme poses serious doubts upon its unaccountable behaviour. Transparency helps in enhancing the credibility of any institution but its inaction on the errant behaviour of different insurance companies provides an ideal example of iniquitousness in its functioning.

The Supreme Court has also been continuously monitoring the rehabilitation issues of thousands of people who are languishing in different hospitals despite they are fit for discharge. According to SC, rehabilitation has a wider scope and includes physical, medical, occupational and psychological services necessary for basic existence. But the irresponsible behaviour of IRDAI has excluded a multitude of people from taking benefits of health insurance scheme.

Conclusion
In these pressing times, the significance of medical treatment for mental illness become paramount for achieving better health care facilities. It is high time that IRDAI and Health Ministry should provide an extensive report regarding the compliance of Section 24(1) by different insurance companies for achieving transparency. With recent advancements, it is the hour that society should revamp its ideals to change the notion of mentally ill patients from neglected to being accepted by every section of society.


Comments

Popular posts from this blog

Section 58B of The Advocates Act - Special provision relating to certain disciplinary proceedings

 Section 58B The Advocates Act Description (1) As from the 1st day of September, 1963, every proceeding in respect of any disciplinary matter in relation to an existing advocate of a High Court shall, save as provided in the first proviso to sub-section (2), be disposed of by the State Bar Council in relation to that High Court, as if the existing advocate had been enrolled as an advocate on its roll. (2) If immediately before the said date, there is any proceeding in respect of any disciplinary matter in relation to an existing advocate pending before any High Court under the Indian Bar Councils Act, 1926 (38 of 1926), such proceeding shall stand transferred to the State Bar Council in relation to that High Court, as if it were a proceeding pending before the corresponding Bar Council under clause (c) of sub-section (1) of section 56: Provided that where in respect of any such proceeding the High Court has received the finding of a Tribunal constituted under section 11 of the Indian B

Case Laws related to Defamation in favour of ClaimantCase Laws related to Defamation in favour of Claimant. TOLLEY Vs, J.S FRY & SONS LTD – (1931) Facts The defendants were owners of chocolate manufacturing company. They advertised their products with a caricature of the claimant, who was a prominent amateur golfer, showing him with the defendants’ chocolate in his pocket while playing golf. The advertisement compared the excellence of the chocolate to the excellence of the claimant’s drive. The claimant did not consent to or knew about the advertisement. Issue The claimant alleged that the advertisement suggested that he agreed to his portrait being used for commercial purposes and for financial gain. He further claimed that the use of his image made him look like someone who prostituted his reputation for advertising purposes and was thus unworthy of his status. At trial, several golfers gave evidence to the effect that if an amateur sold himself for advertisement, he no longer maintained his amateur status and might be asked to resign from his respective club. Furthermore, there was evidence that the possible adverse effects of the caricature on the claimant’s reputation were brought to the defendants’ attention. The trial judge found that the caricature could have a defamatory meaning. The jury then found in favor of the claimant. Held The House of Lords held that in the circumstances of this case – as explained by the facts – the caricature was capable of constituting defamation. In other words, the publication could have the meaning alleged by the claimant. The Lords also ordered a new trial limited to the assessment of damages. NEWSTEAD V LANDON EXPRESS NEWSPAPER LTD, (1939) Facts: A newspaper published a defamatory article about Harold Newstead. However, another person with this name brought an action in libel. He claimed that the article had been misunderstood as leading to him. The defendant newspaper recognised that they published the article. Also, they denied that they had the intention of being defamatory of him. Consequently, the claimant argued that the newspaper was under a duty. The duty was to give a clear and complete description of the correct person. Moreover, the claimant argued that the defendants were in breach of the duty. Issues: The issue in Newstead v London Express Newspaper, was if the reasonable persons would have understood the words complained of to refer to the plaintiff. Held: The Court of Appeal stated that in accordance with the current law on libel, liability for libel does not depend on the intention of the defamer; but on the fact of the defamation. Accordingly, a reasonable man, in this case a newspaper publisher, must be aware of the possibility of individuals with the same name and must assume that the words published will be read by a reasonable man with reasonable care.

  Case Laws related to Defamation in favour of Claimant.  TOLLEY  Vs,  J.S FRY & SONS LTD – (1931) Facts The defendants were owners of chocolate manufacturing company. They advertised their products with a caricature of the claimant, who was a prominent amateur golfer, showing him with the defendants’ chocolate in his pocket while playing golf. The advertisement compared the excellence of the chocolate to the excellence of the claimant’s drive. The claimant did not consent to or knew about the advertisement.   Issue The claimant alleged that the advertisement suggested that he agreed to his portrait being used for commercial purposes and for financial gain. He further claimed that the use of his image made him look like someone who prostituted his reputation for advertising purposes and was thus unworthy of his status. At trial, several golfers gave evidence to the effect that if an amateur sold himself for advertisement, he no longer maintained his amateur status and might be aske

Rules as to delivery of goods

                             Rules as to delivery of goods Section 2(2) of Sale of Goods Act defines ‘delivery’ as a ‘voluntary transfer of possession from one person to another.’ Thus, if the transfer of goods is not voluntary and is taken by theft, by fraud, or by force, then there is no ‘delivery. Moreover, the ‘delivery’ should have the effect of putting the goods in possession of the buyer. The essence of the delivery is a voluntary transfer of possession of goods from one person to another. There is no delivery of goods where they are obtained at pistol point or theft. 1. Mode of Delivery: According to Section 33, delivery of goods sold may be made by doing anything which the parties agree shall be treated as delivery or which has the effect of putting the goods in the possession of the buyer or of any person authorized to hold them on his behalf. Delivery of goods may be actual, symbolic or constructive. 2. Expenses of Delivery: According to Section 36(5), unless otherwise agree