Many healthcare policies are structured in a way that excludes genetic disorders from the benefits of the health system. This is unfair and violates the Indian Constitution.
In a landmark ruling, Justice Pratibha M Singh declared that it is unconstitutional for companies to deny health insurance to individuals suffering from genetic disorders. The Delhi High Court declared that this practice is descriminatory, stating that such exclusion relies on a type of categorisation which is “writ with ambiguity and vagueness”. The Court determined that, “The fact (is) that there are different types of genetic disorders and even common diseases like diabetes and cardiac diseases could be included in the broad definition, and makes the exclusion vulnerable. In effect, it would mean that large swathes of the population would be excluded from availing health insurance…”
Owing to India’s high birth rate, the country must deal with a sizeable population of infants born every year who carry genetic disorders. Almost half a million have malformations and about 21,000 have Down syndrome.
In a large complex country like India, it is important that all individuals are given equal rights. This is especially true when it comes to healthcare. Exclusionary practices in this area clearly violate Articles 14 and 21 of the Constitution. Article 14 is concerned with the Right to Equality, while Article 21 reads, “No person shall be deprived of his life or personal liberty except according to a procedure established by law.”
It is understood that the Right to Life implies a right to a healthy life, as was determined in the case Sunil Batra v. Delhi Administration. In this case, the Supreme Court stated that individuals must be guaranteed a right to enjoy all the facilities of the human body in its prime condition. However, the ruling also stated that firms are free to structure their policies in a way that requires rigorous tests which might exclude individuals on the basis of genetic conditions.
However, according to industry expert K Ramchandran there is still a way around this for insurers. “Typically, any health insurance policy excludes latent, unknown diseases and pre-existing disorders. As a result of the judgement, 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.”
In its latest decision, the court also called out the callous manner in which the unclear term ‘genetic disorders’ is being misused by many insurance companies. This ought to have been supervised by the Insurance Regulatory Development Authority of India (IRDAI), which is tasked with regulating insurance policies. The court has called upon the agency to ensure that no claims were rejected based on such biased clauses.
It is unfair that this insurance system existed in the first place. Those individuals who are affected by genetic conditions need help the most, and to exclude them from health care benefits is unreasonable. The government should ensure that this ruling by the court is followed through with and that much-needed change is implemented.
