Introduction

The case of Saurabh Shukla v. Max Bupa Health Insurance Co. Ltd. And Others was adjudicated in the Delhi High Court on December 13, 2022. Mr. Saurabh Shukla, a professional afflicted with Tetraplegia due to a spinal cord injury sustained in 2011, faced refusal from two prominent health insurance companies—Max Bupa Health Insurance Co. Ltd. and Oriental Insurance Co. Ltd.—to issue him a health insurance policy. Confined to a wheelchair with limited arm mobility, Mr. Shukla continues his professional endeavors from home, highlighting his capability and need for adequate health coverage. The primary legal question revolved around the denial of health insurance to a person with disabilities and whether such an act constituted discrimination under existing laws and regulations.

Summary of the Judgment

The Delhi High Court quashed the refusals by Max Bupa Health Insurance and Oriental Insurance to issue health insurance to Mr. Saurabh Shukla. The court held that denying health insurance to a person with disabilities without proper consideration of individual circumstances constitutes discrimination, thereby violating the Rights of Persons with Disabilities Act, 2016 (RPwD Act) and the United Nations Convention on the Rights of Persons with Disabilities, 2006. The court directed the Insurance Regulatory and Development Authority of India (IRDAI) to supervise insurance companies in designing inclusive health insurance products and mandated the immediate reconsideration of Mr. Shukla’s application.

Analysis

Precedents Cited

The judgment referenced several key precedents that informed the court’s decision:

• C.E.S.C. Limited v. Subhash Chandra Bose (1992): Affirmed that the right to health encompasses medical care and facilities, vital for social security and economic productivity.
• Vikas Gupta v. Union of India (2009): Established that disability cannot be a basis for discrimination in insurance, emphasizing individual risk assessment rather than blanket classifications.
• Shikha Nischal v. National Insurance Company Ltd. (2021): Highlighted that mental illnesses should not be discriminated against in insurance policies, aligning with broader non-discrimination principles.

Legal Reasoning

The court's legal reasoning was grounded in both domestic and international laws that prohibit discrimination against persons with disabilities. Key elements of the reasoning include:

• Rights of Persons with Disabilities Act, 2016: Sections 3, 25, and 26 clearly prohibit discrimination in healthcare and related services, including insurance.
• United Nations Convention on the Rights of Persons with Disabilities, 2006: Article 25 mandates non-discriminatory access to health insurance.
• IRDAI (Insurance Regulatory and Development Authority of India) Regulations, 2016: Regulations 8(b) and 8(c) require insurers to extend coverage to sub-standard lives, which includes persons with disabilities, ensuring that denial of coverage is a last resort.
• The court criticized the IRDAI for not enforcing its regulations effectively, noting a disconnect between policy and implementation.

Impact

This judgment has significant implications for the insurance industry and persons with disabilities in India:

• Insurance Industry: Insurers are compelled to reevaluate and redesign their health insurance products to ensure inclusivity, avoiding discriminatory practices against persons with disabilities.
• Regulatory Oversight: The IRDAI is under obligation to actively supervise and enforce regulations that promote non-discrimination, ensuring compliance from all insurance entities.
• Future Legal Precedents: The case sets a precedent reinforcing the prohibition of discrimination in health insurance, potentially influencing similar judgments and policies in the future.
• Empowerment of Persons with Disabilities: Enhances the rights and access to essential health services for individuals with disabilities, promoting equality and social justice.

Complex Concepts Simplified

Underwriting Policies

Underwriting in insurance involves assessing the risk of insuring a potential client. An Underwriting Policy outlines the criteria and processes insurers use to evaluate whether to accept, modify, or deny an insurance application based on the applicant's health conditions and other risk factors.

Sub-Standard Lives

The term "sub-standard lives" refers to individuals who are considered higher risk due to certain health conditions or disabilities. However, this terminology is criticized for being insensitive and discriminatory, as it categorizes persons with disabilities as inherently less standard or more risky.

Rights of Persons with Disabilities Act, 2016

The RPwD Act is a comprehensive legislation in India that aims to protect the rights and dignity of persons with disabilities. It ensures equal opportunities, non-discrimination, and accessibility in various spheres, including healthcare and insurance.

IRDAI Regulations

The Insurance Regulatory and Development Authority of India (IRDAI) formulates regulations to govern the insurance sector. The 2016 Health Insurance Regulations require insurers to offer coverage to all individuals, including those with disabilities, ensuring that denial of coverage is only a last resort after exploring all feasible options.

Conclusion

The Delhi High Court's judgment in Saurabh Shukla v. Max Bupa Health Insurance Co. Ltd. And Others reinforces the fundamental principle of non-discrimination in health insurance for persons with disabilities. By mandating insurance companies to develop inclusive policies and directing regulatory bodies to enforce these standards, the court has significantly advanced the rights of persons with disabilities in accessing essential healthcare services. This landmark decision not only sets a robust legal precedent but also propels the insurance industry towards greater inclusivity and social responsibility, aligning with both national laws and international human rights conventions.