HC Seeks IRDAI Explanation On Denial Of Insurance Cover To People Suffering From Congenital Anomalies

New Delhi: The Delhi High Court has asked the Insurance Regulatory and Development Authority (IRDAI) to explain the reason for not granting insurance cover to people suffering from congenital anomalies. Congenital disorders, also known as congenital diseases or birth defects, are conditions present from birth.

“What is the objection to giving insurance cover to them,” a bench of Chief Justice Rajendra Menon and Justice V K Rao asked the IRDAI.

The bench has sought the response of General Insurance Council and the Life Insurance Council, which represent the entities that carry on the business of general and life insurance, before the next date of hearing on December 17.

This came after a petition was filed by Nipun Malhotra challenging the arbitrary and illegal mechanism adopted by the IRDAI in denying the rights of Person with Disability to seek insurance cover for themselves. It contended that their conditions are categorized under the scope of “congenital anomalies”, as defined under a July 29, 2016 circular by the regulator.

In the petition, Malhotra, a disability rights activist who suffers from locomotor disability from birth, asked for the removal of congenital anomalies, like an external or internal abnormality in the womb, from the list of general exclusions in the health or life insurance policies.

He has also sought direction to take a relook at the exclusionary clauses in insurance contracts and ensure that insurance companies do not reject claims on the basis of exclusions related to congenital anomalies.

In his petition filed through advocate Jai Dehadrai, he has said the effect of the circular and regulations was that PwDs found it next to impossible to seek insurance cover when undergoing any health-related complications.


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