Persons with disabilities are entitled to health insurance coverage, and IRDAI must ensure insurance products are designed for them.

JUDGMENT

Prathiba M. Singh, J.(Oral)

1. This hearing has been done through hybrid mode.

C.M No. 12950/2023 in W.P.(C) 6074/2019

2. At the outset, Mr. Pradeep K Bakshi, ld. Counsel for Respondent No. 1 submits that name of Max Bupa Health. Co. Ltd, Respondent No. 1 has been changed to Niva Bupa Health Insurance Company Limited (hereinafter `Niva Bupa'). Therefore, an application being C.M. No. 12950/2023 which is not listed today has been moved for change of name of Respondent No. 1.

3. Let the said application be brought on record. Considering that the same is a formal application, the application is allowed.

4. The name of the Respondent No. 1 shall now be reflected as Niva Bupa Health Insurance Company Limited. The amended memo of parties be filed by the Petitioner within one week.

W.P.(C) 6074/2019

5. The present petition has been preferred by Mr. Saurabh Shukla who is suffering from Tetraplegia and paralysis below his chest due to a spinal cord injury which he had suffered in 2011. His physical condition is such that he is confined to a wheelchair and has limited use of his arms. Despite this injury, as recorded in the previous order, he is an investment banking professional, employed with a hedge fund and works from home.

6. The grievance of the Petitioner is that he had approached two insurance companies namely Max Bupa Health Insurance Co. Ltd. and Oriental Insurance Limited seeking medi-claim/health insurance. However, he was initially denied health insurance by both the insurance companies. The Petitioner was then constrained to approach the Court of the Chief Commissioner for Disabilities, which took up the matter with the Chairperson, Insurance Regulatory and Development Authority of India (IRDAI) and also obtained the response from IRDAI. However, the same continued to linger on and the Petitioner was unable to obtain a health insurance policy.

7. This Court, vide previous order dated 13th December, 2022 had after considering the entire matter and hearing the submissions of all the ld. Counsels for the parties, directed as under:

"24. In the background of this case, the manner in which both the insurance companies have simply rejected the proposal of the Petitioner that too with cryptic rejection letters is disconcerting. The Petitioner is a person who is working as an investment professional who can afford an insurance policy by paying a reasonable premium. Irrespective of the economic standing of a person with disability, insurance coverage cannot be rejected or refused.

25. Under these circumstances, this Court is of the opinion that there is no doubt that persons with disabilities would be entitled to health insurance coverage and products would have to be designed to enable them to obtain health insurance coverage.

26. In view of the above discussion the following directions are issued:

i. The IRDAI, shall call a meeting of all insurance companies to ensure that the products are designed for persons with disabilities and other persons in terms of the circular dated 2nd June, 2020. The process of designing such products shall be supervised by the IRDAI and it shall be ensured that the said products are introduced on an early date, preferably within two months.

ii. The Petitioner is permitted to approach Max Bupa Health Insurance Co. Ltd. & Oriental Insurance Co. Ltd., once again. The two insurance providers shall consider the case of the Petitioner for issuance of a health insurance policy and the question of extending insurance to the Petitioner shall be reviewed. A proposal shall be placed on record by the next date of hearing.

iii. Immediate steps shall be taken by the IRDAI to modify the terminology `sub-standard lives' in their Regulations so as to ensure that such unacceptable terminology is not used in its Regulations or other documents while referring to persons with disabilities.

27. Let a status report be filed on behalf of the IRDAI and the insurance companies at least two weeks before the next date of