'Cannot force firms to provide insurance for particular illness'

The Delhi High Court was Wednesday informed by the General Insurance Council of India that insurance companies can not be compelled to provide insurance cover for any particular illness.

A division bench of Chief Justice G. Rohini and Justice P.S. Teji was told that there were no legal provisions which create an obligation on the insurance companies to provide insurance against their wishes. The court was hearing a public interest litigation (PIl) seeking necessary health policies by insurance companies or health schemes by government bodies be made available for babies with birth defects.

The PIl filed by Sanjay Kulshrestha, a paediatric surgeon, also sought some guidelines for management of babies having birth defects and congenital diseases in order to reduce the high neonatal mortality rate in India. Filing an affidavit, General Insurance Council of India said insurance contracts are essentially a commercial contract between insurance company and the insured, based on specific terms and conditions of the agreement and no insurance companies can be directed by courts to issue any health policy for any particular illness or ailment against their wishes.

"The companies can not be compelled to provide insurance cover to persons suffering from a particular disease, which in the present case is congenital diseases or birth defects in children a new born," the affidavit stated. The plea said it has been observed that in cases of newborns and foetuses having some congenital anomalies or birth defects, various health insurance companies and government organisations were making clear-cut discriminations.

"Almost all insurance companies have not extended any medical insurance facility or policy for treatment of various newborn diseases, including birth defects during or after pregnancy," it said. The plea said the discrimination by various insurance agencies indirectly encourages parents to opt for abortion in case some birth defect is detected during pregnancy.

Aborting foetuses because they may be disabled sends an implicit message of rejection to people with disabilities as if they are no more required in this world and they have no right to live, though this is not true in 80 percent of cases as babies lead a completely normal life after operation, the plea said. The plea sought direction to the government to ensure universal health insurance policies for medical and surgical diseases for foetuses, newborns and children during pregnancy and after delivery. 

It said that around four percent of newborns have some major congenital anomalies (approximately five lakh babies per year) and account for 8-15 per cent of pre-natal deaths and 13-16 percent neonatal deaths in India.