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Tuesday, March 20, 2018

Health insurers cannot reject claims on basis of exclusions related to genetic disorders: IRDAI

The Insurance Regulatory and Development Authority of India (IRDAI) has directed insurers not to reject claims on the basis of exclusions related to genetic disorders. In a recent judgement in the matter of United India Insurance Company Ltd Vs Jai Parkash Tayal, the Delhi High Court had held that the exclusionary clause of ‘Genetic Disorders’ in the insurance policy “is too broad, ambiguous and discriminatory – hence violative of Article 14 of the Constitution of India.’’
It also directed Insurance Regulatory and Development Authority of India (IRDAI) to re-look the exclusionary clauses in insurance contracts and ensure that insurance companies do not reject claims on the basis of exclusions relating to genetic disorders. “Thus, in pursuance of the directions of Hon’ble High Court all insurance companies offering contracts of health insurance are hereby directed that no claim in respect of any existing health insurance policy shall be rejected based on exclusions related to ‘Genetic Disorder’,’’ IRDAI said in an order.
All insurance companies are directed by the regulator not to include ‘Genetic Disorders’ as one of the exclusions in new health insurance policies issued in respect of all their existing health insurance products and also in the new products launched and/ or filed under the provisions of Guidelines on Product Filing in Health Insurance Business.

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