Insurance policies

Insurance law and mental health – Need to overhaul current insurance policies

There were times in India when mental health or mental disabilities were not covered by health insurance. In health, all importance was given to physical health and mental health was always ignored. Even health insurance companies have never included mental health in their insurance policies.

During this ongoing corona pandemic, the most worrying topic is people’s mental health. Many Bollywood celebrities like Anushka Sharma, Deepika Padukone etc. talked about mental health and its impact on daily life. Why go far, we are all aware of the death of Sushant Singh Rajput. Previously, people suffering from any kind of mental illness did not wish to talk about it and felt ashamed of it, but now, with increased awareness, people’s thinking is changing positively. According to a recent study, one in 20 people in India, including children, suffer from mental illness.

In this modern era, can you imagine health insurance that does not cover cancer, high blood pressure, heart disease, etc.? ? The answer would certainly be a resounding “NO”, but mental illness has never been included in such a list. With all this attention that mental health has gained, it has become of vital importance for the Indian Insurance Regulatory and Development Authority to cover mental health or illness under health insurance. This move blurs the line between physical and mental health.

The Mental Health Care Act 2017 made it compulsory for all insurance companies to cover medical insurance for the treatment of mental health or mental illness of sufferers, in the same way as physical illness is covered. Now, with increased awareness and knowledge among people, they are opening up about mental illness. Therefore, the Insurance Regulatory and Development Authority of India (IRDAI) has found it important to cover mental health and mental illnesses under health insurance.

In accordance with IRDAI regulations, psychological disorders, mental illnesses, stress and neurological illnesses are covered by health insurance. This stage of IRDAI will certainly ensure a progressive life and holistic development for people with mental illness, thereby reducing the financial burden on families and promoting maximum client benefits and access to better health facilities.

Here, it is important to note that this law is not applicable to all people suffering from mental illness. In order to determine mental illness, the law stipulates to comply with nationally and internationally accepted medical standards. The basic benefits of mental illness coverage by health insurance are to provide cashless treatment for anyone suffering from mental illness and also to cover all pre and post hospitalization costs resulting in reduced burden. family finances.

We know that there are always certain exclusions in general health insurance, in the same way there are certain exclusions in mental illness insurance. The definition of mental illness under the Mental Health Care Act 2017 does not mention the inclusion of mental retardation of any kind and consequences arising from the influence of alcohol or drugs. It is extremely important that the person taking out the insurance is aware of all these exclusions in order to avoid a claim rejection by the company in the future.

In Gaurav Kumar Bansal V Union of India and Ors, the court observed that no action was taken by the Insurance Regulatory and Development Authority of India (IRDAI) for the implementation of its own circulars, and that no insurance company had followed such IRDAI circulars. Thus, the court sent a notice to the authorities concerned, instructing them to carefully consider the matter and take the necessary measures in favor of people suffering from mental illness.

Mental illness has been considered a disgrace for years. People were never ready to talk about their mental health. People have always emphasized physical illness rather than mental illness. Thus, this initiative of the IRDAI and the law on mental health care ensures a better life for the person affected as well as for the members of his family by covering all hospitalization costs and by giving access to state-of-the-art care structures. But the need of the hour is to take strict measures for law enforcement and circulars by IRDAI.