Bombay High Court
Jigisha Manoj Yadav vs The Union Of India And 5 Ors. on 22 January, 2026
Author: Bharati Dangre
Bench: Bharati Dangre, R.N.Laddha
2026:BHC-OS:2205-DB
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Salgaonkar
Digitally signed by MANDIRA
IN THE HIGH COURT OF JUDICATURE AT BOMBAY
MANDIRA MILIND MILIND SALGAONKAR
SALGAONKAR Date: 2026.01.27 15:36:26
+0530
ORDINARY ORIGINAL CIVIL JURISDICTION
WRIT PETITION NO.1627 OF 2021
Hemangi Nilesh Modi .. Petitioner
Versus
The Union of India through the .. Respondents
Ministry of Home Affairs & Ors.
WITH
WRIT PETITION NO.1710 OF 2021
Jigisha Manoj Yadav .. Petitioner
Versus
The Union of India through the .. Respondents
Ministry of Home Affairs & Ors.
...
Mr.Fredun Devitre, Senior Advocate and Mr.Kirti Munshi,
Senior Advocate with Mr.Chaitanya Mehta and Ms.Sonali
Agarwal i/b Dhruva Liladhar and Company for the Petitioner
in both the Petitions.
Mr.D.P.Singh for the Respondent No.1-Union of India in both
the Petitions.
Mr.Milind More, Additional Government Pleader with
Ms.Manisha Gawade, AGP for the State-Respondent No.2.
Mr.Shrinivas Bhave for the Respondent No.3 in both the
Petitions.
Ms.Jyoti Mhatre with Ms.Anuja Tirmali i/b Ms.Komal Punjabi
for the Respondent No.4-MCGM.
Ms.Kalpana Trivedi with Ms.Yashika Jain for the Respondent
No.5 in WP/1710/21.
Ms.Fatima Khan h/f G.N.Shenoy for the Respondent No.6 in
both the Petitions.
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CORAM: BHARATI DANGRE &
R.N.LADDHA, JJ.
DATE : 22nd JANUARY, 2026
...
JUDGMENT (Per Bharati Dangre, J.) :-
1. The global Covid pandemic, popularly known as 'Coronavirus' caused by Severe Acute Respiratory Syndrome Coronavirus 2 ( SARS-CoV-2) began with an outbreak in Wuhan, China in December 2019. Soon afterwards it spread to other part of the globe and engulfed the entire world in early 2020. The World Health Organisation ("WHO") declared the outbreak, a public health emergency of international concern on 30/01/2020 and assessed it as pandemic on 11/03/2020.
India was not an exception, as the first cases of Covid-19 were reported on 30/01/2020 in Kerala as three Indian medical students returned from Wuhan, the epicenter of pandemic. Lock-down was announced in Kerala to be followed by rest of the country and there was a peak in the infection rate, so much so that in mid September of 2020, 90000 cases were reported per day. Gradually, there was drop in the number of infections, but after a small respite, a second waive began in March, 2021, much harsher and devastating than the first. The medical infrastructure in the country was put to test with surge in number of cases being contrasted with the shortage of vaccines, hospital beds, oxygen cylinders and other medical supplies. By April, 2021, India became the highest country to report over 400,000 new cases in twenty- four hour period. However, with the concerted efforts including implementation of the vaccination programe, the ::: Uploaded on - 27/01/2026 ::: Downloaded on - 30/01/2026 21:38:18 ::: 3/23 WP-1627-21+1.odt pandemic was brought in control, though not completely eradicated.
2. The two Petitions before us are filed in the year 2021 by the two Petitioners finding themselves in different situations, both being infected by the virus, and they are aggrieved by the action on part of the Respondents denying them the coverage of the 'HealthGain' Insurance Policy, under which they were insured and denial of the benefit flowing from the decision of the Government, has constrained them to approach the Court.
Jigisha Manoj Yadav, the Petitioner in Writ Petition No.1710 of 2021 is a health worker, indulged in providing health services at Criticare Hospital, Andheri and in discharge of her duties, she contracted the virus, which called for her admission in Bombay Hospital and Medical Research Centre, a private hospital situated at Marine Lines, Mumbai, where she received treatment between 26th April and 6th May,2020.
Jigisha was covered by 'HealthGain' Insurance Policy purchased by her husband for the entire family in May 2009, being renewed from time to time and the policy was active for the year 2020-21, covering the expenses incurred for the treatment, when she contracted Covid. It is her specific case that while offering services at Criticare Hospital at Andheri, she tested positive for Covid on 24/04/2020 and was admitted in Balasaheb Thackeray Trauma Hospital, but on account of lack of facility, she was shifted to Bombay Hospital on 26/04/2020 and was discharged on being treated in Respondent No.6-Hospital. At the time of her discharge, the hospital charged her for Rs.2,61,643/- and she was furnished ::: Uploaded on - 27/01/2026 ::: Downloaded on - 30/01/2026 21:38:18 ::: 4/23 WP-1627-21+1.odt the detailed bill, which included the ICU charges, cost of medicine, nursing care charges, doctor visit charges and the charges for Personal Protection Equipment ('PPE') Kit (Non- Sterile) in the sum of Rs.7,500/- per day and on one occasion to the tune of Rs.10,000/- for a day.
As the family of the Petitioner managed to arrange for some money, she prayed that the unpaid bill of Rs.1,65,000/- is beyond her capacity, though she was able to settle an amount of Rs.71,000/- for her nine days treatment. She prayed for waiving of the payment towards PPE kits, masks, gloves i.e. consumable bill for nine days. Further, she addressed a communication to the Hon'ble the Chief Minister of Maharashtra State as well as the Health Ministry, where she relied upon the newspaper articles reflecting that the Government of Maharashtra had directed not to charge the Covid patients in private hospital and, therefore, she requested for waiving of the consumable bill.
It is the grievance of the Petitioner that the State Government adopted a policy of treating Covid patients free of costs, as the news article reflected that in Mumbai, 52000 out of 60000 Covid-19 patients have received free care under Mahatma Jyotiba Phule Jan Arogya Yojana ('MJPJAY') in empanelled hospital. The Petition, therefore, seek two fold reliefs, either to extend the cover of MJPJAY to her and reimburse the entire cost of her hospitalization and treatment for Covid 19, including the charges of PPE kits, masks, gloves and necessary material or direct Respondent Nos.3 and 5 to cover the charges towards PPE kits, masks and gloves as a part of the insurance scheme.
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3. Hemangi Nilesh Modi, the Petitioner in Writ Petition No.1627 of 2021 is also a beneficiary of 'Health Guard' policy from Respondent No.5-Bajaj Alllianz General Insurance Company Ltd. in the year 2017, which was renewed from time to time.
Since she contracted Covid, she was admitted to Bombay Hospital on 01/04/2020 and this information was furnished to the Insurance Company by the Petitioner's Insurance Agent. It is the claim of the Petitioner that on her discharge on 05/04/2020, the hospital raised a bill on her in the sum of Rs.4,44,213/- and out of the same, a sum of Rs.69,998/- was paid by Respondent No.5-the Insurer, leaving a deficit of Rs.3,74,225/-, which was borne by the Petitioner. The balance amount, though mainly consisting of cost of PPE kits, masks, gloves and such other items used by the hospital staff for the Petitioner's treatment, was not paid by the insurer and deducted this cost from the claim amount. According to the Petitioner, out of the sum of Rs.3,74,225/-, which was disallowed by the insurer, an amount of Rs.3,42,750/- approximately is the cost of consumable items like PPE kits, masks, gloves etc. The Petitioner is aggrieved by this wrongful deduction made by Respondent No.5-insurer, though the said items are covered in the existing policy of which the Petitioner is the beneficiary.
4. We have heard learned senior counsel Mr.Fredun Devitre alongwith senior counsel Mr.Kirti Munshi for the Petitioner in both the Petitions.
::: Uploaded on - 27/01/2026 ::: Downloaded on - 30/01/2026 21:38:18 :::6/23 WP-1627-21+1.odt The reliefs in the Petitions are contested by Mr.D.P.Singh representing the Union of India and by Mr.Milind More, learned Additional Government Pleader with Ms.Manisha Gawade, A.G.P. for the State.
The Insurance Regulatory & Development Authority of India ("IRDAI") is represented by Mr.Shrinivas Bhave, whereas Ms.Jyoti Mhatre has marked her presence for MCGM. Ms.Kalpana Tiwari has appeared for the Reliance General Insurance Company Ltd., Respondent No.5 in Writ Petition No.1710 of 2021, whereas Mr.S.R.Singh represented Bajaj Allianz General Insurance Company Ltd., Respondent No.5 in Writ Petition No.1627 of 2021.
5. Both the Petitions are admitted by the Division Bench on 14/08/2020, being registered as WP-LD-VC 296 of 2020 and WP-LD-VC- 295 of 2020, by granting liberty to the Respondents to file their response and the pleadings to be completed. Accordingly, the contesting Respondents have filed their response and by consent of the learned counsel for the respective parties, we have heard the Petitions finally.
6. The Respondents to the Petitions are the Union of India through the Ministry of Home Affairs as well as the State of Maharashtra. In addition, IRDAI, established under the Insurance Regulatory & Development Authority Act, 1999 is impleaded as Respondent No.3, which is the authority established to protect interests of holders of insurance policies and to regulate, promote and ensure the orderly growth of the insurance and reinsurance business in India.
::: Uploaded on - 27/01/2026 ::: Downloaded on - 30/01/2026 21:38:18 :::7/23 WP-1627-21+1.odt In the wake of the Covid pandemic on 04/03/2020, IRDAI issued guidelines to all insurers for handling of claims reported under Coronavirus and it was directed that where coverage is granted for treatment of hospitalization expenses, in order to alleviate the hardships that may be caused to the policyholders, all claims reported under corona virus shall be handled as per the following norms :-
"(i)Where hospitalization is covered in a product, insurers shall ensure that the cases related to Corona virus disease (COVID-19) shall be expeditiously handled.
(ii) The costs of admissible medial expenses during the course of treatment including the treatment during quarantine period shall be settled in accordance to the applicable terms and conditions of policy contract and the extant regulatory framework.
(iii) All the claims reported under COVID 19 shall be thoroughly reviewed by the claims review committee before repudiating the claims."
The guidelines also provided that for the purpose of meeting health insurance requirements of various sections, insurers are advised to design products covering the costs of treatment of Corona Virus and the above instructions issued under the provisions of Section 14(2)(e) of IRDA Act, 1999 were directed to come into force with immediate effect.
7. The aforesaid guidelines were followed by the guidelines issued on 23/06/2020 by IRDAI for introduction of short term health insurance policies providing coverage for Covid-19 disease, it being the need of the hour and all the insurers (Life, General and Health Insurers) were allowed to offer COVID-19 specific short term health insurance policies subject to the guidelines prescribed.
::: Uploaded on - 27/01/2026 ::: Downloaded on - 30/01/2026 21:38:18 :::8/23 WP-1627-21+1.odt The aforesaid guidelines permitted short term health policies to be offered both, as individual or group products for a minimum period of three months and a maximum term of eleven months with an optional cover that enhance the health insurance coverage for the very said duration.
The aforesaid policy was followed by another guidelines issued by IRDAI in form of Guidelines on Covid Standard Health Policy on 26/06/2020.
The Preamble of the Guidelines highlighted and provided thus :-
"A.1. In view of the global pandemic Covid 19, the Authority has decided to mandate all general and health insurers to offer Individual Covid Standard Health Policy with the following objectives:
* To have a Covid specific product addressing basic health insurance needs of insuring public related to Covid. * To have a standard product with common policy wordings across the industry
2. Towards this, the following Guidelines on Covid Standard Health Policy are issued under the provisions of Section 34 (1) (a) of Insurance Act, 1938.
3. All general and health insurers shall offer the Covid Standard Health Policy by duty complying with the following guidelines.
4. The Covid Standard Health Policy shall have One Basic mandatory cover as specified in these Guidelines which shall be uniform across all General and Health Insurers.
5. One Optional Cover specified in these Guidelines, shall be offered along with the Covid Standard Health Policy within the sum insured. The total amount payable in respect of Covers B (I) (11) (12) (13) (14) (15) and B(II) (18) shall not exceed 100% of the Sum Insured during a policy period. The premium payable towards this Optional Cover shall be specified separately so as to enable policyholders to choose and pay based on the need.
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7. The Base Cover of Covid Standard Health Policy shall be offered on Indemnity basis whereas Optional Cover shall be made available on Benefit Basis.
8. The Covid Standard Health Policy shall offer a policy tenure of three and half months (3 ½ months), six and half months (6 ½ months), and nine and half months (9 ½ months) including waiting period.
9. Every General and Standalone Health Insurer, who has been issued a Certificate of Registration to transact General and/or Health Insurance Business, shall mandatorily offer this product.
However, if any insurer is currently not offering health insurance products at all, the above stipulation will not apply to those.
10. The Covid Standard Health Policy shall comply with all the provisions of Insurance Regulatory and Development Authority of India (IRDAI) (Health Insurance) Regulations, 2016, all other applicable Regulations, Guidelines on Standardization in Health Insurance (Ref: IRDA/HLT/REG/CIR/146/07/2016) dated 29th July, 2016, Guidelines on Product Filing in Health Insurance Business (Ref: IRDA/HLT/REG/CIR/150/07/2016) dated 29th July, 2016, Guidelines on Standardization of Exclusions in Health Insurance Contracts (Ref: IRDAI/HLT/REG/CIR/177/09/2019) dated 27 th September, 2019 and other applicable Guidelines as amended from time to time."
The guidelines provided that the Covid Standard Health Policy shall have one basic mandatory cover, which shall be uniform across all General and Health Insurers.
8. The 'Base Cover' as per the Covid Standard Health Policy provided for the following :-
"a) Room, Boarding, Nursing Expenses as provided by the Hospital/Nursing Home.
b) Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist Fees (including consultation through telemedicine as per Telemedicine Practice Guideline of 25th March 2020) whether paid directly to the treating doctor /surgeon or to the hospital.
c) Anesthesia, blood, oxygen, operation theatre charges, surgical appliances, ventilator charges, medicines and drugs, costs towards diagnostics, diagnostic imaging modalities, PPE Kit, gloves, mask and such other similar expenses (Expenses on Hospitalization for a minimum period of 24 hours are admissible.)
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e) Expenses incurred on road Ambulance subject to a maximum of Rs.2000/- per hospitalization.
9. The guidelines also directed the Insurer to cover the costs of treatment of Covid incurred by the Insured person on availing treatment at home maximum upto fourteen days with the specifications provided therein.
In addition, the guidelines also provided for Optional cover and directed the company to pay 0.5% of sum insured per day for each twenty-four hours of continuous hospitalization for treatment of Covid following an admissible hospitalization claim under the policy, the benefit being payable maximum upto fifteen days during a policy period in respect of every insured person.
10. The aforesaid guidelines were accompanied with 'Corona Kavach' Policy floated by Respondent No.5, which was introduced as a contract of insurance to cover the insured persons, the policy being based on the statements and declaration provided in the proposal Form by the proposer and is subject to receipt of the requisite premium.
The Corona Kavach Policy defined various terms and the base cover in form of in-built policy benefits to be made available to all insured persons provided for Covid Hospitalization Cover, as the company shall indemnify the medical expenses incurred for hospitalization of the insured during the policy period for the treatment of Covid on positive diagnosis of Covid in a Government authorized diagnostic centre, including the expenses incurred on treatment of any comorbidity alongwith the treatment for Covid upto the sum ::: Uploaded on - 27/01/2026 ::: Downloaded on - 30/01/2026 21:38:18 ::: 11/23 WP-1627-21+1.odt insured and it covered anesthesia, blood, oxygen, operation theatre charges, surgical appliances, ventilator charges, medicines and drugs and costs towards diagnostics, diagnostic imaging modalities, PPE kit, gloves, mask and such other similar expenses.
The policy also provided for specific exclusions of expenses like in case of investigation and evaluation, rest cure, rehabilitation and respite care etc. The policy has enlisted the items for which the coverage is not available and this include 59 items, but PPE kit is not included.
List III enlisted the items that are subsumed in procedure charges, which includes 23 items, whereas List IV enlisted the items to be subsumed in the costs of treatment, which include vaccination charges, urine container, HIV kit, nutrition planning charges/dietician charges etc.
11. With these guidelines issued by Respondent No.3, which is an authority established to protect the interests of holders of insurance policies and to regulate, promote and ensure the orderly growth of the insurance and reinsurance business, is empowered to exercise the power and function to protect the interest of policy holders in the matters concerning the policy, settlement of insurance claim etc. The guidelines,being issued by the Authority in exercise of its statutory function, necessarily bind the insurance companies.
12. In both the cases, the Petitioners are aggrieved by non- adherence to the guidelines, as the insurance companies under ::: Uploaded on - 27/01/2026 ::: Downloaded on - 30/01/2026 21:38:18 ::: 12/23 WP-1627-21+1.odt which they were covered, denied them the coverage for PPE kits, gloves, masks, which was the essential part of the Covid treatment. As far as Hemangi Modi is concerned, the insurer admitted and paid the claim only to the extent of Rs.69,998/- and the balance amount of the total bill of Rs.4,44,213/-, included a sum of Rs.3,42,750/- being the cost of PPE kits, masks, gloves. The claim has been refused to the Petitioner on the ground that there was no circular by IRDAI about PPE kits masks and gloves and they were 'non medical expenses'. As far as other Petitioner-Jigisha is concerned, the insurance company only paid Rs.71,171/- out of the total bill of Rs.2,61,643/- and out of the disallowed amount, as per the insurance company, the amount of Rs.1,65,000/- was towards PPE kits, masks and gloves, being disposable items for non medical use and not covered in the policy.
13. Mr.Devitre, the learned senior counsel, by inviting our attention to the guidelines issued by the IRDAI dated 23/06/2020 providing for Covid Standard Health Policy, would submit that it has covered PPE kits, gloves, masks and such other similar expenses, but with a clarification that they would be applicable only from 10th July, 2020, and since the Petitioner-Hemangi was hospitalized before this date, she is denied the benefit of the expenses towards PPE kits. It is his submission that the 'Health Guard' policy of the Petitioner did not exclude the PPE kit, which all the while is considered as part of the treatment and by inviting our attention to the term 'Medically Necessary Treatment', he would submit that it would cover any treatment, tests, medication, or stay in ::: Uploaded on - 27/01/2026 ::: Downloaded on - 30/01/2026 21:38:18 ::: 13/23 WP-1627-21+1.odt hospital or part of a stay in the hospital, which is required for the medical management of illness or injury suffered by the insured, provided it is prescribed by a medical practitioner and must confirm to the professional standards widely accepted in international medical practice or by the medical community in India.
The new policy, however, mandated the insurers to offer the product on or before 10/07/2020 and according to Mr.Devitre, this cut-off date has no rationale, as IRDAI mandated insurers to offer the Standard Covid Policy, which cover hospitalization, including the coverage of cost of PPE kits, masks and gloves from 10/07/2020, and it unreasonably excluded the existing policy holders from the benefit of the said cost being covered by the policies that were operative, when the Covid was declared as pandemic in February-March, 2020.
According to him, the policy created two classes i.e. those who required hospitalization for the treatment of Covid after its outbreak in the month of February-March, 2020 and those, who received treatment prior to 10/07/2020 and those who required hospitalization for treating Covid, but after 10/07/2020. Mr.Devitre would place reliance upon the decision of this Court in the case of Bombay Municipal Pensioner's Association Vs. Municipal Corporation of Greater Bombay1 to urge that a cut-off date prescribed by an authority, which has the power to specify a date prospectively or retrospectively from which the newly introduced benefits should be conferred, cannot be completely arbitrary or unreasonable, as the State has no right to pick and choose a 1 1994 Mh.L.J. 1458 ::: Uploaded on - 27/01/2026 ::: Downloaded on - 30/01/2026 21:38:18 ::: 14/23 WP-1627-21+1.odt date out of its hat. According to him, if the cut-off date is to be prescribed, it should be so set out in a reasonable manner, having regard to all relevant facts and circumstances, which should justify it, but in no case, the date should be fixed in such a manner, that it would bring about discrimination between the persons similarly situated. According to him, the selection of date of '10/07/2020' by the authority, making it mandatory for the insurers to offer Covid Health policies covering the cost of PPE kits, masks, gloves from that date onwards is arbitrary with no rational basis, as even before this date, the Covid protocols remained the same. In any case, it is the submission of Mr.Devitre that never ever did the policy excluded PPE kits, gloves and masks. He would submit that a contract of insurance must be construed having regard to the larger public policy and public interest and the 'Health Guard' policy in force on the date of the Petitioner's hospitalization, otherwise provided that on hospitalization, the insurer shall pay the 'reasonable and customary medical expenses', including inter alia payment towards anesthesia, blood, oxygen, surgical appliances and such similar expenses that are 'medically necessary' and though some of the items were clearly specified therein, the clause was kept open ended to cover such expenses that are medically necessary and the policy specifically provide the heads, which were not covered, but PPE kit is not included in the category of exclusion, as there was exclusion qua the "all non-medical items" as per List II.
14. Mr.Munshi, the learned senior counsel, who adopts the similar line of argument as Mr.Devitre, would place reliance ::: Uploaded on - 27/01/2026 ::: Downloaded on - 30/01/2026 21:38:18 ::: 15/23 WP-1627-21+1.odt upon the decision of the Apex Court in the case of United India Insurance Company Limited Vs. Manubhai Dharmasinhbhai Gajera & Ors.2, where it is held that the policy floated by the insurance company must offer a fair deal and all the terms and conditions of the offer must be transparent and there should not be any hidden agenda. It also categorically held in paragraph 35 as below :
"35. ....When, however, the terms of the new product or revised product require the approval of the Insurance Regulatory and Development Authority, prima facie, the same would mean that they are fair and reasonable. The action on the part of the Authority is not a question. Regulations, guidelines and circulars are binding on the insurance companies."
Mr.Munshi would further submit that the Apex Court has drawn a distinction between the private player in the field and public sector insurance companies, as a private player is bound by the statutory regulations operating in the field but the public sector insurance companies are also bound by the directions issued by the General Insurance Corporation as also the Central Government and they cannot ignore the same.
15. The learned counsel appearing for the insurance companies would submit that the insurance policy is a contingent contract, where an insurer promises to compensate an insured for financial losses or damages or extend the benefit in exchange of regular payments called premiums, covering uncertain future events like accidents, illness or death and is built on principles of indemnity, utmost good faith and insurable interest. The contract of insurance outlines responsibility, conditions, coverage and the policy term 2 (2008) 10 SCC 404 ::: Uploaded on - 27/01/2026 ::: Downloaded on - 30/01/2026 21:38:18 ::: 16/23 WP-1627-21+1.odt creates a financial safeguard against the risk, with the actual document detailing the terms of the policy. As premium is a fixed sum paid by the insured for coverage, it is the contention advanced on behalf of the insurance company that an insured will be covered as per the premium paid and if an item is not covered by the premium, no benefit can be claimed. In short, the defence adopted by the insurance companies is, that the contract was fixed and either an item falls within the same or it cannot, but in any case, it is not open to re-write the contract and, therefore, the item which is not covered within the policy could not be catered to and that is the specific reason, why in both the cases, the claim of insurance did not cover the expenses incurred towards the PPE kits, gloves etc.
16. In the conspectus of the matter, it is worth to note that Coronavirus (Covid 19) pandemic, being a global outbreak of an infectious disease caused by Severe Acute Respiratory Syndrome, had profound impact on the world causing millions of death, overwhelming health care systems and disrupting societies and economies throughout the world. When Covid broke, the entire world including the medical fraternity, was not well equipped as for a while everyone was grappling in the dark.
Judicial notice can be taken of the fact that in the initial days, a mechanism of quarantining a Covid patient and the persons who had come in his close proximity, was considered to be a most appropriate way of curbing the transmission of the virus. Lock-down was considered to be one of the most effective manner in which its spread could have been curbed as people, who had contracted Covid, were required to be kept ::: Uploaded on - 27/01/2026 ::: Downloaded on - 30/01/2026 21:38:18 ::: 17/23 WP-1627-21+1.odt away from the uninfected people and this strategy of lock-down was widely accepted throughout the world.
17. While dealing with the patients, who required hospitalization, a balance had to be struck, as it was necessary to offer them the medical treatment by hospitalizing them and offering medication and caring from them. However, on the other hand, it was also necessary to keep the health workers catering to them equally safe. This gave rise to an invention of Personal Protective Equipment (PPE) aimed to create barrier between the virus/germs and the health worker or the person, who came in contact with the person who was infected with Covid. This kit reduced the chance of touching, being exposed to and spreading of the germs. This equipment could be in form of protective clothing/garment or in any other form to prevent further transmission of the virus and it would include masks, face shields, protective helmets etc. All the equipments ultimately reduced exposure to the hazard of the virus and was considered to be a necessary part of the treatment, as it could prevent spread of the virus even to the health care workers, who were performing their duties in the hospital, treating the infected patients.
Personal Protective Equipment (PPE) was considered necessary and integral part of treatment of Coronavirus. A patient, who had to be picked up from his home and brought to a quarantine facility set up in form of hospital or any other place or he had to be brought to the hospital for administering treatment necessarily had to be assisted, but in order to avoid his contact with the health worker, who was assisting him to ::: Uploaded on - 27/01/2026 ::: Downloaded on - 30/01/2026 21:38:18 ::: 18/23 WP-1627-21+1.odt be taken to such facility, had to be protected and the only way was wearing a PPE kit, which could reduce the chances of the uninfected person, being infected by virus, which the Corona patient was carrying. It is also well known that the health workers operating in the hospitals, dispensaries and quarantine facilities, who cared for Corona patients, continued to wear PPE kits throughout, their working hours so as to insulate themselves from the infected patients and the virus which they would transmit, would affect large number of health workers, leaving few of them to actually take care of the Corona patients.
18. There can be no doubt about the fact that PPE is an essential element in treating the patients infected with Corona and this is the specific reason that the guidelines issued by IRDAI, which introduced Health Insurance Policies providing coverage for Covid-19 diseases, insured the base cover as a part of the Covid Standard Health Policy and while it included the Covid hospitalization expenses incurred by the insured person for treatment of Covid, on its positive diagnosis in Government authorized diagnostic centre, it covered room, boarding, nursing expenses as well as the cost of surgeon, anesthetists, medical practitioner, consultant etc. The base cover also extended to anesthesia, blood, oxygen, operation theatre charges, surgical appliances, ventilator charges, medicines and drugs, costs towards diagnostics, and also included PPE Kit, gloves, mask and such other similar expenses.
PPE kits, gloves, masks etc. were considered to be integral part of the expenses incurred during hospitalization, ::: Uploaded on - 27/01/2026 ::: Downloaded on - 30/01/2026 21:38:18 ::: 19/23 WP-1627-21+1.odt as it was compulsory for the doctors as well as the hospital staff to put on their protective gear in form of PPE kit, gloves, masks and IRDAI considered it to be a necessary element in the hospitalization expenses that would be incurred which were covered by the insurance policy. It is not in dispute that this policy, however, was made applicable from 10/07/2020 and those patients, who were hospitalized and received treatment before the said date, were not held entitled to have reimbursement of the claim towards PPE kit, gloves, masks etc. This is what is objected to by the Petitioners, as it is the specific contention advanced that cut-off date of 10/07/2020 has no rationale, to the object that is sought to be achieved.
19. It is trite position in law that any decision by the State Authority must meet parameters of Article 14 of the Constitution of India, based on the principle of equality and that it do not bring about discrimination between similarly situated persons. It is not open for the State to pick and choose a date for implementation of its decision out of its hat at its own whims and fancies, but when it prescribe a date for the applicability of its policy, it must have regard to the relevant facts and circumstances, and in any case, while it apply the same, it shall not result into two distinct classes of similarly situated persons, as it would then amount to discrimination. It is not that the State is not empowered to classify the similarly situated persons, but if it desire to do so, it must do so based on an intelligible differentia, which has a nexus to the object sought to be achieved by it and if it fails to satisfy the twin test, ::: Uploaded on - 27/01/2026 ::: Downloaded on - 30/01/2026 21:38:18 ::: 20/23 WP-1627-21+1.odt then such a classification cannot be sustained and shall be discriminatory and liable to be struck down. While fixing up a date for applicability of the policy, either prospectively or retrospectively, such date must be specified in a reasonable manner, without bringing about a discrimination between the similarly situated persons and the date shall not be an artificial date creating two different classes, which are not possible to be separated without any rationale.
Reliance placed by Mr.Devitre on the decision in the case of Bombay Municipal Pensioner's Association (supra) is most apt and relevant, as it is held that the choice of cut-off date by an authority must be made in a reasonable manner, after considering all reasonable facts and circumstances and the date should not be drawn in such a manner, so as to discriminate between the persons similarly situated.
20. In the case before us specifying that those insured, who had used the PPE kits and gloves during the course of treatment after 10/07/2020 will be covered by the insurance policy, but not those who were hospitalized before 10/07/2020, although their bill covered hefty expenses towards PPE kits, according to us, there is no intelligible differentia, as we find that they belong to the same class i.e. class of Covid patients, who are insured and who have paid premiums and when they are hospitalized, the insurance company has undertaken to indemnify them against the expenses that have been incurred in the course of the treatment. PPE kits, being admittedly essential part of the treatment and hospitalization which the Authority has also now accepted, and therefore, has issued ::: Uploaded on - 27/01/2026 ::: Downloaded on - 30/01/2026 21:38:18 ::: 21/23 WP-1627-21+1.odt guidelines covering PPE kits, gloves, masks etc., we see no reason why the Petitioners should be deprived of the same.
It is also pertinent to note that the 'Health Guard' policy which the Petitioners had taken, which otherwise cover the in- patient hospitalization treatment, including room, boarding and nursing expenses, ICU expenses, expenses of surgeon, anesthetist, medical practitioners, consultants etc.. The Health Guard Gold Plan also cover items like anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines and drugs, dialysis, chemotherapy, x-ray, laboratory diagnostic tests and such similar expenses that are 'medically necessary'. The annexure to the policy clearly stated that the description is illustrative and not exhaustive.
The policy also carved out the items which are not covered and PPE kits and gloves are not definitely excluded from the policy.
Since the coverage of the policy, agreed to pay in respect of an admissible claim, any or all of the following covers, subject to the sum insured, limits, terms,conditions and definitions and the coverage covered in-patient hospitalization treatment, without having a specific inclusion of PPE kits, masks, gloves etc., but definitely even not being excluded, with the term used 'such similar expenses that are medically necessary', according to us, do not justify exclusion from the amount of bill, which has computed the cost of PPE kits, masks, gloves etc.
21. When we perused the medical bill of the hospital in cases of both the patients, we find that the patient is charged for PPE ::: Uploaded on - 27/01/2026 ::: Downloaded on - 30/01/2026 21:38:18 ::: 22/23 WP-1627-21+1.odt kits on everyday, with a hefty sum and since these PPE kits were used by the doctors and the medical staff in the hospital, the charge is shifted to the patient, but its use was extremely essential, to keep the health staff being insulated against the Covid virus, and similarly to prevent the patient being further infected by any other infection coming from the medical health facility.
We find it extremely difficult to accept that PPE kits are non clinical items and in ordinary circumstances, it may be, but for the Covid pandemic, which was considered to have its spread through droplets of saliva or any particles coming out from sneezing or coughing by an Covid positive patient, it was the PPE kit which acted as barrier and prevented the user, from being infected. The most essential feature of the system and life saver for the community being the doctors and health care workers, and we find absolutely no justification in creating discrimination between the patients, who were admitted and during their treatment, the PPE kits were used had a cut-off date as 10/07/2020 and those who were charged for the PPE kits before the cut-off date, were not held to be covered in the policy.
22. As far as Jigisha Yadav, the Petitioner in Writ Petition No.1710 of 2020 is concerned, she in fact was a health worker and contracted Covid while she was on her duty and she had to suffer and fight Corona, because she was offering help and assistance to the patients in a dispensary. In fact, it should have been the State Government who should have come forward and compensated her and borne expenses for her ::: Uploaded on - 27/01/2026 ::: Downloaded on - 30/01/2026 21:38:18 ::: 23/23 WP-1627-21+1.odt treatment, but unfortunately, it failed to step in. In this case, we could have also directed the State Government to bear the expenses of medical treatment of Jigisha, a health worker who came directly in contact with Covid patient, but since we find that she was insured, we declare that the insurance claim necessarily cover 'expenses that are medically necessary' and being declared that PPE kits/masks/gloves were very much essential part of the medical treatment for Covid 19, we deem it appropriate to grant relief in both the Petitions, by directing the insurance companies-Bajaj Alllianz General Insurance Company Ltd. (Respondent No.5 in WP/1627/21) and The Reliance General Insurance Company Ltd. (Respondent No.5 in WP/1710/21) to reimburse the entire cost of hospitalization of the Petitioners for treatment of Covid 19, including the charges for PPE kits, masks, gloves to which the Petitioners have been charged by the Bombay Hospital.
As we are informed that the insurance companies in both the cases have paid part of the claim and the remaining was borne by the Petitioners, we direct the insurance companies to reimburse the amount shown towards PPE kits, gloves and masks as reflected in the Bills raised by Respondent No.6, in favour of the Petitioners as a part of their existing policy within a period of six weeks from today.
The Petitions are made absolute in the aforesaid terms.
(R.N.LADDHA, J.) (BHARATI DANGRE, J.)
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