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Bombay High Court

A.B.C vs Insurance Regulatory And Development ... on 5 April, 2022

Author: Madhav J. Jamdar

Bench: G.S. Patel, Madhav J. Jamdar

                                                                   919-OSWPL-13251-2021.DOC




                   Ashwini



                        IN THE HIGH COURT OF JUDICATURE AT BOMBAY
                              ORDINARY ORIGINAL CIVIL JURISDICTION
                                 WRIT PETITION (L) NO. 13251 OF 2021


                   ABC                                                        ...Petitioner
                         Versus
                   Insurance Regulatory and Development Authority          ...Respondents
                   of India & Ors


                   Mr Aditya R Iyer, with Advait Helekar, for the Petitioner.
                   Ms Komal Shah, i/b Bhave & Co, for Respondent No. 1.
                   Mr Rahul Karnik, with Jinal Rathi, for Respondent No. 2.


                                           CORAM        G.S. Patel &
                                                        Madhav J. Jamdar, JJ.

                                           DATED:       5th April 2022
                   PC:-


ASHWINI

1. We are thoroughly dissatisfied with the approach of the 1st HULGOJI GAJAKOSH Respondent and 2nd Respondent. The 1st Respondent's Affidavit in Digitally signed Reply is a completely unnecessary disquisition on the theory of by ASHWINI HULGOJI GAJAKOSH insurance. That is not what we believe is necessary in this Petition. Date: 2022.04.06 19:33:15 +0530 The 2nd Respondent, a private insurer, seems to have taken a line that it is entitle to reject the case of the Petitioner (who has a mental health condition) allegedly on the ground that this is a "prior or pre- existing medical condition". This betrays a complete lack of understanding of mental health care to begin with. Prima facie, it is Page 1 of 3 5th April 2022 919-OSWPL-13251-2021.DOC contrary to several provisions of Mental Health Care Act 2017 including Section 21.

2. The Petitioner has filed an Additional Affidavit that shows the payment of a renewal premium pro-rata. A copy of this Affidavit is to be served on the Advocates for Respondents Nos. 1 to 3.

3. By the next occasion, we expect a detailed Affidavit by Respondents Nos. 1 and 2 on specifically and only on the question of:

(a) the directions, if any, issued by the 1st Respondent to all insurers, public and private, in regard to providing insurance cover for mental health care issues;

(b) what are the exclusions from coverage accepted by the 1st Respondent;

(c) an explanation from 2nd Respondent as to how the stand that it has now taken regarding pre-existing conditions can be reconciled with Section 21 of the Mental Heath Care Act 2017 and with what the 2nd Respondent itself said at 'Exhibit H' when it disclosed its underwriting philosophy inter alia in regard to disabilities and mental illness.

4. The Affidavits of the 1st Respondent and 2nd Respondent are to be filed and served on or before 10th June 2022.

5th April 2022 919-OSWPL-13251-2021.DOC

5. Issue notice to Respondent No. 3, returnable on 21st June 2022.

6. In the meantime, the 3rd Respondent, a Public Sector Insurance Company has not responded and has remained absent throughout. So that there is no break in coverage, we direct the 3rd Respondent to extend the coverage until the next date. The 3rd Respondent will act on being furnished with an ordinary or digitally signed copy of this order.

(Madhav J. Jamdar, J) (G. S. Patel, J) Page 3 of 3 5th April 2022