October 20, 2018:

Delhi High Court has asked the Insurance Regulatory & Development Authority (IRDAI) to "explain the reasonableness" of not granting insurance cover to people suffering from congenital anomalies.

Bench comprising of Chief Justice Rajendra Menon & Justice V K Rao asked the IRDAI,"What is the objection to giving insurance cover to them (people suffering from congenital anomalies)?" and sought its response before the next date of hearing which is December 17.

Court has said to the insurance regulator to give the justification for such exclusion.

Bench also issued notices to the General Insurance Council & the Life Insurance Council, which represent the entities that carry on the business of General & Life Insurance respectively, and sought their stand on the issue before the next date.

Court was hearing a PIL seeking directions to the Centre, the IRDAI & Insurance Companies to remove congenital anomalies, like external or internal abnormality in the womb, from the list of general exclusions in the Health or Life Insurance Policies.

The petition filed by Nipun Malhotra, has challenged the "arbitrary" & "illegal" mechanisms adopted by the IRDAI in denying the rights of Persons with Disabilities (PwD) to seek insurance cover for themselves on the ground that their conditions are categorized under the scope of "congenital anomalies."

Congenital anomalies are also known as birth defects and could be caused by single gene defects, chromosomal disorders, multi factorial inheritance, environmental teratogens and micronutrient deficiencies.

Malhotra, a disability Rights Activist who suffers from loco motor disability from birth, has sought a direction to the IRDAI to remove the phrase 'congenital anomalies' from the standardized definition of the 2016 circulars.

He has also sought direction to take a re-look at the exclusionary clauses in insurance contracts & ensure that Insurance Companies do not reject claims on the basis of exclusions related to congenital anomalies.

In his petition filed, he has said the effect of the circular & regulations was that PwDs found it next to impossible to seek insurance cover, when undergoing any health related complications.

Source: PTI

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