Breaking: Clauses in insurance policies excluding genetic disorders violate Art. 14, Delhi HC

In a landmark judgment, the Delhi High Court has ruled that Right to Health Insurance is an integral part of the right to health and healthcare as recognised by Article 21 of the Constitution. Hence, exclusionary clauses in insurance policies seeking to exclude “genetic disorders” are too broad and ambiguous, and consequently, unconstitutional..The judgment was rendered by Justice Pratibha M Singh in an insurance claim by one Jai Prakash Tayal against United India Assurance..Tayal, who was suffering from Hypertrophic Obstructive Cardiomyopathy, was denied his insurance claim on the ground that the said condition was genetic, and genetic diseases were not payable as per the policy..The Trial Court had ruled in favour of Tayal, holding that there cannot be a discriminatory clause against those persons who suffer from genetic disorders and that they are entitled to medical insurance..This led to the appeal in High Court..The High Court considered at length the scope of “genetic disorders”, laws and norms in various foreign jurisdictions and the Indian position, before holding the following:.Right to avail health insurance is an integral part of the Right to Healthcare and the Right to Health, as recognised in Art. 21 of the Constitution;Discrimination in health insurance against individuals based on their genetic disposition or genetic heritage, in the absence of appropriate genetic testing and laying down of intelligible differentia, is Unconstitutional;The broad exclusion of “genetic disorders” is thus not merely a contractual issue between the insurance company and the insured but spills into the broader canvas of Right to Health. There appears to be an urgent need to frame a proper framework to prevent against genetic discrimination as also to protect collection, preservation and confidentiality of genetic data. Insurance companies are free to structure their contracts based on reasonable and intelligible factors which should not be arbitrary and in any case cannot be “exclusionary”. Such contracts have to be based on empirical testing and data and cannot be simply on the basis of subjective or vague factors. It is for lawmakers to take the necessary steps in this regard.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;Insurance Regulatory Development Authority of India (IRDA) is directed to re-look at the Exclusionary clauses in insurance contracts and ensure that insurance companies do not reject claims on the basis of exclusions relating to genetic disorders..Read the judgment below.