Whether Non-Inclusion of Mental Illnesses Under Health Insurance Violates the Mental Health Act, 2017?

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On June 16, the Supreme Court issued a notice to the Insurance Regulatory and Development Authority (“IRDAI”). This was after a petition filed before the Court by Gaurav Kumar Bansal, a mental health activist.

Background

In August 2018, the IRDAI had, under the Mental Healthcare Act, 2017, issued a circular. The circular directed insurance companies to follow the provisions of the Act. In January 2019, Gaurav Bansal applied for the Right to Information Act. The application sought details about companies complying with the circular. He also inquired whether the Insurance Regulatory had taken any action against non-compliance. The IRDAI replied denying any compliance or actions against non-compliance.

Gaurav Kumar then filed a petition before the Apex Court. It stated that insurance companies failed to provide any coverage for mental illnesses. The petition stated that there was inaction. The inaction was hampering the rehabilitation process of a thousand patients. The petition suggested a violation of the Right to Equality and non-discrimination.

Notices Issued

The Bench led by Justice R.F. Nariman issued notices to the IRDAI. Through these notices, the Court seeks to inquire about the steps taken to give effect to the provisions of the Act. The notice was issued to the Union Health Ministry in addition to the IRDAI.

The notice comes as a much-required step, according to mental experts. It is observed that due to the lockdown amid the pandemic this has led to an increase in people suffering from mental illnesses. Illnesses such as depression, anxiety, and others have seen a spike in the past few months. In addition to issuing notices, the Court also sought affidavits from the IRDAI as well as the Central Government. The affidavits have to be filed before the next date of hearing.

Violation of the Rights

The petitioner pleaded a violation of the right to equality and non-discrimination. The right to equality and non-discrimination is provided by the Constitution of India.

Article 14 of the Constitution provides the right to equality.  It states that the State shall not deny any person equality before the law or equal protection of the laws. In addition to providing equality, the provision also elaborates upon discrimination. Article 14 provides for rights against discrimination on any ground.

Mental Healthcare Act, 2017

The Act provides for healthcare and services for persons with mental illnesses. It protects and promotes the rights of such persons, and deals with all matters relating to mental illnesses.  The Act lays down the responsibilities of the Government in providing healthcare and services for mental illnesses. It also provides for bodies such as the Central and State Mental Health Authority. These statutory bodies regulate and co-ordinate mental health services.

The Mental Health Care Act empowers accessibility to services to all suffering from mental illnesses. The Act ensures that such services are affordable and effective. It seeks to mandate the establishment of services in all districts of the country.

According to the petition, the lack of inclusion of mental illnesses by insurance companies is a violation of provisions of the Act. The provisions referred to are the ones provided under Section 21 of the Act. The section states that persons with mental illnesses shall be treated equally to persons with physical illnesses. It provides that treatment of mental illnesses should be at par with physical illnesses. Further, it elaborates upon facilities such as emergency services, living conditions, and others. It also provides specifications for the treatment of children.

The provision relevant to the petition lies in sub-section 4 of Section 21. Sub-section 4 states that every insurer shall ensure medical insurance for the treatment of mental illnesses. It also states that the insurance shall be available on the same basis as is available for physical illnesses. The provision discourages discrimination against persons with mental illnesses.

Conclusion

With the current lockdown imposed as a result of the pandemic, there has been a steady increase in the concerns about mental health. The concern also extends to illnesses and their treatment.  Over the past few years, various steps taken by the government and its regulatory bodies. However, there has been a failure to ensure that mental illnesses are treated at par. The filing of such petitions seeks to hold the governments and authorities accountable for the lack of improvement in the status quo.


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