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Mental Illness to Now Be Covered by Medical Insurance Companies

Mental Illness to Now Be Covered by Medical Insurance Companies

New Delhi: The Insurance Regulatory Development Authority of India (IRDA) has issued a circular to all insurers, saying, “Every insurer shall make provision for medical insurance for treatment of mental illness on the same basis as is available for treatment of physical illness.”

The notification comes as a major win for the community of patients, activists and doctors working on mental health in India. It means patients diagnosed with various ailments such as depression, bipolar disorder and schizophrenia, can now come forward for treatment and insurance coverage.

Their notification draws reference to India’s Mental Healthcare Act, 2017 which was passed by parliament last year and came into force this May. Section 21(4) of the Act stipulates that insurers need to include mental illness coverage as well.

IRDA has told insurance companies to comply with immediate effect.

Non-compliance by insurance companies can result in penal action against directors and CEOs of insurance companies, according to Section 109 of the Act. Punishments include a prison sentence of anything between six months to two years.

The notice is a big step forward for patients in need of mental health care services, as insurance companies behaved arbitrarily on the issue of mental health coverage. There is some ambiguity over whether pre-existing diagnoses can be covered or not, as even with physical ailments, there is currently considerable arbitrariness here across companies and across polices.

The last few years have seen considerable strides made in the area of mental health in India. India released the National Mental Health Policy and also passed the Mental Healthcare Act, 2017. Specific successes have included the decriminalisation of suicide, the allowance of patients to issue advance directives, and now this extension of insurance coverage also to the mentally ill.

Recently, the Delhi high court ruled that genetic disorders would also need to be covered by insurance companies without denials: “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.”

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