The Bombay High Court today issued notices to 25 non-life insurance companies on a PIL seeking pre-packaged compensation for 42 ailments, covered under medical insurance policies, on the basis of sum insured and on the type of the hospital.
The notices were issued by a bench headed by Chief Justice Mohit Shah on a PIL filed by social worker Gaurang Damani detailing hardships faced by mediclaim policy-holders.
"We are not here to decide individual matters but we want the consumers to benefit. They should know in advance how much package would they get to undergo treatment for a particular illness. This will enable an insured to decide in which hospital he may undergo treatment," said the bench.
The court had earlier asked Insurance Regulator and Development Authority (IRDA) to come out with pre-packaged compensation for the ailments covered under the medical insurance policies. The court had asked IRDA to include such guidelines in the regulations framed by it this year.
However, IRDA, today, moved a chambers summons saying such a step was practically not possible to implement.
General Insurance Council (GIC), which represents collective interests of the non-life insurance companies in the country, said that 25 such insurance companies should be made respondents to this petition.
The GIC said there should be uniformity in packages offered in insurance policies. It demanded that a regulator should be appointed to regulate the hospitals because in the existing scenario different hospitals were charging varying amounts for treating patients for the same kind of illness. The petitioner argued that there was a provision in the Clinical Establishments (Registration and Regulation) Act to appoint a regulator to regulate the hospitals. Yet, IRDA had not appointed such an authority.
In the interest of consumers and policy holders, a regulator should be appointed, he urged the court.
The petitioner submitted that "there have been instances where patients, who have undergone the same kind of treatment at the same hospital, have been disbursed different insurance amounts. If pre-packaging was made available, then the insured can also choose the kind of hospital in which he wants to be treated," his petition said.