No discrimination between physical & mental illness in medical claims: Jharkhand HC


Ranchi, Feb 11 (IANS): In a significant ruling, the Jharkhand High Court has held that expenses incurred for the treatment of mental illness cannot be excluded from medical claims. No company can discriminate between physical and mental illnesses while settling medical claims for current or retired employees.

The verdict was delivered by Justice Ananda Sen while hearing a petition filed by a retired executive of Bharat Coking Coal Limited (BCCL), a subsidiary of Coal India.

The court directed the BCCL to reimburse the medical expenses incurred for the mental health treatment of the petitioner’s wife.

BCCL had initially refused the claim, citing provisions under the "Contributory Post Retirement Medicare Scheme (CPRMS) for Executives of CIL and its Subsidiaries," which did not cover mental illness treatment.

However, the court ruled that such an exclusion violates Section 21 of the Mental Healthcare Act, 2017, which explicitly prohibits discrimination between physical and mental illnesses in healthcare coverage.

Quoting the Act, the court stated that insurers must offer the same health insurance benefits for mental illnesses as they do for physical conditions. “No health insurance policy can exclude coverage for mental health treatment under the Government of India’s law,” the judgment emphasised.

The court noted that the existing medical insurance scheme in Coal India and its subsidiaries lacks provisions for mental illness treatment, which contradicts the Mental Healthcare Act.

Furthermore, the court asserted, "Coal India Limited and its subsidiaries fall under the definition of 'State' as per Article 12 of the Constitution. No policy or resolution they adopt can override a parliamentary law. Any provision contrary to such a law will be deemed invalid."

The Court noted that CPRMS was adopted in 2008, prior to the enactment of the Mental Healthcare Act, 2017.

It held, “I hold and declare that after the promulgation of Mental Healthcare Act, 2017 and especially taking into consideration Section 21(4) of the Act, exclusion of psychiatric treatment in CPRMS is rendered nugatory."

This ruling reinforces legal protections for mental health treatment, ensuring parity in medical claims across all health conditions.

 

  

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Title: No discrimination between physical & mental illness in medical claims: Jharkhand HC



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