Pranali Vyas, a 2nd year law student of Pravin Gandhi College of Law discusses the need for insurance policies to cover the important issue of mental health.

INTRODUCTION:

Mental health issues are more prevalent in conflict-affected areas. Given the large numbers of people in need and the humanitarian imperative to reduce suffering, there is an urgent need to implement scalable mental health interventions to address this burden.[1] In light of the ongoing pandemic, making means meet one’s ends is but a distant dream. These adverse effects strike not only the economically weaker sections but also the middle class who strive to live a sustainable life. COVID-19 has had a serious impact on people’s socio-economic and mental health. Human beings are social animals, and separating them from society would have dire psychological consequences. Hence, making provisions for psychological illnesses under insurance policies during this pandemic and in perpetuity is imperative as it eases the financial burden on patients and their families in difficult times. 

LEGAL PROVISIONS:

In India, the Insurance Regulatory and Development Authority (IRDA) regulates insurance-related schemes and provides rules and regulations to govern the same.[2] The Mental Health Act, 2017[3] (hereinafter ‘the said act’) aims at destigmatizing this tabooed topic along with creating awareness about it. In India, mental health lies buried under the superficial layer of well-being; it is considered a figment of imagination rather than a result of any suppression.  

Recently, the Supreme Court had issued a notice to the IRDA and the Centre regarding a PIL seeking inclusion of mental health to be considered under insurance policies.[4] The Petitioner, Gaurav Bansal, has urged the Supreme Court to take action on this matter by establishing that Sec. 21(4) of the said act talks about the Right to equality and non-discrimination. He also placed reliance on an IRDA order in August 2018, stating the above. However, none of the insurance companies have complied with it and extended the scope of the illnesses under their respective policies.

Sec. 21(4) of the act talks about the Right to equality and non-discrimination. It states that every insurer should make medical insurance provisions to treat mental illness the same way they do for physical illness.[5]

Analyzing the provisions outlined in this section, emphasis on mental illness is included in insurance policies is widely expressed. With the evolving times and technology, humans are becoming more susceptible to mental strains. To provide them with a sense of security, these laws are laid down. Non-compliance with these laws shows badly on the company’s part, which works in the insurance sector. The essence of insuring something lies in the fact that the possessions in question are valuable; insurance acts as a contingency plan. Hence, the mind being the most valued asset of an individual should, without a doubt, be insured against unforeseeable or foreseeable circumstances. Clause 4 of this section explicitly provides for equality in treatment for physical and mental illness.

Insurance is an important tool with the help of which one can be excused from paying complete medical costs. It guarantees access to the proper treatment required to get well. While opting for any type of medical insurance, the following factors should be kept in mind:

  • Affordability- Comparing monthly premiums, deductibles, co-pays, and/or co-insurance for surety of the best deal available. On should consider the payment per month as well as how much money is needed to pay co-pays and co-insurance.
  • Availability of mental health professionals- Ensure there is a broad range of mental health professionals included in the health plan’s network of providers. Some mental health professionals do not take insurance. Therefore, an individual should check to see what the insurance plan will pay for out of network providers.
  • Coverage of prescription medications- If a person has found the right medication to treat their illness, they should find a plan covering that medication to maintain wellness.
  • Limits on the number of mental health-related office visits- Some health plans place limits on the number of office visits for things like therapy. Hence, choosing a plan that allows the number of visits is of utmost importance.[6] 

CONSTITUTIONAL PROVISIONS:

The Constitution incorporates provisions guaranteeing everyone’s right to the highest attainable standard of physical and mental health.[7] Art. 21 guarantees the Right to life and liberty to all citizens of the country.[8] The Supreme Court has held that the Right to live with human dignity, enshrined in Article 21, derives from the directive principles of state policy and therefore includes the protection of health.[9] Hence, it is safe to equate mental health with physical health for the convenience and better interpretation of laws. 

Adv. Gaurav Bansal through his petition[10] brings out that due to the red tape attitude of the IRDA, provisions of the said act are not being complied with. This matter holds great significance as health experts have said that the lockdown amid the COVID pandemic has led to a rise in cases of depression and anxiety. He further argued that the Parliament had treated mental health at par with physical health after due consideration emanating from their wisdom.[11] But still, non-compliance is observed on the part of these insurance companies. As a result, they are hampering several patients’ lives due to the incompetence/laid back attitude of the IRDA in strictly implementing these rules and regulations. For this, the Petitioner suggests an effective remedy of penalizing them for their non-compliant behavior.

FOREIGN PERSPECTIVE:

In these times, the pandemic has not targeted particular regions but has plagued the entire world. In countries like Canada, The Canadian Mental Health Association collects games, craft supplies, and more to engage their patients and members during COVID-19 to help them cope.[12] Apart from this, Governments around the world are urged to get on board and employ the various tools of the state to provide targeted support to groups of individuals identified as needing this support, informed by sound scientific evidence, to prevent a pervasive mental health crisis in the future. [13]

CONCLUSION:

The facts being in black and white, it is high time that insurance companies consider bringing mental illness under the scope of insurance. The Judiciary, as well as many public-spirited persons, have sought to achieve this goal through PILs and reinforcement of court orders, but being a democratic society, success is only possible if all the citizens and companies that work for the benefit of these citizens function in harmony keeping in mind the betterment of the people and upliftment of society as a whole.


Pranali Vyas is a Second year law student from Pravin Gandhi College of Law, Mumbai.


[1]Fiona Charlson,  Mark van Ommeren, Abraham Flaxman,  Joseph Cornett,  Prof Harvey Whiteford, Shekhar Saxena, New WHO prevalence estimates of mental disorders in conflict settings: a systematic review and meta-analysis, THE LANCET(June 11, 2019), https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30934-1/fulltext.

[2]Insurance Regulatory and Development Authority https://www.irdai.gov.in/.

[3]Mental Healthcare Act 2017.

[4]Samanwaya Rautray, SC wants mental illness to be covered by insurance companies as provided in law, ECONOMIC TIMES (Jun. 21, 2020, 2:30 PM), https://economictimes.indiatimes.com/wealth/personal-finance-news/why-not-give-insurance-cover-for-mental-illness-sc-to-centre-irdai/articleshow/76400702.cms

[5]Mental Healthcare Act, 2017 §21(4).

[6]Understanding Health Insurance, NATIONAL ALLIANCE ON MENTAL ILLNESS, https://www.nami.org/Your-Journey/Individuals-with-Mental-Illness/Understanding-Health Insurance#:~:text=Insurance%20is%20a%20crucial%20tool%20that%20can%20grant,from%20paying%20the%20full%20cost%20of%20medical%20services.

[7]K Mathiharan, The fundamental right to health care, Vol. 11 No. 4, INDIAN JOURNAL OF MEDICAL ETHICS,(2003),https://ijme.in/articles/the-fundamental-right-to-health care/?galley=html#:~:text=Article%2021%20of%20the%20Constitution%20guarantees%20protection%20of,policy%20and%20therefore%20includes%20protection%20of%20health%20%284%29.

[8]INDIAN CONST. Art. 21.

[9]Bandhua Mukti Morcha v. Union of India AIR 1984 SC 802.

[10]Gaurav Kumar Bansal v. Union of India and Another, 2020.

[11]Ibid.

[12]Natalie Fournier, ‘This is an extreme’: Canadian Mental Health Association adjusts amid coronavirus pandemic, GLOBAL NEWS (Jun. 21, 2020, 4:40 PM), https://globalnews.ca/news/7034954/coronavirus-covid-19-mental-health-cmha-halifax-dartmouth/

[13]Rita Corser, COVID-19: Dealing With The Post-Pandemic Mental Health Crisis, VANGUARD (Jun. 21, 2020, 4:42), https://www.vanguardngr.com/2020/05/covid-19-dealing-with-the-post-pandemic-mental-health-crisis/.

IMPORTANT – Opinions expressed in this article are the sole responsibility of the author and do not necessarily reflect the views of IJOSLCA.

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