Discrimination against people with mental illness on the rise

Insurance companies playing hide and seek with coverage for psychiatric issues

Published - October 10, 2021 02:00 am IST - KOCHI

A man in his 30s recently got admitted to a private hospital in Kochi for COVID-19 treatment. He was billed around ₹1.50 lakh but was denied coverage by the insurance company as he, in his honesty, admitted that he had in the past undergone treatment for a mental disorder.

Another patient who had undergone abdomen surgery at a prominent private hospital was also denied her claim in a similar manner since she suffered from bipolar disorder.

As yet another World Mental Health Day is being observed on Sunday, the fact remains that those suffering from mental illness are still being discriminated against.

“Paradoxically, the theme for this year’s observance is ‘Mental Health in an Unequal World’ even as mentally-ill patients continue to be treated unequally, and their illness is used as a ruse for denying them their rightful claims. This is a clear violation of the right to equality and protection from discrimination as laid down in the Mental Health Care Act 2017,” said noted psychiatrist C.J. John.

The Act categorically directs that “every insurer shall make provision for medical insurance for treatment of mental illness on the same basis as is available for treatment for physical illness.”

Dr. John observed that the cost of treatment for mental illness continues to be comparatively much low, and patients either do not even bother to claim it or take the matter to the court in the event of denial of claim because of the stigma associated with the illness. “Yet, they are made to further suffer by denying claims even for treatment of other illnesses,” he rued.

U. Vivek, consultant psychiatrist, lamented that years after the passage of the Act, it was being observed more in breach by a large section of insurers.

“They put up far too many hurdles to dissuade people from claiming coverage for mental illness. This amounts to violation of the Insurance Regulatory and Development Authority of India [IRDAI] notification and multiple High Court and Supreme Court rulings. While insurance companies have started allowing claims up to 25% of the treatment expenses for mental illness, it is still far from being considered on par with other medical illnesses,” said Dr. Vivek.

IRDAI via a circular in June last year had asked all insurance providers to offer coverage to persons diagnosed with mental illnesses and gave all insurance companies in the country, be it life, health or general insurers, to comply with it by October 1, 2020.

P.K. Vijayakumar, former insurance ombudsman for Kerala and Lakshadweep, recalled how for long there was even a sadistic saying in the insurance circle to the effect that ‘dental and mental’ illness may be overlooked for insurance claim.

“But since the passage of the Mental Health Care Act, people can now challenge the denial of claims in court. Insurance companies though continue to play in the grey area between ignorance and deliberate denial in the matter for their convenience,” he said.

Mr. Vijayakumar observed that it was all the more significant to cover mental illness under insurance policies considering the spike in mental health issues following the pandemic.

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