IMPORTANCE OF MEDICLAIM POLICY

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This article has been written by Samridhi Prakash from Symbiosis Law School, Noida

(In reference to Advocates)

BACKGROUND

The concept of ‘Mediclaim’ was introduced in India in the year of 1986, offering minimum coverage of Rs. 15,000 and a maximum of Rs. 5 lakhs. For the employees in the government sector, the Central Government Health Insurance Scheme was launched, while for the people employed in the private sector, Employees State Insurance Scheme was introduced to cater to their medical necessities. The idea envisaged was narrow in scope and extent, providing minimal insurance relief-only to individuals and their families. There was capping on every relief offered through these policies. With the opening of the market in the 1990s and introduction of diverse economic reforms, health insurance schemes too, witnessed drastic advancement. Removal of sub-limits, entry of private players in the medical sector, increased life expectancy, reforms in the varieties of policies offered- all these factors helped influence the public, pushing them to try various health insurance schemes. Moreover, in 2001, IRDA (Insurance Regulatory & Development Authority) introduced third party administrators, facilitating the set-up between hospitals and companies by providing cashless provisions on their products. With the advancement of technology and the growth of the IT sector as well as the service sector and the wide spectrum of life-style diseases, chronic diseases, critical illnesses etc. plaguing our generation, the need for health insurances and life insurances have taken the market by frenzy.

IMPORTANCE/ NEED FOR MEDICLAIM POLICY

Bearing the current pandemic in mind, as well as the illnesses afflicting our society due to the life-style we pursue, the importance of health insurance cover can be recognised and realised. As families are grappling with the fear and havoc caused by Coronavirus, the inflated costs of hospitalisation, oxygen cylinders, PPE kits, oximeters, masks etc., are burning holes in our collective pockets. Mediclaim policies provide security, protection and confidence in these tough trying times. They ease the financial strain by eliminating expenses which might be out-of-pocket for families who are currently grappling with the clutches of the virus.

MEDICLAIM POLICIES AND LAWYERS

It was highlighted by the Madras High Court very recently in re Sudha Ramalingam v. The Bar Council & Ors., W.P. No. 13047 of 2020, Madras High Court (2021) that there are roughly 65,000 advocates on the rolls of the Bar Council of Tamil Nadu and Puducherry and none of them are provided any health cover benefits by the said authority. The appalling state of affairs beckon the State and the legal administration to introspect upon their handling of the current crisis and provide respite to their lawyers. The hon’ble court directed the council to set-up a 9-member committee to review the introduction of a group health insurance whose benefits might also be extended to the families of concerned lawyers. In 2019, the Central Government had set up a 5-member committee to frame a health policy supporting a structured framework and also to deliberate upon the modalities of its execution. The scheme was formulated to provide a comprehensive welfare mechanism for all the advocates across India.

Yet, the grim reality suggests otherwise about the intentions of the authorities regarding the implementation of this scheme. Delhi Government in collaboration with the Bar Council of Delhi had, in December 2019, contrived a medical insurance scheme for all the advocates residing in Delhi and enrolled with the Bar Council by The New India Assurance Company Limited (NIAC). The scheme was allocated Rs. 40.60 crore out of the Rs. 50 crore budget of the Chief Minister Advocates Welfare Scheme as announced by the Law Minister Kailash Gehlot. Under this scheme, Rs. 5 lakhs have been columnised under medical insurance and Rs. 10 lakhs for term insurance individually. The registration under the scheme started in March 2020 but owing to the Covid-19 pandemic the process got inadvertently delayed. A petition regarding the same was filed before the Delhi High Court urging the court to pass immediate orders as the undue delay of the said welfare scheme was responsible for bereaving the legal fraternity of its benefits, that too in the present unprecedented circumstances.

The abysmal delay in the implementation of this scheme rendered many advocates helpless in the times of need and it was only on 10th December, 2020 that the registration was opened by the Delhi Government. Under this welfare scheme, the immediate family members as well as dependent parents are also provided an inclusive cover. According to the data provided by the Bar Association, out of the 37,135 lawyers registered as voters in Delhi 29.098 are on the rolls of the council to avail health benefits under the said welfare scheme. Another commendable health security step has been taken by the Delhi Bar Council by providing a much-needed breather to advocates registered under its tutelage. It has offered financial assistance of Rs. 25,000 (home quarantine) and Rs. 50,000 (hospitalisation and not covered under any scheme) to the advocates afflicted with the virus.

CONCLUSION

In these trying times of extraordinary physical as well as mental anguish the authorities in power should not hold back in assisting their workers. Spotlighting the way ahead, this pandemic has flagged the loopholes in the administration of medical and health infrastructure and services. With the most recent numbers shared by the World Health Organisation (WHO), the current death due to Covid data stands at 31,64,577 globally as on 29th April, 2021. The staggering variety as well as figure of cases is a matter of grave concern for a country as diversely/deeply populated as India with limited medical infrastructure and services which themselves are wrapped in bureaucratic red tape. The legal community, despite the existence of welfare funds, has been deprived of the benefits it may legally derive from the said funds. Streamlining of welfare health benefit schemes is the urgent need in order to bring the legal family under a single umbrella of Mediclaim cover. The central government in association with the BCI and the State Bar Councils should revamp its health policy terms and provide the much-needed respite sought by the advocates for themselves and their families.

REFERENCES

Akshita Saxena, Madras High Court Constitutes Committee To Make Recommendations On Insurance Cover For 65,000 Lawyers, LiveLaw (April 26, 2021) https://www.livelaw.in/news-updates/madras-high-court-insurance-cover-for-lawyers-173129?infinitescroll=1

N. Kirubakaran,j. And R. Pongiappan,j. Madras HC Insurance Cover for Lawyers, W.P. No. 13047 of 2020, https://www.livelaw.in/pdf_upload/madras-hc-insurance-cover-for-lawyers-392429.pdf

Law Ministry to launch cohesive insurance scheme for lawyers, OutLook (July 24, 2019) https://www.outlookindia.com/newsscroll/law-ministry-to-launch-cohesive-insurance-scheme-for-lawyers/1582200

Devika Sharma, Secretary Legal Affairs to head committee on Comprehensive Insurance Scheme for Advocates, SCC Online (March 11, 2019) https://www.scconline.com/blog/post/tag/comprehensive-insurance-scheme-for-advocates/

Secretary Legal Affairs to head committee on Comprehensive Insurance Scheme for Advocates, PolicyBazaar, (May 15, 2020) https://www.policybazaar.com/health-insurance/general-info/articles/a-glance-at-the-evolution-of-health-insurance-in-india/#:~:text=In%201986%20when%20’Mediclaim’%20was,and%20INR%205%20Lakh%20respectively.&text=In%20India%2C%20health%20insurance%20started,reimbursement%20for%20hospital%20treatment%20only

Lawyers approach HC against restrictions in Delhi govt”s advocate welfare scheme, OutLook (March 24, 2020) https://www.outlookindia.com/newsscroll/lawyers-approach-hc-against-restrictions-in-delhi-govts-advocate-welfare-scheme/1778475

Curated by Shivanshika Samaddar of National law University Delhi.

 

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