Bombay high court declines relief on plea against mediclaim order
The Bombay high court recently declined urgent interim relief on a petition by a body of nursing homes/hospitals challenging an Insurance Regulatory and Development Authority circular that excludes hospitals having less than 15 beds from medical insurance. The HC said it would first like to know IRDA’s response. The new policy defining hospitals comes into effect from July 1.
A division bench of Justices S J Vazifdar and M S Sonak heard a petition by the Association of Medical Consultants, comprising 7,300 medical consultants in Mumbai, the suburbs and other townships who operate from government/private clinics and nursing homes. They challenged the February 20, 2013 circular, saying it has changed the definition of hospitals which existed before mediclaim was introduced in India in 1996. They also said that IRDA has not given any reason for the change.
AMC advocates Avinash Jalisatgi and Robin Fernandes told the court that with the change in definition, many hospitals will be out of the mediclaim’s purview. They explained that the industry definition of hospitals would be either one that is registered under the Bombay Nursing Homes Registration Act or one that has 15 or more beds in a metro and 10 or more beds in a non-metro, along with certain other conditions.
“Earlier, all hospitals, irrespective of the number of beds, were eligible for mediclaim. Now, even registered nursing homes/hospitals with less than 15 beds in metros and less than 10 beds in non-metros will not fall under the new definition. They will be automatically disqualified from mediclaim,” said Jalisatgi.
The petition said IRDA had acted arbitrarily by excluding hospitals with less beds from health insurance. Giving an instance, it stated: “In Mumbai, where transport woes are a constant impediment to quick and easy travel, these small nursing homes have ensured easy access to quality healthcare at reasonable rates to members of society.” The petition said the circular discriminates between small and bigger hospitals and urged the court to quash and set it aside.
To a query from the judges on whether an insurer can be compelled by IRDA, Jalisatgi said 600-odd hospitals here will be excluded. “Patients will not come to us,” said Jalisatgi. The judges were informed that although IRDA, based in Hyderabad, was served a copy of the petition, it has not represented itself in court. The judges said it would not be possible to stay the circular without hearing IRDA and posted the hearing on July 5.
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