Kochi: The Kerala High Court has ruled that denying an insurance claim for medical treatment amounts to a violation of the right to life under Article 21 of the Constitution. Delivering the judgment in a writ petition, Justice P M Manoj said that once an insured person undergoes treatment or surgery based on the opinion of a qualified doctor, the insurer cannot arbitrarily reject the claim. Such rejection, the Court noted, amounts to a denial of treatment and infringes upon the fundamental right to life and health.

The petitioner approached the Court after the Life Insurance Corporation of India (LIC) rejected and restricted his medical insurance claims. Despite paying premiums since 2008, LIC limited his first claim to ₹5,600 against an expenditure of ₹60,093 and rejected a subsequent claim of ₹1.8 lakh, citing a “pre-existing illness.”

The Court reiterated that the right to medical treatment is an integral part of the right to life, citing precedents including Bengal [1996 (4) SCC 37], Consumer Education and Research Centre v Union of India [1995 (3) SCC 42], and State of Punjab v Mohinder Singh Chawla [1997 (2) SCC 83].

“Declining the claim in respect of treatment undergone amounts to denial of treatment itself, thereby violating the right to life under Article 21,” the Court observed. It also warned that insurers often exploit patients’ vulnerability, undermining the purpose of health insurance and eroding public trust.

The Court quashed LIC’s rejection orders and directed it to settle the petitioner’s claim without delay, noting that the policy remained valid until March 31, 2024.
(With LiveLaw inputs)