The Insurance Regulatory and Development Authority of India (IRDAI), which had directed insurers to ensure that claims on existing health policies are not rejected based on exclusions for genetic disorders, has put that direction on hold.

In effect, this means it is not mandatory for insurers to provide cover for genetic disorders in health policies, at least for the time being.

The move comes after the Supreme Court last week partially stayed an earlier Delhi High Court order which had said that the exclusion of genetic disorders from health policies was unconstitutional.

“In view of the above stay granted by the Supreme Court, the (earlier) circular … stands abated until further orders,” said IRDAI, adding that the claim settlement for existing policies will be according to the applicable framework.

At present, genetic disorders such as certain cardiac conditions and haemophilia are not covered by policies.

However, in February this year, the Delhi High Court had said that the exclusionary clause of “genetic disorders in insurance policies is too broad, ambiguous and discriminatory”.

It had directed IRDAI to take a re-look at the clauses and ensure that insurance companies do not reject claims on the basis of exclusions relating to genetic disorders.

Following that, IRDAI had in March directed all insurance companies to not exclude genetic disorders from health policies.

Awaiting clarity

Reacting to the latest ruling, insurers said they would await more clarity from the Supreme Court and IRDAI.

“As of now, we will follow the IRDAI circular. We also hope for more clarity once the final ruling of the Supreme Court comes in,” said an executive with an insurance company.

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