The Supreme Court of India has agreed to hear a case filed by a consumer group against three large insurance companies.
The case was filed by the Consumer Federation of India (CFI) on behalf of a woman, who had been forced to undergo gender reassignment surgery after a health care provider, Suresh Kumar, refused to carry out the surgery.
The complaint alleged that the insurance companies’ policy did not provide sufficient cover for the woman, as it did not cover the cost of her treatment, and therefore was liable to her.
The decision to hear the case was taken on Thursday by Chief Justice B.V. Narasimha Rao, who will decide whether to hear it or not.
“The decision has been taken to hear this case and take action against the companies in this case,” Rao told reporters.
“There are a lot of cases in the court now where there is litigation related to medical services.
We are also in the process of examining the entire structure of insurance companies,” he said.
While Rao has said he will decide the matter on March 14, the CFI had filed the case in March last year.
In the case, the woman sought compensation for the cost incurred by her health care services in the event of an accident, or the cost for surgery.
“As an insured person, the plaintiff had incurred medical costs which are covered under insurance.
But the insurance company has refused to provide medical cover for these medical expenses.
Therefore, she has been compelled to undergo the surgery,” said the woman’s lawyer, M. K. Mishra.
The woman had undergone gender reassessment surgery, which was performed by a surgeon who had a license from the National Institute of Medical Sciences (NIMS).
The insurance company had refused to pay for the procedure.
In its submission, the Insurance Corporation of India had said that it has no insurance policy for transsexuals and did not offer coverage for this purpose.
The insurer had also said that the procedure would not require a referral from the medical team and it would not affect its ability to provide a premium for the surgery as the procedure was performed in a private hospital.
“If we accept that insurance companies have no policy for transgender patients, why would we have insurance for a surgical procedure that will cost us Rs 5 lakh,” Mishra asked.
However, the NIMS said that insurance policies do cover medical services related to transsexual surgeries.
“It is our position that the court has to take a balanced view of the facts in this matter.
We have received a detailed briefing on the matter and will take up the issue in a matter of days,” said NIMs general manager of insurance, Amit Agarwal.