Mumbai, Jan 28: The Bombay High Court has directed insurance companies to reimburse the cost of Personal Protective Equipment (PPE) kits charged to Covid-19 patients during hospitalisation in April–May 2020, holding that PPE formed an essential part of Covid treatment and could not be excluded from insurance coverage.
Petitions filed by Covid patients
The ruling came in two petitions filed in 2021 by Hemangi Nilesh Modi and Jigisha Manoj Yadav, who had challenged the rejection of PPE kit, mask and glove costs under their health insurance policies.
Court rejects cut-off date
A bench of Justices Bharati Dangre and R.N. Laddha, on January 22, held that excluding PPE costs based on a cut-off date of July 10, 2020, was arbitrary and discriminatory.
“The most essential feature of the system and lifesaver for the community is doctors and healthcare workers, and we find absolutely no justification in creating discrimination between patients who were admitted and during whose treatment PPE kits were used,” the court observed.
Insurers’ stand turned down
The petitioners were hospitalised during the first wave of Covid-19 in April 2020, when hospitals charged high daily rates for PPE kits used by doctors and staff. However, insurers refused to reimburse these costs, terming them “non-medical expenses” and citing the absence of specific IRDAI guidelines at the time.
The court rejected this stand, holding that PPE kits, masks and gloves were “very much an essential part of the medical treatment for Covid-19”. It noted that Covid spread through droplets and contact, and PPE acted as a critical barrier protecting both patients and healthcare workers.
“We find it extremely difficult to accept that PPE kits are non-clinical items. In ordinary circumstances, it may be so, but for the Covid pandemic, it was the PPE kit which acted as a barrier and prevented the user from being infected,” the bench said.
Relief granted to petitioners
The court also struck down reliance on the July 10, 2020 cut-off date, stating that patients hospitalised before and after that date belonged to the same class and could not be treated differently. “PPE kits being admittedly essential, we see no reason why the petitioners should be deprived of reimbursement,” it said.
In Jigisha Yadav’s case, a health worker who contracted Covid while on duty, her claim of Rs 2.61 lakh was partly rejected, with Rs 1.65 lakh disallowed towards PPE charges. In Modi’s case, out of a Rs 4.44 lakh bill, only around Rs 70,000 was reimbursed.
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Insurers directed to pay
Directing relief, the High Court ordered Bajaj Allianz General Insurance Co Ltd and Reliance General Insurance Co Ltd to reimburse the full hospitalisation costs, including PPE kit charges, within six weeks.
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