“Medical Insurance and Health Insurance Services Qualify as ‘Essential Services’ During COVID-19”
The Delhi High Court vide an impugned order dated 6th May, 2021 in the matter of Max Bupa Health Insurance vs Government of NCT Delhi and Another observed that employees of insurance companies engaged in clearance of claims shall be exempted from curfew restrictions.
The Petitioner, is a leading insurance company which is engaged in the business of health insurance plans and Mediclaim policies. The Government of NCT of Delhi (“GNCTD”) through the Delhi Disaster Management Authority (“DDMA”) in its order dated 19th April, 2021 had classified insurance companies under category 4 (l) and persons in the said categories require an e-pass in order to be able to move freely during the lockdown. Since the outbreak of the COVID-19 there has been an upsurge in claims being filed and therefore the employees of the company, pursuant to the said requirement, applied to the GNCTD for an e-pass. However, all their applications had been rejected without any reasons and consequently the instant petition had been necessitated.
The Court had to determine whether processing and clearing of claims relating to health insurance policies or Mediclaim policies should be treated as equivalent to general insurance services?
On perusal of the notification dated 19th April, 2021, imposing curfew, as extended vide order dated 1st May, 2021, two classes of individuals are granted exemption from curfew restrictions. The first category is those who are rendering services as specified in categories 4(a) to 4(k). Persons falling in these categories are exempted from the movement restrictions upon producing a valid Identity card/permission letters. The second category of individuals are those who fall under categories 4(l) and 4(m) for whom movement is permitted only after applying and obtaining an epass.
However, GNCTD, was treating all the employees of the Petitioner under clause 4(l)(ii). Consequently, the Court took the view that the services rendered by the Petitioner are incidental to the other services as mentioned in clause 4(d), and ought not to be treated as equivalent to general insurance services. It further observed that medical insurance and health insurance services are essential services and employees of the Petitioner company, who are dealing with medical and health insurance services, ought to be permitted to move freely between hospitals and their own offices, in order to expedite the processing of medical insurance claims.
In light of the above, it was held that the said employees shall be considered as rendering essential services and shall be deemed to be covered under entry No. 4(d) of the order passed by the DDMA, GNCTD dated 19th April, 2021.
