Insurance claim of terminally ill person refusing treatment valid: HC
24 May 2016
In a ruling in favour of insurance consumers, the Punjab and Haryana High Court has passed a verdict that insurance companies cannot deny the claim amount to the family of a person who has been declared as terminally ill, even if the patient decides to stop medical treatment against the advice of his doctors.
The high court has stated that the family of the patient who is terminally ill will get insurance claim benefits even if the patient decides to discontinue treatment against the advice of the doctors and then dies.
The high court has clarified that the decision of refusing or not taking adequate treatment is the patient's prerogative and this is based on the fact of ''patient autonomy'' and ''dignity in death''.
Many insurance companies in the past have denied medical claims to the families of patients by quoting ''leave against medical advice'' as the excuse to deny the claim to the family.
The recent decision is a result of denial of an insurance claim of Rs35.46 lakhs to a family of 56-year-old R K Dogra, a bank employee from Chandigarh, who had sustained serious head injuries in a road collision on 15 March 2013. The patient was sent back after four days but had to return to the hospital because his condition had deteriorated and the reason was stated to be ''right temporoparietal bleed with midline shift''.
He requested to be released from hospital when the medical fraternity did not see hope of his recovery. So against doctors' advice, he had asked for a discharge on 7 May in a bad condition. The insurance company refused to pay the claim money on the basis of ''LAMA''. The case was taken to court and the family of the deceased won the plea.
Justice K Kannan on the bench said that patient autonomy was a human right and ''whether the patient shall be allowed to die by withdrawal of life support is quite different from a patient expressing desire not to be treated. In the former, we are broaching the issue of passive euthanasia and in the latter; it is an issue of patient autonomy.''
Earlier this month, the government uploaded a draft bill on passive euthanasia that gives patients the right to "withhold or withdraw medical treatment to herself or himself" and "allow nature to take its own course".
The government has invited comments on the Terminally Ill Patients (protection of patients and medical practitioners) Bill via email from people before 19 June.