Mumbai : In a landmark judgment, the Bombay High Court has ordered health insurance firms to reimburse Personal Protective Equipment (PPE) kit costs incurred by COVID-19 patients admitted to hospitals in April and May 2020, finding that such expenses were an integral part of medical treatment during the pandemic and should not have been excluded from coverage.
The bench of Justices Bharati Dangre and R.N. Laddha delivered the judgment on January 22, addressing two petitions filed in 2021 by policyholders Hemangi Nilesh Modi and Jigisha Manoj Yadav. Both petitioners challenged the refusal of their insurers to pay for PPE kits, masks and gloves under their health insurance policies, on the ground that these costs had been classified as “non-medical” and thus were not covered.
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Insurers had partly rejected claims by citing a July 10, 2020 cut-off, after which PPE costs were recognised for reimbursement. The Bombay High Court dismissed this reasoning as arbitrary and discriminatory, observing that patients hospitalized before and after the date formed the same class and faced identical PPE-related expenses. The court also rejected the argument that PPE charges were non-medical due to the absence of early IRDAI guidelines. It held that PPE kits, masks and gloves were essential to COVID-19 treatment, protecting both patients and healthcare workers, and could not be classified as non-clinical items during the pandemic.
Details of the individual claims illustrate the impact of the order: in Yadav’s case, the insurer had disallowed ₹1.65 lakh of her ₹2.61 lakh claim on PPE kit charges; in Modi’s claim, out of a ₹4.44 lakh bill, only about ₹70,000 was reimbursed. Directing the insurance firms, Bajaj Allianz General Insurance Co Ltd and Reliance General Insurance Co Ltd , to settle full hospitalisation costs including PPE charges, the High Court has given them six weeks to complete the reimbursements.
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