ValkyaEditorial

Tagged “mediclaim”

3 articles on mediclaim.

Weekly Report

Insurance law in May-June 2026: collateral source, mental-health parity, IRDAI cyber-security, and the Sabka Bima reforms

The May-June 2026 cycle in Indian insurance law has produced three threads running in parallel — the Supreme Court's collateral-source recalibration in Dolly Satish Gandhi alongside the Santhosh anti-double-counting discipline and the Sayona Colors fraud-vitiates-all line; the operational implementation of the Sabka Bima Sabki Raksha (Amendment of Insurance Laws) Act 2025 with 100 per cent FDI and SEBI-style disgorgement powers for the IRDAI, alongside the Bima Sugam commercial launch and the continued delay of the Bima Vistaar composite product; and the IRDAI's substantive regulatory recalibration through the Information and Cyber Security Guidelines 2026, the KMP remuneration amendment tying half of the performance assessment to policyholder-outcome metrics, and the Karnataka HC and Supreme Court interventions on MACT jurisdiction over PA cover and on the personal liability of insurer top brass.

Valkya Editorial··15 min
Landmark JudgmentSupreme Court of India

Satwant Kaur Sandhu v. New India Assurance: the prudent-insurer test and mediclaim repudiation

On 10 July 2009, a two-judge bench of the Supreme Court — Justice D.K. Jain authoring, with Justice R.M. Lodha on the panel — imported the English 'prudent insurer' test of materiality into Indian mediclaim jurisprudence and crystallised the insured's positive duty of disclosure at the proposal stage. The judgment held that a mediclaim policy is a contract of uberrimae fidei, that the insured is bound to disclose health conditions material to the risk regardless of whether the proposal form asks the specific question, and that consumer forums cannot override the uberrimae fidei architecture to reach equity outcomes.

Valkya Editorial··14 min
Landmark JudgmentDelhi High Court

Shikha Nischal v. National Insurance: Section 21(4) of the Mental Healthcare Act 2017 as enforceable parity

On 19 April 2021, Justice Pratibha M. Singh of the Delhi High Court held that Section 21(4) of the Mental Healthcare Act 2017 imposes a positive, justiciable statutory obligation on every insurer to provide mental-illness cover on the same basis as physical illness, and that any policy clause excluding or sub-limiting mental-illness cover is void to the extent of inconsistency with the Act. The judgment directed National Insurance to reimburse the petitioner's Rs.5.54 lakh schizoaffective-disorder claim and required the IRDAI to circulate the order to every insurer. It was the doctrinal foundation for the IRDAI's 18 October 2022 circular and for the 2024 Master Circular on Health Insurance Business.

Valkya Editorial··13 min