Lawyers Association, Guwahati vs State Of Assam And 2 Ors

Heard Mr. A Chamuah, learned counsel for the petitioner. Also heard Mr. D Saikia, learned Advocate General, Assam, Mr. R Dhar, learned Senior

Government Advocate, Assam and Ms. A Gayan, learned Central Govt. Counsel for the respondents.

In this public interest litigation, one of the concerns raised by the petitioners is that many of the private hospitals are not admitting patients suffering

from COVID-19 even though such patients have an insurance cover.

In this case, learned counsel for the petitioner Mr. A Chamuah has placed before this Court an order passed by the regulatory authority, i.e. Insurance

Regulatory and Development Authority of India created under Insurance Regulatory and Development Authority Act, 1999 (for short, “1999

Actâ€). The said authority has passed an order on 04.03.2021 under Section 14 of the 1999 Act, which clearly stipulates that persons having insurance

cover will be given treatment by the designated private hospitals in case such persons get infected with Coronavirus. All the hospitals have to abide by

the order of the Regulatory Authority which has been passed under Section 14 of the Act.

DUTIES, POWERS AND FUNCTIONS OF AUTHORITY.â€

(1) Subject to the provisions of this Act and any other law for the time being in force, the Authority shall have the duty to regulate, promote and ensure

orderly growth of the insurance business and re-insurance business.

(2) Without prejudice to the generality of the provisions contained in sub-section (1), the powers and functions of the Authority shall include, -

(a) issue to the applicant a certificate of registration, renew, modify, withdraw, suspend or cancel such registration;

(b) protection of the interests of the policy holders in matters concerning assigning of policy, nomination by policy holders, insurable interest, settlement

of insurance claim, surrender value of policy and other terms and conditions of contracts of insurance;

(c) specifying requisite qualifications, code of conduct and practical training for intermediary or insurance intermediaries and agents;

(d) specifying the code of conduct for surveyors and loss assessors;

(e) promoting efficiency in the conduct of insurance business;

(f) promoting and regulating professional organisations connected with the insurance and re-insurance business;

(g) levying fees and other charges for carrying out the purposes of this Act;

(h) calling for information from, undertaking inspection of, conducting enquiries and investigations including audit of the insurers, intermediaries,

insurance intermediaries and other organisations connected with the insurance business;

(i) control and regulation of the rates, advantages, terms and conditions that may be offered by insurers in respect of general insurance business not so

controlled and regulated by the Tariff Advisory Committee under section 64U of the Insurance Act, 1938 (4 of 1938);

(j) specifying the form and manner in which books of account shall be maintained and statement of accounts shall be rendered by insurers and other

insurance intermediaries;

(k) regulating investment of funds by insurance companies;

(l) regulating maintenance of margin of solvency;

(m) adjudication of disputes between insurers and intermediaries or insurance intermediaries;

(n) supervising the functioning of the Tariff Advisory Committee;

(o) specifying the percentage of premium income of the insurer to finance schemes for promoting and regulating professional organisations referred to

in clause (f);

(p) specifying the percentage of life insurance business and general insurance business to be undertaken by the insurer in the rural or social sector;

and

(q) exercising such other powers as may be prescribed.

Learned Advocate General, Assam, who appears in this matter has also assured this Court that appropriate order shall also be passed by the

concerned authority at the State level to ensure that persons having insurance cover are not denied treatment in the private hospitals.

Let copy of this order be given to all the private hospitals in Assam along with copy of the order dated 04.03.2020 passed by the Regulatory Authority

for onward compliance.

List on 14.07.2021.