The Supreme Court of India has issued notices to the Center and IRDAI regarding a PIL challenging the permanent exclusion of epilepsy from health insurance, with the court noting the policy is prima facie unscientific. A favorable ruling could compel insurers to treat epilepsy as a standard pre-existing disease with a waiting period rather than a total exclusion.

2) While the case is sub-judice, applicants should disclose their condition and highlight that it is well-controlled to seek coverage under 2024 guidelines 

3) 

IRDAI filed a counter affidavit stating that because regulations were updated in May 2024, people with any pre-existing condition—including epilepsy—can now obtain health insurance in India.

The 2024 updates are available on the IRDAI website.

The Supreme Court of India has issued notice to the Insurance Regulatory and Development Authority of India (IRDAI) and the Union of India in a Public Interest Litigation challenging the exclusion of epilepsy from health insurance coverage. The notice was issued on 27 May 2025 by a Bench comprising Justice B.V. Nagarathna and Justice Satish Chandra Sharma. The petition has been filed under Article 32 of the Constitution by Sanvedana Foundation.
The core challenge in the petition is to the IRDAI Master Circular dated 22 July 2020, which permits insurers to permanently exclude epilepsy from health insurance policies. The petitioners have argued that this blanket exclusion is discriminatory and violates Articles 14 and 21 of the Constitution, as persons with epilepsy are denied equitable access to health insurance without a rational or scientific basis.
At present, the Supreme Court has only issued notice and sought responses from IRDAI and the Central Government. No interim order has been passed staying the operation of the IRDAI circular or directing insurers to change underwriting practices. The matter is still at a preliminary stage, and further hearings will take place after the respondents file their affidavits.
In terms of likely legal trajectory, if the Supreme Court ultimately finds the exclusion unconstitutional or arbitrary, it may direct IRDAI to amend its guidelines. This could result in epilepsy being treated like other pre-existing diseases, subject to disclosure, waiting periods, or case-specific underwriting, rather than being permanently excluded. Any such change would likely operate prospectively and through revised IRDAI regulations.
Until a final judgment is delivered, the existing regulatory framework continues to apply. Insurers are legally permitted to exclude epilepsy or deny coverage based on it under the current IRDAI guidelines. Individuals with well-controlled epilepsy may still attempt to obtain coverage through individual underwriting, higher premiums, waiting periods, or insurers offering specialised products, but there is no statutory compulsion on insurers at this stage.
Raising awareness or seeking clarification through public or legal forums is legally permissible, provided personal medical details are handled carefully and disclosures to insurers remain truthful. Advocacy focused on policy reform does not, by itself, adversely affect an individual insurance application.
As of now, there is no interim relief or subsequent order reported by the Supreme Court lifting or suspending the epilepsy exclusion. The only confirmed judicial action is the issuance of notice calling for responses from IRDAI and the Union of India.

This Supreme Court notice is a significant step, indicating the Court is willing to examine whether blanket exclusions for epilepsy violate constitutional rights and IRDAI's own regulations against discrimination. The likely trajectory involves IRDAI and insurance companies filing responses, followed by hearings. Possible outcomes range from the Court directing IRDAI to frame new, non-discriminatory guidelines for underwriting pre-existing conditions like controlled epilepsy, to a more specific order prohibiting permanent, blanket exclusions. The petitioner's argument that such exclusions are arbitrary and unscientific, especially for controlled cases, has a strong foundation in recent judicial trends favoring the rights of persons with disabilities.

If the Supreme Court rules in favor of the petitioner, it would fundamentally change underwriting practices. Insurers would likely be prohibited from applying a permanent, blanket exclusion for epilepsy. Instead, they would have to adopt a more nuanced risk-assessment model, potentially loading the premium or imposing a moratorium period (e.g., 2-4 years of stability) for well-controlled cases, after which coverage would be provided. This would align with practices for other controlled chronic conditions like hypertension or diabetes. IRDAI would likely issue a circular mandating these changes, making health insurance accessible to millions with controlled epilepsy.

Until a final decision, individuals with well-controlled epilepsy should disclose their condition transparently in applications. Approach multiple insurers to see their underwriting stance, as some may offer coverage with a loading or a specific exclusion period. Clearly provide medical records demonstrating long-term control and stability. You can also reference the pending Supreme Court case in your communication with the insurer's underwriting team, urging a fair assessment. Avoid withholding information, as that can lead to policy cancellation later. Consider proceeding with the best available option while the legal process unfolds, as a future favorable judgment could lead to a review of your policy terms.

Yes, raising awareness through appropriate forums is advisable and can strengthen the collective cause. You can contribute to or follow the discourse in responsible media, patient advocacy groups (like the Indian Epilepsy Association), and on legal platforms. This public pressure can encourage IRDAI to proactively review its guidelines. However, for your individual application, it is prudent to keep advocacy separate. Directly confronting an insurer's underwriting team with legal arguments during your personal application might not be productive and could lead to a straightforward rejection. Focus first on securing a policy, while supporting the broader legal challenge externally.

As of my last update, there has been no publicly reported interim order from the Supreme Court in this specific case (Writ Petition (Civil) No. 561/2024). The notice was issued on July 19, 2024. The next step would be the filing of counter-affidavits by IRDAI and the insurance companies. For the most current status and to access any official orders, you should regularly check the Supreme Court's case status website (https://main.sci.gov.in/) using the diary number, or follow reliable legal news portals like LiveLaw or Bar & Bench for updates. No interim relief has been granted yet.

The matter will be ruled against the insurance companies and the same will be inclusive 

As per affidavit filed by IRDA in SC persons with any pre existing condition would be coveted including epilepsy 

No, the Supreme Court’s May 2025 notice to IRDAI does not legally disallow permanent or lifelong exclusions for chronic diseases, as it merely seeks responses on the PIL without issuing any interim orders or judgments altering IRDAI guidelines.

Epilepsy is not required to be covered after any moratorium period, even without fraud, because IRDAI’s guidelines explicitly list it among 16-17 conditions eligible for permanent exclusion if pre-existing at policy inception

Epilepsy is not mandated to be treated solely as a Pre-Existing Disease (PED) subject to waiting periods (e.g., up to 48 months); insurers may apply permanent exclusion instead, per IRDAI’s standardization allowing this for listed conditions while covering unrelated ailments.

The writ petition filed before supreme court in SANVEDANA FOUNDATION Vs UNION OF INDIA|W.P.(C) No. 501/2025 is pending.

The present petition, filed under Article 32 of the Constitution of India, seeks relief for PWE, whose denial of equal access to healthcare and insurance coverage on parity with those suffering other illnesses, amounts to a gross violation of their rights guaranteed under Articles 14 and 21 of the Constitution.

The Supreme Court of India has issued notice to the Union of India and the Insurance Regulatory and Development Authority of India (IRDAI) in the PIL filed by Sanvedana Foundation challenging the exclusion of epilepsy from health insurance coverage under the IRDAI Master Circular dated 22 July 2020.

The bench (Justices B.V. Nagarathna & Satish Chandra Sharma) directed that responses be filed, and the matter is set for further hearings. There is no reported interim order yet suspending the exclusion or altering underwriting practices.

The outcome may rather than an absolute striking down, the Court could direct IRDAI to frame risk-refined guidelines rather than permanent exclusions, making it akin to other pre-existing or chronic conditions. If the government or IRDAI successfully demonstrates actuarial risk or regulatory competence to exclude epilepsy, the policy could remain unchanged. However, given the prima facie characterization in reported petitions that the exclusion is “unscientific,” a complete denial is less likely.

Interim approach of the applicants with well controlled epilepsy may be that the applicants should truthfully disclose epilepsy and provide detailed medical records demonstrating control/stability (e.g., no seizures for a long period). Concealing information can lead to policy voidance or claim denial later. Legally, the existing IRDAI guidelines still apply until they are set aside. So individuals must follow the actual terms and underwriting norms in force. Raising awareness in appropriate forums (e.g., legal seminars, disability rights forums, patient advocacy groups) is both lawful and constructive, especially on constitutional rights and equitable insurance access. While advocacy is positive, individuals should avoid publicly disclosing sensitive medical history unless they consent, as insurers may use such disclosures in underwriting decision

There is no interim orders from supreme court in this regard. 

Insofar as Para 1(a)(iii) of the Master Circular, it indicates the regulatory intent to encourage coverage for chronic conditions, including those that are ongoing or have existed prior to the policy issuance rather than permanently excluding them. It essentially says coverage options must exist, which implies chronic conditions should not be categorically blocked from all products.

Interpretation to permanent exclusions meant that permanent or lifelong exclusions for chronic diseases are, at least, discouraged under the regulatory framework,  From a legal/regulatory standpoint, the combined effect of the Circular and the Regulations suggests insurers should not impose permanent or lifelong exclusions on chronic conditions that would defeat the regulatory intent of providing choices and eventual coverage (via riders/products) for such conditions.

Under the Insurance Products Regulations, 2024, PED waiting periods are capped at 36 months, meaning that a declared pre-existing condition should be covered once the waiting period expires, provided the policy terms allow it.

As far as moratorium and contestability is concerned, the para 13 states that after completion of the Moratorium Period (60 continuous months/5 years of coverage), no policy or claim shall be contestable on grounds of non-disclosure or misrepresentation, except proven fraud. This means that after 5 years of continuous coverage, the insurer cannot renege on claims by alleging non-disclosure  including in relation to the insured’s pre-existing epilepsy  unless fraud is established. Importantly, the moratorium does not automatically create coverage if a condition is permanently excluded by the policy wording; however, the regulatory preference is that exclusions should not be permanent where coverage is reasonably possible.

Dear client,

The Supreme Court has only issued a notice to IRDAI  the matter is still pending and at this stage no final change in law or insurance policy rule has taken place and the court is mainly examining whether the blanket exclusion of epilepsy in  health insurance is fair and constitutional

If the court finally decides in favor of the petitioner, insurers may be required to stop treating epilepsy as an automatic permanent exclusion, especially where the condition is well controlled. Insurance companies may then have to assess such cases individually instead of rejecting them outright.

Until a final decision is given, insurance companies are legally allowed to treat epilepsy as a preexisting disease and may impose waiting periods or exclusion as per existing IRDAI regulations. From a legal point of view, applicants should truthfully disclose the condition while applying to avoid future claim rejection.

Raising awareness or seeking clarification through public or legal forums is generally acceptable and does not affect an individual insurance application as long as disclosure made to insurers are honest and accurate. 

As of now there is no interim order or final direction from the supreme court changing the current position. The notice only indicates that the issue is under judicial consideration, and updates should be tracked through official court orders or IRDAI notifications.

If you have any queries, please feel free to contact us.

Whether these provisions legally disallow permanent or lifelong exclusions for chronic diseases?

While the Master Circular does not use the explicit phrase "permanent exclusions are banned," its provisions collectively create a regulatory framework that strongly disallows them. The requirement in Para 1(a)(iii) for insurers to offer products catering to "pre-existing diseases and chronic conditions" signals a regulatory intent to ensure these conditions are insurable. More critically, Para 13 introduces a transformative "Moratorium Period" of 60 months of continuous coverage. After this period, a policy and its claims cannot be contested on grounds of non-disclosure or misrepresentation, except for proven fraud. This effectively nullifies any permanent exclusions for conditions disclosed or which should have been disclosed, as after 60 months, the insurer's right to contest based on the policy's terms (like a permanent exclusion) is extinguished, barring fraud.

Whether epilepsy is required to be covered at least after completion of the moratorium period, assuming no fraud?

Yes, epilepsy, being a chronic neurological condition, should be covered after the completion of the 60-month moratorium period, provided there is no established fraud. As per Para 13, after 60 months of continuous coverage, the policy and its claims become incontestable on all grounds except fraud. This means the insurer cannot deny a claim related to epilepsy by arguing it was a pre-existing condition that was not disclosed or was misrepresented. The protection of the moratorium period applies to the policy, covering all conditions, including chronic ones like epilepsy. Therefore, any claim arising from epilepsy after this period would be legally payable, assuming all other policy terms are met and there was no fraud at inception.

Whether epilepsy should be treated as a Pre-Existing Disease (PED) for underwriting and waiting-period purposes, rather than being subjected to permanent exclusion?

Yes, from a regulatory standpoint, epilepsy should be treated as a standard Pre-Existing Disease (PED). This approach aligns with the spirit of Para 1(a)(iii), which requires products to cater to chronic conditions. Treating it as a PED allows insurers to underwrite the risk appropriately by applying a defined waiting period (e.g., 1 to 4 years) during which related claims are not payable. After the satisfaction of this specific waiting period and the general moratorium period, coverage should attach. Subjecting epilepsy to a "permanent exclusion" would directly contradict the regulatory objective of providing wider choices and coverage for chronic conditions, and it would be effectively nullified after the 60-month moratorium period as per Para 13, making such an exclusion impractical and potentially non-compliant with the regulatory intent.