SUMAN K SHRIVASTAVA
For a long time, mental illness occupied a silent corner of Indian society. It was present everywhere, yet acknowledged nowhere. Families whispered, neighbours speculated, and institutions—especially those entrusted with care—looked away. Illness of the body was visible, measurable, and deserving of sympathy. Illness of the mind, however, was burdened with suspicion, shame, and exclusion.
This deeply ingrained distinction—between what could be seen and what could not—shaped not only social behaviour but also law, policy, and insurance. Medical schemes reimbursed heart surgeries and cancer treatments generously, while psychiatric care was quietly excluded, as if suffering of the mind was less real, less deserving, or somehow self-inflicted.
It was against this historical backdrop that a seemingly routine dispute reached the Jharkhand High Court.
A case that began at home
On February 7, 2025, the Jharkhand High Court delivered its judgment in Santosh Kumar Verma vs Bharat Coking Coal Limited & Others, arising out of W.P.(S) No. 4945 of 2022. The case, decided by Justice Ananda Sen, involved a retired executive of Bharat Coking Coal Limited (BCCL) whose claim for reimbursement of psychiatric treatment for his wife had been rejected under the Contributory Post Retirement Medicare Scheme (CPRMS).
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The rejection was based on Clause 6.3(i) of the scheme, which expressly excluded psychiatric treatment from reimbursement. The clause reflected a long-standing administrative mindset—one that treated mental illness as an exception rather than as healthcare.
What appeared to be a personal grievance soon unfolded into a broader constitutional and statutory inquiry.
The Mental Healthcare Act and a new legal consciousness
In examining the claim, the court placed decisive reliance on the Mental Healthcare Act, 2017, a transformative statute that altered the legal understanding of mental illness in India.
The Act recognises mental illness as a medical condition and guarantees to persons suffering from it the rights to equality, dignity and non-discrimination. It rejects the historical separation between physical and mental illness and mandates parity in treatment, services and access to care.
Justice Ananda Sen noted that the legislative intent behind the Act was clear: mental healthcare cannot be treated as secondary or optional.
Equality that cannot be selective
The judgment draws particular strength from Section 21 of the Mental Healthcare Act, which guarantees equality in healthcare. Sub-section (4) mandates that every insurer must provide medical insurance for treatment of mental illness on the same basis as for physical illness.
The court held that once a medical reimbursement or insurance scheme exists, exclusion of psychiatric treatment amounts to discrimination prohibited by law.
The CPRMS, though described as a welfare measure, was found to possess the essential attributes of a medical insurance scheme—it is contributory, structured and benefit-oriented. As such, it cannot deny benefits selectively.
When executive policy yields to parliamentary law
Justice Sen observed that Coal India Limited and its subsidiaries are “State” under Article 12 of the Constitution, and therefore bound by parliamentary enactments.
While the CPRMS was adopted in 2008, long before the Mental Healthcare Act came into force, its exclusionary clause could not survive after 2017. Any executive policy inconsistent with a later statute, the court held, must give way.
Clause 6.3(i), insofar as it excludes psychiatric treatment, was therefore declared unenforceable.
Reflecting society’s evolving understanding of mental illness
Beyond its legal reasoning, the judgment mirrors a broader social shift.
Mental illness, once cloaked in stigma and silence, is now increasingly recognised as treatable and manageable. Psychiatry has moved from isolation to integration within mainstream healthcare. Therapy rooms have replaced confinement, and diagnosis has replaced superstition.
By treating psychiatric care as ordinary healthcare, the court aligned the law with contemporary medical science and social understanding.
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The insured individual as a rights-holder
A recurring theme in the judgment is dignity.
Insurance and medical reimbursement are not acts of charity. Contributions create enforceable rights. Rights demand equality. And equality cannot permit selective exclusion.
By directing reimbursement and setting aside the rejection orders dated October 26, 2019 and January 23, 2020, the court reaffirmed that mental healthcare is an entitlement, not a concession.
Legal and social significance of the ruling
The judgment in Santosh Kumar Verma vs BCCL carries implications beyond the immediate parties. It strengthens the enforceability of the Mental Healthcare Act, compels public sector employers to revisit outdated medical schemes, and reinforces the principle that mental health parity is not aspirational but mandatory.
More importantly, it situates the judiciary within the larger movement to dismantle stigma through law.
A quiet but enduring judgment
Justice Ananda Sen’s decision does not rely on rhetoric. Its power lies in clarity, restraint and fidelity to statutory purpose.
It captures a moment when Indian law decisively rejected the artificial divide between body and mind. In doing so, it affirms a truth long denied:
An illness does not lose legitimacy because it resides in the mind.
