Health Insurance In India: A Financial Necessity And An Islamic Perspective

The question of health insurance deserves serious consideration, particularly in a country like India, where access to affordable and quality healthcare remains a significant challenge for ordinary middle-class families.

Although the government has introduced healthcare schemes such as Ayushman Bharat, their benefits are primarily directed towards eligible economically weaker sections of society. A considerable proportion of the middle class remains outside the scope of such assistance. Consequently, families are often left to bear the enormous cost of medical treatment themselves.

Healthcare expenses in India have increased considerably. Even an ordinary hospital room can cost several thousand rupees per day, while diagnostic investigations, surgeries, medicines and other medical procedures can place an enormous financial burden on a family. In cases of serious illness or major surgery, expenses can easily reach ₹10 lakh, ₹15 lakh or even ₹30 lakh.

We regularly witness the suffering of families who are compelled to seek financial assistance from mosques, charitable organisations and members of the community. People contribute whatever they can: ₹50, ₹100, ₹500 or, occasionally, larger amounts. Although such generosity reflects the compassion and solidarity of our society, individual contributions are often insufficient to meet the enormous financial requirements of serious medical treatment.

This raises an important question: Should an ordinary middle-class family have to exhaust its lifetime savings, sell its property or depend on public donations simply to secure essential medical treatment?

In my view, this situation calls for a serious reconsideration of how we approach financial protection against medical emergencies.

From the perspective of Islamic jurisprudence, conventional insurance, in its various forms, has generally been regarded as impermissible by many Islamic scholars and jurists. Their objections are principally based on the presence of gharar (excessive uncertainty), maysir (gambling-like elements) and, in certain arrangements, riba (interest). Nevertheless, it is equally important to understand that Islamic jurisprudence does not operate independently of the realities of human life. Islamic law recognises the principles of necessity (darurah) and genuine need (hajah), and provides concessions in circumstances where avoiding an otherwise prohibited matter would result in considerable hardship or serious harm.

One of the well-established legal maxims states: Al-darurat tubih al-mahzurat. Necessities make prohibited matters permissible. Another important legal maxim states: Al-hajah tunazzalu manzilat al-darurah, ‘ammah kanat aw khassah. A genuine need may be treated as a necessity, whether that need is general or particular.

These principles demonstrate the flexibility, practicality and compassion inherent in Islamic jurisprudence. The Shariah does not intend to place people in unbearable hardship, nor does it require individuals to expose themselves and their families to serious financial ruin when facing circumstances beyond their control.

This is particularly relevant in countries like India, where a comprehensive public healthcare and social welfare system is not available to a large section of the population. The middle class often finds itself in a vulnerable position: it may not qualify for government assistance, yet it cannot comfortably afford the enormous expenses of private healthcare. A single major medical emergency can wipe out years of savings and push an otherwise financially stable family into debt.
In such circumstances, I believe there is a strong jurisprudential basis for considering conventional health insurance permissible on the grounds of genuine need and necessity. The ruling on a matter cannot always be considered independently of the circumstances in which people find themselves. Islamic jurisprudence recognises that necessity, hardship and the prevention of serious harm are important considerations when determining the applicability of legal rulings.

It would therefore be inappropriate to apply the general prohibition of conventional insurance without considering the actual circumstances of people living in countries where adequate public healthcare and social protection are lacking. At the same time, this should not be understood as an unrestricted declaration that every form of insurance is permissible under all circumstances. Rather, it is an argument for recognising a concession where genuine need exists and the absence of financial protection could expose individuals and their families to substantial hardship.

This issue becomes even more significant when we consider our parents. As they grow older, their healthcare requirements generally increase. Unfortunately, obtaining health insurance at an advanced age can become considerably more expensive. Some insurance companies may impose waiting periods, exclusions, co-payment requirements and other restrictions, while certain applications may be declined altogether.

For this reason, planning ahead is extremely important. If an individual can arrange appropriate health insurance for their parents at a reasonable cost, it may protect the family’s savings and ensure that medical decisions are made according to the patient’s healthcare needs rather than the family’s financial limitations.

Islam places great emphasis on the protection of life, the fulfilment of family responsibilities and the prevention of harm. Preserving one’s financial stability is also important because financial hardship can affect the welfare of an entire household. We should therefore seriously consider whether refusing all forms of health insurance, despite the circumstances and the absence of an adequate public healthcare system, is necessarily the most appropriate course of action.

My suggestion would be that ordinary middle-class families in India seriously consider obtaining health insurance, particularly for their parents and other dependants. They should carefully examine the coverage, exclusions, waiting periods, room-rent limits, co-payment clauses and pre-existing disease conditions before purchasing a policy. It is equally important to seek the guidance of qualified Islamic scholars who are familiar with contemporary financial transactions and the realities of healthcare in India.

The purpose of Islamic law is not to make human life unnecessarily difficult. Its principles are founded upon justice, compassion, the prevention of harm and the protection of essential human interests.

While conventional insurance may remain impermissible under the general principles of Islamic commercial jurisprudence, genuine necessity and widespread hardship are recognised considerations in determining whether a concession may be granted.
In a country like India, where a comprehensive and dependable healthcare safety net is not available to a large section of the middle class, the question of health insurance deserves a more nuanced and context-sensitive Islamic assessment.

We should not encourage people to disregard the principles of Shariah, but neither should we overlook the financial and human suffering that ordinary families face when confronted with a medical emergency.

In my considered understanding, where genuine need exists and the absence of health insurance could expose an individual or their family to serious financial hardship, there is a legitimate basis for considering conventional health insurance permissible under the principles of necessity and need.
Ultimately, protecting the health, dignity and financial security of our parents and families is a responsibility that should be taken seriously. Islamic jurisprudence provides principles through which such responsibilities can be addressed with wisdom, balance and compassion.