Human Rights

Supreme Court: Down Syndrome is No Illness

SANTIAGO – An insurance company that refused to pay out for medical expenses for a client with Down syndrome is obliged to compensate all medical bills, the Chilean Supreme Court ruled yesterday. According to the court, Down syndrome is not a disease, and the client should be treated as any other. The company had refused to cover expenses, arguing that the client had “congenital malformations and/or pathologies diagnosed or known by the insured, prior to the purchase of the policy.”

A father who had filed against insurance company Colmena over its refusal to cover medical expenses for his son with Down syndrome (aka Down’s syndrome) was vindicated by the Chilean Supreme Court on Wednesday, June 18. The company had refused to pay out because they argued Down syndrome is an illness and that the insured therefore had hidden his illness when signing the policy.

The Supreme Court argued in its ruling that the father of the child with Down syndrome was not obliged to either inform or declare to the insurance company that his son was diagnosed with the syndrome. “Down syndrome is no illness and it is not appropriate to mention it in the health declaration,” the court ruled. The insurance company Colmena, part of the private insurance system Isapre, must therefore cover all medical expenses as agreed upon in the policy.

Government spokeswoman Karla Rubilar called the ruling from the Supreme Court historic. “Today we took another step in building a more inclusive Chile. The Supreme Court’s decision to rule that Down’s syndrome is not an illness will allow these people to have (complete) health coverage and greatly alleviate the economic burden on their families,” Rubilar said.

Attorney Eduardo Arévalo, who represented the family in the case, hoped that with the ruling “the arbitrary discrimination by Isapres and other insurance companies will stop.”

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