Is taking medical insurance permissible, due to high medical costs and the deplorable public health care?

Question:

I understand that life/medical insurance is haraam because of several reasons including interest/gambling/uncertainty but vehicle insurance and compulsory insurance (like National Insurance) is allowed.
Can i get an explaination as to why these are allowed? And do all scholars permit it?
Also i work in the Industry where there are many high risks involved which are simmilar to which the divers who worked for Paria drowned(died) due to an accident. Is there any possibility that medical insurance can be allowed for extremely high risk jobs?
Also can medical insurance be allowed in present time to help with the high cost of medical bills like dental (braces etc), and other surgeries, scans and tests are very costly for the average person to afford for themselves and their family?
For example i opted to go private for my wife’s delivery so that

1) she felt comfortable with a female muslim doctor 2) she had her own room with full privacy (no non-mahrams could have freely entered as what happens in public hospital due to everyone being warded in one open room and where pregnant women not allowed to wear hijab just before, during and after delivery). However the cost of private delivery have almost doubled/trippled since then and is almost inaccessible for the average muslim to afford but with medical insurance which might make it more affordable to more persons)

Answer:

In the Name of Allah, the Most Gracious, the Most Merciful.

On the outset it must be clear that the default position in relation to medical insurance and all forms of prevalent insurances is unlawful (haram) according to Shari’ah, for they have either an element of interest (riba) or chancing (qimar), both of which have been explicitly and sternly forbidden by Allah Ta’ala in the Qur’an and numerous Ahadith.

Allah Ta’ala states:

أَيُّهَا الَّذِينَ آَمَنُوا اتَّقُوا اللَّهَ وَذَرُوا مَا بَقِيَ مِنَ الرِّبَا إِنْ كُنْتُمْ مُؤْمِنِينَ () فَإِنْ لَمْ تَفْعَلُوا فَأْذَنُوا بِحَرْبٍ مِنَ اللَّهِ وَرَسُولِهِ وَإِنْ تُبْتُمْ فَلَكُمْ رُءُوسُ أَمْوَالِكُمْ لَا تَظْلِمُونَ وَلَا تُظْلَمُونَ () وَإِنْ كَانَ ذُو عُسْرَةٍ فَنَظِرَةٌ إِلَى مَيْسَرَةٍ وَأَنْ تَصَدَّقُوا خَيْرٌ لَكُمْ إِنْ كُنْتُمْ تَعْلَمُونَ () وَاتَّقُوا يَوْمًا تُرْجَعُونَ فِيهِ إِلَى اللَّهِ ثُمَّ تُوَفَّى كُلُّ نَفْسٍ مَا كَسَبَتْ وَهُمْ لَا يُظْلَمُونَ

“O you who believe, fear Allah and give up what still remains of Riba, if you are believers. But if you do not (give it up), then listen to the declaration of war from Allah and His Messenger. However, if you repent, yours is your principal. Neither wrong, nor be wronged. If there is one in misery, then (the creditor should allow) deferment till (his) ease, and that you forgo it as alms is much better for you, if you really know. Be fearful of a day when you shall be returned to Allah, then every person shall be paid, in full, what he has earned, and they shall not be wronged.” (2:278 – 2:281)

قال رسول الله  صلى الله عليه وسلم درهم رباً يأكله الرجل وهو يعلم أشد عند الله من ستةٍ وثلاثين زنيةً

Furthermore, Rasulullah صلى الله عليه و سلم  mentions, “If a person consumes a single Dirham of Riba knowingly, it is considered more severe to Allah than 36 acts of fornication.”(Musnad Ahmad)

الربا وإن كثر فإن عاقبته تصير إلى قل

Rasulullah صلى الله عليه و سلم   is also reported to have mentioned, “Even if Riba (apparently) increases, it will eventually lead to a decrease.” (AlHakim)

There is gambling in conventional insurance cover:

For example, I pay $100 premium a month, that is $1200 per year. I may get sick and benefit for a cover up of $30 000 or may even lose my premiums. That is qimaar (gambling). You stand to lose or gain.
 

يَسْأَلُونَكَ عَنِ الْخَمْرِ وَالْمَيْسِرِ قُلْ فِيهِمَا إِثْمٌ كَبِيرٌ وَمَنَافِعُ لِلنَّاسِ وَإِثْمُهُمَا أَكْبَرُ مِنْ نَفْعِهِمَا

Allah Ta’ala states in the Holy Quran, “They ask you about wine and gambling. Say, In both there is great sin, and some benefits for people. And their sin is greater than their benefit.” (2:219)

There is Garar (uncertainty) in conventional insurance cover:

Likewise, my premiums are in lieu of an uncertain event of the future. If I get sick, the company will pay and if I don’t get sick, then they won’t pay. This is gharar (uncertainty). I don’t know if I will get sick or not and to what extent.

Rasulullah صلى الله عليه و سلم   advised

نَهَى رَسُولُ اللَّهِ صلى الله عليه وسلم عَنْ بَيْعِ الْحَصَاةِ وَعَنْ بَيْعِ الْغَرَرِ

Rasulullah صلى الله عليه و سلم   prohibited from dealing in a future uncertain event. (Muslim)

However, it would be permissible for one to have insurance up to the minimum level required when it is a dire necessity like that of being the law of the land etc.

If one is employed, and is required by the law of the country to pay the N.I.S., then paying and taking benefits from such an insurance will be permissible.

Concerning the ruling of medical insurance in the light of the current health care system, as you have correctly mentioned, we face the problem of very high and increasing costs of private medical care along with the deplorable condition of the free public health care. We agree it is not a practical solution to resort to the public health system, as it is very unreliable and in the case of female patients, there is no Hijaab and lack of female doctors especially for child birth.

Therefore, in light of such deplorable conditions of the governmental health care system, if someone is unable to afford private medical treatment, taking medical insurance will be permitted based on such needs and necessities[1]. If one is able to afford the costs of such private medical treatments, he should avoid taking medical insurance. This permission is restricted to such situations where there is a necessity, and is specifically for medical insurance only.

And Allah Ta’āla Knows Best

Mufti Arshad Ali

Darul Iftaa, Jaamia Madinatul Uloom (Trinidad)

www.fatwa-tt.com /www.jaamia.net


[1] الأشباه والنظائر لابن نجيم (ص: 85)

 الضَّرُورَاتُ تُبِيحُ الْمَحْظُورَاتِ

درر الحكام شرح مجلة الأحكام – ط. العلمية (1/ 33)

( المادة 21 )  الضرورات تبيح المحظورات  الضرورة هي العذر الذي يجوز بسببه إجراء الشيء الممنوع .