I currently live in Bangladesh. My father suffers from Liver Cirrhosis. I have plans to do Masters or PhD from USA. It is recommended for my father to do liver transplant. But Currently I liver transplant is not available in Bangladesh. Will it be permissible for me to buy an insurance for my father, take him to US and do the liver transplant and then send him back to Bangladesh? Currently I couldn’t find any Takaful Health Insurance in US. And don’t know how the rest of the insurance work there might be be riba and qimar. So will it be permissible in case like this? Can I call it dire need and buy insurance for him and take him to US?
In the Name of Allah, the Most Gracious, the Most Merciful.
All conventional medical Aid schemes are not permissible because they have three prohibited elements in it: interest, gambling and uncertainty. Let me explain all three in the context of Medical Aid.
There is interest in conventional medical aid cover:
Take for example I take out a medical cover and pay a premium of $100 a month. If something happens to me in the second month, and the bill came to $10 000, the insurance company is obliged to pay the $9 900 excess on my behalf. I paid only R100 and get a legal right of more than that amount. That is riba and interest. You are getting something in lieu of nothing. It is incorrect to assume that the medical aid company provides medical services. The official client of the hospital is the patient and not the medical aid company. If the medical aid company does not pay the bill, the patient will be responsible for the bill. Interest is clearly Haram.
Allah Ta’ala mentions :
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 21957)
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 2262)
There is gambling in a conventional medical aid cover:
For example, I pay R100 premium a month, that is R1 200 per year. I may get sick and benefit for a cover up of R50 000 or may even lose my premiums. That is qimaar (gambling). You stand to loose 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 medical aid 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, v. 5 pg. 3, Dar al-Jeil & Dar al-Afaq Jadidah)
That is exactly how medical aid works. I might as well also explain the first part of the Hadith. In the pre-Islamic era, there were different types of transactions. For example, Mulaamasah, Munabazah and Bai al-Hasat. Munabazah and Mulumasah is where the shopkeeper throws an item to the customer and the deal is concluded. Or, where the consumer touches an item and the transaction is concluded. Bai al-Hasat is where there used to be a container of pebbles and the customer would take a pebble and throw it at a particular item and that transaction would be concluded. All this is prohibited.
Nevertheless, Ulama must also be conscience of the needs of the people and create halal alternatives for the people. The king at the time of Yusuf (AS) saw a dream that seven weak cows are devouring seven healthy cows and seven green corns and seven dry corns. Yusuf (AS) did not only give the interpretation that there will be drought he also showed the solution to it. At the time of rain the surplus grain should be kept and hoarded for the time of drought.
We advise you to contact reliable ulamaa in the US that may guide you to any possible Halaal alternatives or solutions instead of the conventional medical insurance.
You may contact https://darulifta.darulqasim.org/ , a reliable Darul Iftaa in the US.
And Allah Ta’āla Knows Best
Mufti Arshad Ali
Darul Iftaa, Jaamia Madinatul Uloom (Trinidad)
 Excerpt from a transcript of Hazrat Mufti Ebrahim Desai Saheb’s (Rahimahullah) talk on medical aid