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What is the ruling on medical aid?

Answered as per Hanafi Fiqh by Askimam.org

What is the sharia ruling on medical aid, hospital plan n what about the permissible of using services of Roster


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

As-salāmu ‘alaykum wa-rahmatullāhi wa-barakātuh.

Attached is a transcript of Hazrat Mufti Ebrahim Desai Saheb’s talk on medical aid.

1 ) Medical Aid

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 R100 a month. If something happens to me in the second month, and the bill came to R10 000, the insurance company is obliged to pay the R9 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.

In today’s times, we have the toy machine with toys of different values, a child puts a R5 coin and the machine picks up a toy of any value and gives it to the child. That also falls under Bai-al-Hasat.

Many people think that some Ulama have a dogmatic and radical approach, everything that comes their way, they make it haraam.

Dear brothers, Ulama-e-haq always have this approach. Whatever was clearly wrong, they proclaimed it. Imagine if ulama kept on giving into the demands of people and issuing rulings to suit the desires of people, then everything would be halal, nothing will be haram. What will be left of Shari’ah?

Allah Ta’ala condemned the Ulama of the Yahood and Nasara for the same reason.

لَوْلا يَنْهَاهُمُ الرَّبَّانِيُّونَ وَالأحْبَارُ عَنْ قَوْلِهِمُ الإثْمَ وَأَكْلِهِمُ السُّحْتَ

Why do not the Ulama and saintly people forbid the people from sin and eating Haram?(5:63)

Ibrahim bin Abdur Rehman Uzri narrates that Rasulullah صلى الله عليه و سلم   said,

يرث هذا العلم من كل خلف عدوله ينفون عنه تحريف الغالين وانتحال المبطلين و تأويل الجاهلين

The knowledge of Shariah will be carried by just people, upright people. They will refute extremism of the extremists, wrong attributions of Batil people and wrong interpretations of ignorant people. (Baihaqi Sunan Kubra v. 10 pg. 209, Dar al-Baz)

It is mentioned in the Hadith that The Ulama of the Ahl al-Kitab used to condemn the people from the wrong. When the people didn’t listen, they stopped condemning people and they joined the people in the wrong. That is when Allah’s punishment came down.

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. [1]

End of transcript.

If a person is required to take out a medical aid scheme due to employment
rules and principles, he will be excused to do so. However, he may use the
benefits of the medical aid scheme only to the extent of the premiums paid
by him. It is not permissible to voluntarily take out a conventional medical
aid scheme.

The same rulings applies for hospital plans.[2]

Explain, what is the services of Roster? Who are they and what are the details of the services they provide?

And Allah Ta’āla Knows Best

Arshad Ali

Student Darul Iftaa

Checked and Approved by,
Mufti Ebrahim Desai.


[1] http://askimam.org/public/question_detail/16743

[2] A Hospital Plan is not a medical aid, but the money you receive can help with the stress of having no income while hospitalised, to pay school fees or to cover any medical expenses due to hospitalisation.( https://www.clientele.co.za/hospital/products)

A comprehensive medical aid plan is one that offers both hospital cover and day-to-day benefits, such as cover for doctor’s appointments and medication. A hospital plan, however, is just that: a plan that offers cover for in-hospital treatment only and that does not provide any day-to-day benefits.

In a nutshell, “comprehensive” medical aid is any medical aid that covers you for both hospital and out-of-hospital procedures(http://www.selfmed.co.za/comprehensive-hospital-plan.aspx)

This answer was collected from Askimam.org, which is operated under the supervision of Mufti Ebrahim Desai from South Africa.

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