Answered by: Maulana Yūsuf Badāt
We have reached a point in the UK where the quality of care from the NHS has deteriorated rapidly. Due to covid, the waiting lists to be seen for serious conditions has been extended even more, and the backlog won’t be cleared for at least another decade.
There are many illnesses and diseases that are not diagnosed on time and therefore not treated on time. Leading to poor quality of life, not being able to work, not being able to care for dependents, and potential death. There are countless stories of patients not being referred on time to consultants and by the time they are, they are in their last stages of cancers to which they lose their life to as an example.
As a family with vulnerable children with ongoing health care needs, and as parents that need to be fit enough to care for them on a constant basis, we are now feeling that the NHS in its current state is not going to be sufficient for us.
We have tried to find shariah-compliant health insurance but no such thing exists right now in the UK. Private treatment is unaffordable for the majority, and the rising costs of living due to inflation are already placing a huge burden on families.
Is it therefore permissible to take out health insurance under these circumstances?
We will continue to rely on the NHS, however in dire situations where we need to be seen faster for diagnosis and treatment, are we able to use the insurance to pay for these privately?
In the name of Allah, the Most Gracious, the Most Merciful
In response to your concern and query, kindly note that in general, most insurance models entail ribā (usury). The Qur’ān has forbidden ribā. Therefore, in general, any ribā based transaction will remain forbidden.
Regarding health insurance, if a monthly premium is paid, and in return, a cash payout is given when one gets ill or sick, then it is islamicaly forbidden as this is ribā due to the payout either being more or less than the actual amount of the total premiums paid. – (See: Qur’ān 2:2751, Al-Ta’rīfāt Al-Fiqhīyyah, Page 102, Dār Al-Kutub Al-‘Ilmiyyah2)
If, however, the health insurance company takes on the responsibility to provide the treatment and medical help in return for the premiums, then this is permissible. This is similar to hiring a wet nurse to breastfeed an infant. The parent or guardian pays a set amount, usually on a monthly basis, to the wet nurse even though the timings or specific sessions to breastfeed are ambiguous. This ambiguity does not lead to dispute. This type of transaction in fiqh terminology is deemed as ‘aqd-al-ḍamān, ijārah or tabarru’ bi al-‘iwaḍ. – (See: Al-Fatāwā Al-Hindīyyah Vol 4, Page 411, Dār Al-Fikr3, Fatawā Dār Al-‘Ulūm Zakarīyya, Vol 5, Page 438)
That being said, if there is a life and death or extremely compelling situation, the Qur’ān does grant flexibility for the dire circumstance, with the objective of preserving life. – (See: Qur’ān 6:1194, Maqāsid Al-Shari’ah, Al-Ma’had Al-Orubīy, Page 255)
My advice would be to continue to use the NHS. However, if you and your family are genuinely consistently unable to access the health system and you and your dependents remain sick, ill, injured, and untreated then in such dire circumstances you may take out health insurance and use it when required.
Only Allāh knows best
Written by Maulana Yūsuf Badāt
Checked and approved by Mufti Mohammed Tosir Miah
Darul Ifta Birmingham
1 وَأَحَلَّ اللَّهُ الْبَيْعَ وَحَرَّمَ الرِّبَا – البقرة ٢٧٥
2 الرِّبَا هُوَ فِي اللُغة الزِيَادَة وَفِي الشَرْعِ هوَ فَضلٌ خَالٍ عَنْ عِوَضٍ بِمِعْيارٍ شَرْعِيٍ مَشروْطٍ لِأَحَدِ المْتَعَاقِدَيْنِ فِي المْعَاوَضَة – كِتاب التعريفات الفقهِية ج ١٠٢ دار الكتب العلمية
3 وَأَمَّا شَرَائِطُ الصِّحَّةِ فَمِنْهَا رِضَا الْمُتَعَاقِدِينَ وَمِنْهَا أَنْ يَكُونَ الْمَعْقُودُ عَلَيْهِ وَهُوَ الْمَنْفَعَةُ مَعْلُومًا عِلْمًا يَمْنَعُ الْمُنَازَعَةَ فَإِنْ كَانَ مَجْهُولًا جَهَالَةً مُفْضِيَةً إلَى الْمُنَازَعَةِ يَمْنَعُ صِحَّةَ الْعَقْدِ وَإِلَّا فَلَا – كتاب الفتاوى الهندية ج ٤/ ص ٤١١ دار الفكر
4 وَقَدْ فَصَّلَ لَكُم مَّا حَرَّمَ عَلَيْكُمْ إِلَّا مَا اضْطُرِرْتُمْ إِلَيْهِ – سورة الأنعام ١١٩
5 حفظ النفس وهو حفظها من جميع أسباب التلف والفساد – مقاصد الشرعية لعبد الله بن يوسف الجديع ص ٢٥