‘Nation can’t forget COVID-19 heroes’: Supreme Court extends Rs 50 lakh insurance benefit to private doctors

“While COVID-19 pandemic exposed an acute systemic fragility within the global healthcare sector, highlighted lack of preparedness and strained the capacity of health professionals, our doctors and health professionals rose as unwavering heroes, turning challenges into courage,” the court said.

The bench said that it could “never forget” the situation that prevailed in 2020 when it was hearing the plea of a private doctor’s wife, whose husband succumbed to the COVID-19 infection in June 2020. The Bombay High Court previously rejected her plea seeking insurance benefits under the PMGKY-Package on the ground that there was no proof of ‘requisitioning’ of his services for COVID-related duties.

The court partially modified the Bombay High Court’s judgment and observed that the private doctors would be eligible for the PMGKY-Package.

Key findings

• Onset of the COVID-19 pandemic in 2020 unprecedented in its global sweep and consequence
• Event was coeval with the first world war and inflicted a widespread crisis on human civilisation.
• Global death toll rose to millions, according to the WHO data, which presented a tragic picture of this disruption.
• COVID-19 pandemic exposed an acute systemic fragility within the global healthcare sector and highlighted the lack of preparedness, and strained the capacity of health professionals.
• Health professionals rose as unwavering heroes, turning challenges into courage at the time.
• Indian Medical Association’s COVID-19 registry recorded 748 doctors’ deaths in the first wave and hundreds more in subsequent waves; one estimate noted around 798 doctors lost during the second wave alone.
• PMGKY package covered a variety of private healthcare workers if their services were ‘requisitioned by states’.
• According to Prevention and Containment of COVID-19 Regulation 2020, the collector or the municipal commissioner were competent to take measures, such as sealing of the geographical area, requisitioning, if necessary, staff of government departments and organisations.
• The regulation provided that “if required, the Collector, Municipal Commissioner may requisition the services of any other person also”.
• It was not difficult to conceive of the situation of a pandemic, in which individual letter of appointment or requisitioning would not have been possible, and that was exactly the reason for invoking the Epidemic Diseases Act, 1897 and other regulations for implementing immediate measures.
• There was no hesitation in holding that there was a “requisition” of doctors and other medical professionals and was not inclined to accept the rather simplistic submission that there was no specific requisition and therefore the claim for insurance must fail on this ground alone.
• The truth and reality of requisitioning was also evident from the decisions of the government at that time, when a large number of doctors and healthcare professionals were requisitioned, and this compelling measure is not confined to Government employees, but also extended to private doctors and hospitals.
• The insurance cover under PMGKY-Package was extended to all those who were requisitioned by law and the executive actions under compelling circumstances.
• The country has not forgotten the situation that prevailed at the onset of COVID-19, when every citizen contributed in some measure, despite fear of infection or imminent death.
• It was a moment of pride and recognition of the strength of character and discipline that the nation and its people demonstrated when circumstances demanded it.
• The invocation of laws and regulations were intended to leave no stone unturned in requisitioning the doctors, and the insurance scheme was equally intended to assure doctors and health professionals in the front line that the country is with them.

Background

The victim, Dr Surgade, was running a private medical clinic. At the onset of the COVID-19 pandemic, he was allegedly directed to keep his hospital/dispensary open during the lockdown period by the Navi Mumbai Municipal Corporation in 2020, invoking the COVID Regulations, which warned him of criminal prosecution in the event of noncompliance.

He succumbed to COVID-19 in 2020. Subsequently, his wife approached the insurance company seeking insurance benefits under the PMGKY-Package, but was refused. The corporation rejected the insurance request on the grounds that Dr Surgade was carrying out a private practice and hence his next of kin was ineligible for the benefit under the scheme. It was also mentioned that his husband’s dispensary was not a COVID-19-designated dispensary, and his services were not “requisitioned.”

When the doctor’s wife moved the Bombay High Court, her plea was rejected, noting that while private medical practitioners fall under the ambit of the insurance scheme, claims for insurance must necessarily establish that the services of the deceased medical professional were requisitioned in relation to COVID-19-related duty.

The high court also mentioned that the doctor did not respond to the circular concerning requisition of his service and hence his services were not requisitioned.