Private doctors excluded from Rs 50 lakh COVID insurance scheme: SC seeks Center reply

This comes following a petition filed by family members of seven Mumbai-based doctors who died during the first and second wave of the pandemic.

Initially, Kiran Bhaskar Surgade, whose husband had died due to Covid while working in his private clinic in Thane on June 10 last year had approached the Navi Mumbai Municipal Corporation to file a claim under the PMGKP insurance scheme. However, the insurance company rejected her request on September 7, 2020, stating that her husband's dispensary was not recognised as a Covid-19 dispensary.

Surgade then filed a petition in the Bombay High Court challenging the insurance company's order. While her petition was pending in the High Court, the Maharashtra government raised the question to the central government if the welfare scheme could be extended to all private healthcare workers. The centre responded that they are not entitled to claim the "insurance benefit" unless the service provided by the private practitioner was "'requisitioned" by any central government-owned public hospital or autonomous institution.

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Based on this letter issued by the central government, the Bombay High Court had dismissed Surgade's petition, stating that, "The letter (by Union Government) categorically states that for a private healthcare provider to be covered under the scheme, he or she must be "drafted" by the State/Centre for Covid-19-related responsibilities. "

The HC had further added, "Considering that Surgade's services were not requisitioned as mandated under the scheme, we are unable to extend the applicability of the scheme to persons who fall outside the ambit thereof. Resultantly, no relief can be granted to the petitioner".

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Subsequently, the HC judgment was challenged in the apex court. According to a recent media report in Hindustan Times, the SC bench issued notice to the Union Ministry of Health and Family Welfare and the Maharashtra government on Wednesday, noting that the petition raised serious issues of considerable public importance as it has bearing on the security of health professionals who served the nation during Covid-19.

The bench of Justices Dhananjaya Y Chandrachud and BV Nagarathna said, "Prima facie the objective of the scheme is to provide social security to health professionals in view of the risks they faced due to Covid-19, be it in public or private institutions".

Even though the petition filed in the Bombay High Court was by the wife of a medical practitioner who had died, the apex court allowed the family of seven doctors including the original petitioner to appear before the SC considering the "nationwide consequences" of the order.

Further requesting the solicitor general Tushar Mehta to assist the case when it comes to hearing in the after three weeks, the court order stated, "We request the solicitor general to assist the Court with regard to the interpretation of the scheme and to ensure the object underlying the insurance scheme is duly fulfilled."

Another petitioner appearing in person before the SC, identified as Pradeep Arora criticized the Bombay HC judgment as it did not consider an early order passed by the Commissioner of Navi Mumbai Municipal Corporation on March 31, 2020, directing clinics and private medical establishments to continue serving the Covid-19 patients even amidst the nationwide lockdown.

The above municipal corporation order was in confirmation with an earlier order issued by the central government on March 14 stating all medical institutions should remain at the disposal of the municipal commissioner under the Epidemic Act 1897 as part of measures to prevent and contain COVID. The petitioner Arora reasoned that the private medical practitioners were compelled to keep their clinics open in lieu of the above order, fearing criminal action by the authorities. The doctors had therefore lost their lives treating patients in the process.

The insurance scheme was launched under the Pradhan Mantri Garib Kalyan Package (PMGKP) on March 30, 2020, providing Rs. 50 lakh to the family of health care workers of public healthcare institutions who had died fighting Covid. Further, only those private hospital staffers and contract workers were included under the scheme whose services were "requisitioned" by the state or central government hospitals or autonomous institutions such as AIIMS for Covid work. The funds for the scheme are sanctioned from the National Disaster Response Fund (NDRF) and released via the New India Assurance Company.

On Wednesday, a Union Health Ministry released a statement extending the scheme to another six months, which was originally ending on 20 October 2021. According to the release, around 1,351 claims have been settled under the scheme for the past 19 months. However, it did not show the number of claims which were filed or rejected overall.