Accordingly, the Apex Court bench comprising Justice PS Narasimha and Justice R Mahadevan set aside the Bombay High Court's judgment, which held that the private doctors are not entitled to the Government's insurance scheme.
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As per the latest media report by Live Law, while pronouncing the verdict, Justice Narasimha observed, "There was a requisition of doctors as a matter of principle and as per the declaration under the law. Whether a particular doctor was functioning or not is left to be determined on the basis of evidence. Doctors who sacrificed during COVID period cannot be told, their families cannot be told that compensation won't be available. High Court's judgment is set aside to this extent."
The PMGKP was announced in March 2020, and its coverage has been extended since then. It was launched to provide a safety net to the health workers to ensure that in case of any adversity due to Covid-19, their families are taken care of.
An insurance cover of Rs 50 lakh is provided to the health workers under the PMKGP scheme, which has become a safety net for the dependents of the Covid warriors who lost their lives to the infection.
The plea before the Apex Court was filed by Pradeep Arora and others against a March 9, 2021, order of the Bombay High Court, which held that private hospital staffers were not entitled to receive benefits under the insurance scheme unless their services were requisitioned by the state or the Central government.
A plea was filed in the high court by Kiran Bhaskar Surgade, who lost her husband -- who ran a private clinic in Thane -- to Covid-19 in 2020. The insurance company rejected her claim under the Pradhan Mantri Garib Kalyan Package (PMGKP) on the ground that her husband's clinic was not recognised as a Covid-19 hospital.
Previously, Additional Solicitor General Aishwarya Bhati appeared for the Centre and opposed the plea. She highlighted that the insurance cover was for a specific period and the Supreme Court has held that the insurance policies have to be interpreted as per the terms of the insurance contract.
She added that the scheme was not a welfare measure by the state but an insurance policy covering specific people. Further, the doctors involved in the present case did not respond to the call for volunteers for COVID duty specifically, but merely responded to a general call to keep their facilities open, she said. For COVID deaths there is a separate scheme for ex-gratia payment by the National Disaster Management Authority, she said.
Earlier, the Apex Court had said that the Government must ensure insurance companies settle valid claims and added that the assumption that private doctors were working for profit was incorrect.
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