Society will not forgive us if we don't take care of our doctors! SC on insurance for health professionals who died battling COVID-19
Supreme Court of India
New Delhi: While reserving its judgment on a plea against the non-inclusion of doctors and health workers who lost their lives battling Covid-19 at private clinics, dispensaries, and non-recognised hospitals in insurance policies, the Supreme Court recently emphasised the Government's role to protect those who served during the pandemic.
Highlighting the immense contribution of medical professionals in combating the pandemic, the top court bench comprising Justices P S Narasimha and R Mahadevan observed, "Society will not forgive us if we don't take care of our doctors and don't stand for them..."
The bench was dealing with the question of eligibility under the government's scheme, especially in cases where the doctors were not officially on government duty but continued to serve patients during the pandemic.
The Apex Court said the government must ensure that insurance companies settle the valid claims, and added that the assumption that private doctors were working for profit making was not correct, PTI has reported.
"You should compel the insurance company to pay if according to you the condition is met that they were on COVID response and they died because of COVID. Merely because they were not in government duty, the assumption that they were making profits and then they were sitting is not correct," the bench observed orally.
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As per the latest media report by Live Law, the Court clarified that it would not adjudicate individual claims but would instead lay down principles to guide the implementation of the insurance scheme. Justice Narasimha observed, "We will not go into individual claims. We will just lay down the principles." Further, the bench observed that the criteria would focus on whether the deceased doctor was actively engaged in medical service and whether death was a result of COVID-19 infection.
At this outset, the bench observed, "That the said doctor volunteered to offer his medical services by keeping his clinic or hospital open for patients to consult him must be proved by way of some credible evidence."
"There must also be proof about the fact that the doctor has passed away because of being infected by COVID.Once these two questions as satisfied, it is not for us to question as to whether the doctor has opened his clinic or offered his services for COVID alone," explained the bench.
The top court also directed the Centre to provide relevant data and information regarding other similar or parallel schemes available apart from the Pradhan Mantri Insurance Scheme.
"Give the data to us and some information about other parallel schemes that are available apart from the Pradhan Mantri scheme. We will lay down the principle and on that basis claims can be made to the insurance company. It is for the insurance company to consider and pass orders on the basis of our judgment," the bench observed. Concluding the hearing, Justice Narasimha said, “It will be disposed of as per our judgment.”
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.
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.
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.
