Supreme Court Defends Private Doctors' Right to COVID-19 Compensation Insurance Claims

The Supreme Court emphasized that the government must ensure insurance companies process valid claims for doctors who lost their lives to COVID-19.

New Delhi:

On Tuesday, the Supreme Court declared that society would not forgive the judiciary if it fails to protect and stand up for doctors, as it reserved judgment on a plea regarding the exclusion of healthcare workers who died fighting COVID-19 at private clinics, dispensaries, and non-recognized hospitals from insurance policies.

Justices P S Narasimha and R Mahadevan, comprising the bench, stated that the government must compel insurance companies to settle valid claims. They rejected the assumption that private doctors were merely operating for profit, noting this perspective was incorrect.

"Society will not forgive us if we don't take care of our doctors and don't stand for them. 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 stated during proceedings.

The Supreme Court instructed the Centre to provide relevant data and information about other similar or parallel insurance schemes available beyond 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.

The Supreme Court was reviewing a plea by Pradeep Arora and others challenging the Bombay High Court's March 9, 2021 order, which determined that private hospital staff were ineligible for benefits under the insurance scheme unless their services were requisitioned by state or Central government.

The case originated from a plea filed in the high court by Kiran Bhaskar Surgade, whose husband, who operated a private clinic in Thane, died from COVID-19 in 2020.

The insurance company rejected her claim under the Pradhan Mantri Garib Kalyan Package (PMGKP) on the grounds that her husband's clinic was not recognized as a COVID-19 hospital.

The PMGKP was announced in March 2020, with its coverage extended continuously since then.

It was established to provide a safety net for health workers, ensuring their families would be cared for in case of any COVID-19 related adversity.

Under the PMGKP scheme, health workers are provided with Rs 50 lakh insurance coverage, which has become a crucial safety net for dependents of COVID warriors who succumbed to the infection.