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Informist, Thursday, Dec. 11, 2025

 

NEW DELHI – The Supreme Court Thursday ruled that claims under the insurance scheme of Pradhan Mantri Garib Kalyan Yojana could not be denied to health workers, including private doctors, on grounds that there was no specific requisition by the government for their services during the COVID-19 pandemic. "We have no hesitation in concluding that 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," said a bench of Justice P.S. Narasimha and Justice R. Mahadevan.

 

The facts and questions under the health insurance programme and the clarificatory letter issued thereafter also prove that 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, said the top court. The insurance cover under Pradhan Mantri Garib Kalyan Yojana was extended to all those who were requisitioned by law and the executive actions under the compelling circumstances, the court added. "...we are not inclined to take the view that there was no requisitioning of the doctors and medical professionals," said the bench.

 

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, said the top court. That is also a moment of pride and recognition of the character strength and discipline that our people demonstrated when circumstances demanded it, it added. 

 

The top court said individual claims for insurance made as per the Pradhan Mantri Garib Kalyan Yojana will be considered and decided in accordance with the law and on the basis of the evidence. The onus to prove that a deceased lost their life while performing a COVID-19-related duty is on the claimant, and the same needs to be established on the basis of credible evidence, the court added. Whether the doctor or healthcare professional has, and in fact, presented and offered his or her services in furtherance of COVID-19-related responsibilities is a matter of evidence, the court added. If there is clear evidence that the deceased lost his life while performing COVID-19-related duties, the policy will have to be applied, said the court.

 

The apex court modified the Bombay High Court's order that had rejected an insurance claim by the wife of deceased Dr. B.S. Surgade on the ground that there was no proof of 'requisitioning' of his services for COVID-related duties. The apex court said there was a requisition of services of doctors, and that was evident from the conjoint reading of provisions of Epidemic Diseases Act, 1897, the Maharashtra Prevention and Containment of Covid-19 Regulations 2020, the Navi Mumbai Municipal Corporation order in 2020, Pradhan Mantri Garib Kalyan Yojana, explanatory communication to the the programme, and the facts and questions released.  

 

In 2020, the central government had announced relief measures for doctors and frontline workers engaged in the battle against COVID-19. The Pradhan Mantri Garib Kalyan Yojana, brought by the Centre, was an insurance scheme for health workers fighting COVID-19 in government hospitals and health care centres, which was later extended to include private doctors, whose services were requisitioned by the government.

 

The case has its genesis in Dr. Surgade, a medical practitioner, who ran a private medical clinic. According to Dr. Surgade's wife, her husband was directed to keep his clinic open as per the Navi Mumbai Municipal Corp. order in 2020 and his services were also requisitioned by the communication of director of Medical Education & Research. However, the insurance benefit to his wife was rejected on the ground that the government's orders were a general direction to hospitals and dispensaries to remain operational, to ensure the continuity of essential healthcare services and to prevent disruption of routine medical care. Thereafter, the high court had held that claims for insurance must necessarily establish that the services of the deceased medical professional were requisitioned in relation to COVID-19-related duty and in this particular case, Surgade's service was not requisitioned by the government.  End

 

Reported by Surya Tripathi

Edited by Tanima Banerjee

 

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