Families Of Doctors Who Died While Working During COVID-19 Eligible For PMGKY Insurance Even Without Formal Requisition : Supreme Court
Kiran Raj
The Supreme Court of India Division Bench of Justice Pamidighantam Sri Narasimha and Justice R. Mahadevan set aside the Bombay High Court’s view that families of private doctors are outside the Central Government’s “Pradhan Mantri Garib Kalyan Package: Insurance Scheme for Health Workers Fighting COVID-19”, and held that the scheme can extend to such families even where a doctor’s COVID-era deployment was not backed by a formal requisition order. The dispute arose from a claim by the spouse of a private practitioner who died after contracting COVID-19, which was rejected by state authorities and the insurer on the ground that his services were not requisitioned and his clinic was not a designated COVID facility. The Court directed that individual claims be decided case-by-case on evidence that the death occurred while performing COVID-19-related duties.
In March 2020, the Maharashtra Government issued COVID-19 regulations under sections 2, 3 and 4 of the Epidemic Diseases Act, 1897, including a provision empowering the Municipal Commissioner to requisition services, and providing for action under section 188 of the IPC for violations. On 31 March 2020, the Navi Mumbai Municipal Corporation issued a notice to a private medical practitioner directing that his dispensary be kept open during the lockdown, citing the regulations and warning of prosecution for non-compliance. Around the same period, the Union Government announced and then launched the “Pradhan Mantri Garib Kalyan Package: Insurance Scheme for Health Workers Fighting COVID-19”, including cover for certain private healthcare personnel requisitioned by States.
In May 2020, the State’s medical education directorate issued a notification to registered practitioners seeking willingness to render services for COVID-19 prevention and treatment, referring to multiple statutes including the Epidemic Diseases Act and Disaster Management Act. The practitioner tested COVID-19 positive on 8 June 2020 and died on 10 June 2020. His spouse applied to the insurer for benefits under the scheme, but the claim was rejected on 7 September 2020, citing private practice, non-designation of the dispensary as a COVID facility, and absence of requisitioning.
The spouse challenged the rejection before the Bombay High Court. Separately, the State sought clarification from the Union on extending coverage to private practitioners, and the Union replied in October 2020 describing coverage for public providers and specified private categories drafted for COVID-19 responsibilities. The record referred to affidavits and reports from local health authorities stating that the practitioner’s services and clinic were not requisitioned.
The Court recorded, “"The onset of COVID-19 pandemic at the dawn of 2020 was unprecedented in its global sweep and consequence. Not since the 1918 influenza pandemic, an event coeval with the first world war, had a single infectious disease inflicted such widespread crisis on human civilisation. The global death toll rising to millions, as revealed in the World Health Organisation's data, presents a tragic picture of this disruption. While COVID-19 pandemic exposed an acute systemic fragility within the global healthcare sector, highlighted lack of preparedness and strained the capacity of health professionals, our doctors and health professionals rose as unwavering heroes, turning challenges into courage. Indian Medical Association's COVID-19 registry records 748 doctors' deaths in the first wave and hundreds more in subsequent waves; one estimate noted around 798 doctors lost during the second wave alone"
On the central requirement under the insurance scheme, the Court stated, “we have to decide the question as to how requisitioning of services can be inferred and concluded.” It added that “requisitioning has to be seen and assessed in the context of the situation that prevailed.”
Against the COVID-19 regulatory backdrop, the Court noted, “This included requisitioning and drafting of doctors and other healthcare professionals as an emergent measure, as many as possible and as early as State can.”
On the municipal notice relied upon by the claimant, the Court recorded, “This notice clearly refers to the Epidemic Diseases Act, 1897 and the powers thereunder (Sections 2, 3 and 4).” It further stated, “the notice dated 31.03.2020 directs and orders Dr. Surgade to open the hospital/dispensary immediately.”
Dealing with the submission that no individual requisition letter existed, the Court stated, “It is not difficult to conceive the situation, in which individual letter of appointment or requisitioning would not have been possible.” It then held, “we have no hesitation in holding that there was a ‘requisition’ of doctors and other medical professionals.” It also stated, “We are not inclined to accept the rather simplistic submission that there was no specific requisition and therefore the claim for insurance must fail on this ground alone.”
On the scheme’s scope in the prevailing circumstances, the Court recorded, “this compelling measure is not confined to Government employees, but also extended to private doctors and hospitals.” It further stated, “The insurance cover under PMGKY-Package was extended to all those who were requisitioned by law and the executive actions under the compelling circumstances.”
The Court then clarified, “the applicability of the insurance policy will then depend upon actual evidence.” It stated, “If there is clear evidence that the deceased lost his life while performing COVID-19-related duties, the policy will have to be applied.” It also recorded, “We are not examining the credibility of individual claims.”
The Court directed: “In view of the above, in partial modification of the judgment and order of the High Court, we declare that; a) there is a requisition of services of doctors, and this is evident from the conjoint reading of provisions of the Act, the Maharashtra Prevention and Containment of Covid-19 Regulations 2020, the NMMC Order dated 31.03.2020, PMGKY-Package Scheme, explanatory communication to the PMGKY policy, and the FAQs released.”
“b) Individual claims for insurance made as per the PMGKY-Package 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 his 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.”
“With the above observations, the appeal stands disposed of. Pending applications including the application for intervention/impleadment are also disposed of.”
Case Title: PRADEEP ARORA & ORS. VERSUS DIRECTOR, HEALTH DEPARTMENT, GOVT. OF MAHARASHTRA & ORS.
Neutral Citation: 2025 INSC 1420
Case Number: CIVIL APPEAL NO. OF 2025; SPECIAL LEAVE PETITION (C) NO. 16860 OF 2021
Bench: Justice Pamidighantam Sri Narasimha, Justice R. Mahadevan
