The woman had sought the insurance under the Pradhan Mantri Garib Kalyan Yojana holding that the scheme is applicable only to private doctors whose services are requisitioned for Covid-19 duties.
The judgment by bench of justice Shahrukh Kathawalla and justice Riyaz Chagla came on a petition by Koparkhairane resident Kiran Surgade.
On March 31, her husband, Dr Bhaskar Surgude, had received a notice from Navi Mumbai Municipal Corporation to open his clinic to treat patients and was warned of prosecution if he did not.
He then opened his clinic at Turbhe and even treated Covid patients.
He got infected and died on June 10. On September 7, the insurance company rejected her claim saying he did not serve in an hospital designated to treat only Covid-19 patients.
The judges took note of a Union Department of Health and Family Welfare’s October 15 reply to a letter by state government to include all private health care providers/workers who continued delivery of healthcare during the pandemic under the scheme.
The reply said only such private practitioners whose services are requisitioned for Covid-related duties and responsibilities would be covered under the scheme.
“This letter categorically states that for a private healthcare provider to be covered under the scheme, he or she must be “drafted” by the state/Centre for Covid-related responsibilities,’’ they said, adding that the letter states that no other group of healthcare workers can be included under the scheme.
The judges said the widow would necessarily be required to prove that her husband’s services were in fact requisitioned/drafted in relation to Covid-19 duties by the state/Centre to seek application of the scheme.
While her advocate Ajit Karvande relied on a March 31, 2020 notice by the Navi Mumbai Municipal Corporation that called upon the doctor to explain why his private dispensary was kept closed.
Also, a resultant notice to keep open his dispensary after following social distancing measures.
“The NMMC notice cannot be construed as a notice requisitioning Dr Surgade’s services for a specific purpose of treating Covid-19 patients and/or working in a Covid centre/hospital. There is a difference between specifically requisitioning /drafting services and directing private practitioners to not keep their clinic closed. In the present case the distinction is clear from the record,” said the judges.
The judges said the overwhelming record showed that the doctor’s services were not requisitioned as mandated under the scheme and “therefore the petitioner, cannot not now avail of the scheme. Also the widow had not produced any other documentary proof to establish her husband’s services were availed for treating or in relation to Covid-19.
“As a result, we hold that Dr Surgade’s services were not requisitioned as required under the scheme and therefore the scheme would be inapplicable in the present matter,” the judges concluded.