Pradhan Mantri Garib Kalyan Yojana : Health insurance benefits to the family of a deceased privatr doctors can not be denied

Supreme Court Upholds Broader Interpretation of PMGKY Insurance Scheme for Healthcare Workers Apex Court Recognizes Requisition of Private Doctors Amid COVID-19, Expands Scope for Insurance Claims

In a landmark judgment delivered on December 11, 2025, the Supreme Court of India addressed the critical issue of insurance coverage for healthcare workers under the Pradhan Mantri Garib Kalyan Yojana (PMGKY) during the COVID-19 pandemic. The Court ruled that the requisitioning of services of private doctors and healthcare workers during the pandemic, as mandated by the Epidemic Diseases Act, 1897, and subsequent regulations, should be interpreted broadly to include those who were required to keep their clinics open under government directives.

The judgment came in response to an appeal filed by Pradeep Arora and others against the Director of Health Department, Government of Maharashtra, challenging the denial of insurance benefits to the family of a deceased doctor, Dr. B.S. Surgade. The High Court had previously dismissed the petition, emphasizing that the doctor's services were not specifically requisitioned for COVID-19 duties.

The Supreme Court, comprising Justices Pamidighantam Sri Narasimha and R. Mahadevan, overturned the High Court's narrow interpretation. The Court recognized the challenges faced during the pandemic and acknowledged that the NMMC notice dated March 31, 2020, which directed private practitioners to keep their clinics open, constituted a form of requisitioning under the prevailing exigent circumstances.

The Court emphasized the importance of supporting frontline workers and highlighted the intent behind the insurance scheme to provide assurance to healthcare providers. The judgment underscored that individual claims must be substantiated with evidence showing that the deceased was engaged in COVID-19-related duties at the time of their demise.

The decision is a significant step towards acknowledging the sacrifices made by healthcare workers during the pandemic and ensuring they and their families receive the support promised by the government. The ruling mandates that individual insurance claims under the PMGKY scheme be evaluated based on credible evidence, ensuring rightful beneficiaries are not denied coverage.

The judgment reiterates the broader intent of laws and regulations during public health emergencies, emphasizing the need for a compassionate and inclusive approach towards those who risked their lives in the battle against COVID-19.

Statutory provisions: Epidemic Diseases Act, 1897, Indian Penal Code Section 188, Maharashtra Prevention and Containment of Covid-19 Regulations 2020.

Pradeep Arora v. Director, Health Department, Govt. of Maharashtra, (SC) : Law Finder Doc Id # 2820812