Supreme Court Affirms Requisition for COVID-19 Health Insurance Claims

In a landmark ruling delivered on December 11, 2025, the Supreme Court of India has broadened the interpretation of "requisition of services" under the Pradhan Mantri Garib Kalyan Yojana (PMGKY) insurance scheme for health workers combating COVID-19. The bench, comprising Justices Pamidighantam Sri Narasimha and R. Mahadevan, partially overturned a Bombay High Court decision in Pradeep Arora & Ors. v. Director, Health Department, Govt. of Maharashtra & Ors. (2025 INSC 1420), holding that government notices mandating private clinics to remain open during the lockdown constituted a valid requisition. This judgment underscores the extraordinary circumstances of the pandemic and ensures that private health professionals' sacrifices are recognized for insurance benefits.

The decision comes nearly five years after the onset of the COVID-19 crisis, which claimed the lives of hundreds of Indian doctors and health workers. By affirming the requisition framework under the Epidemic Diseases Act, 1897, and related regulations, the Court has provided a vital lifeline for unresolved claims, emphasizing that technicalities should not undermine the intent of protective schemes designed to bolster frontline efforts.

Background: The PMGKY Insurance Scheme and Pandemic Response

The COVID-19 pandemic, erupting in early 2020, overwhelmed global healthcare systems, with India facing acute shortages of medical personnel. In response, the Central Government launched the PMGKY Package on March 26, 2020, as part of a Rs 1.70 lakh crore relief initiative. A key component was a special insurance scheme offering Rs 50 lakh coverage to approximately 22 lakh health workers, including doctors, nurses, paramedics, and sanitation staff, for accidental death or loss of life due to COVID-19 while on duty.

The scheme, formalized by the Ministry of Health and Family Welfare on March 28, 2020, extended beyond public sector employees to include private hospital staff, volunteers, and outsourced workers whose services were "requisitioned" or "drafted" by state or central authorities for COVID-19 responsibilities. Clarificatory documents, such as the explanatory letter dated April 3, 2020, and the FAQs, reinforced this inclusive approach, aiming to instill security among health providers and encourage participation without fear.

At the state level, Maharashtra invoked the Epidemic Diseases Act, 1897— a colonial-era law empowering governments to enact urgent measures during outbreaks—through the Prevention and Containment of COVID-19 Regulations, 2020, notified on March 14. Regulation 10 empowered district collectors and municipal commissioners to requisition services from government staff and, if needed, private individuals to implement containment measures like surveillance, isolation, and quarantine facilities. Violations were punishable under Section 188 of the Indian Penal Code, adding coercive weight to these directives.

This legal scaffolding was crucial amid the chaos: hospitals were designated as essential services, lockdowns disrupted routine care, and private practitioners were compelled to contribute. The Indian Medical Association reported over 748 doctor deaths in the first wave alone, highlighting the risks borne by these "unwavering heroes," as the judgment poignantly describes.

Facts of the Case: A Private Doctor's Tragic Loss

The appellants, led by Pradeep Arora, challenged the denial of insurance benefits to the widow of Dr. B S Surgade, a private homoeopathy and Ayurveda practitioner in Navi Mumbai. Dr. Surgade ran a clinic that was ordered to remain open during the March 2020 lockdown via a notice from the Navi Mumbai Municipal Corporation (NMMC) dated March 31, 2020. Issued under Regulation 10, the notice invoked the Epidemic Diseases Act and warned of criminal prosecution for non-compliance, directing him to maintain operations while adhering to social distancing and masking protocols.

Subsequently, on May 9, 2020, the Directorate of Medical Education and Research (DMER) issued a circular requisitioning services from all registered Ayurvedic and homoeopathic doctors for COVID-19 treatment in Mumbai and suburbs, requiring them to report willingness within three days or face penalties under the Act and related laws, including the Hippocratic Oath breach.

Dr. Surgade tested positive for COVID-19 on June 8, 2020, and died two days later. His widow filed a claim under the PMGKY scheme, but it was rejected on September 7, 2020, by the Joint Director of Health Services. The rejection cited three grounds: Dr. Surgade's private practice status, his clinic not being a designated COVID-19 facility, and lack of proof of requisition for COVID duties. The Bombay High Court upheld this in Writ Petition No. 93840/2020, emphasizing that the NMMC notice merely encouraged clinics to stay open generally, not specifically for COVID-19, and distinguished it from explicit drafts like the DMER circular, to which Dr. Surgade did not respond.

Supreme Court's Reasoning: Interpreting Requisition in Context

The Supreme Court granted leave and delved into the pandemic's "unprecedented" context, rejecting a narrow, technical reading of "requisition." Justices Narasimha and Mahadevan held that the invocation of the Epidemic Diseases Act and the 2020 Regulations created a blanket requisition framework, necessitating immediate action without individualized appointments due to the crisis's scale.

Key to their analysis was the NMMC notice's explicit reference to Sections 2, 3, and 4 of the Act, prior Order No. 123/2020, and the threat of FIR under IPC Section 188. The Court observed: "Taking into account the live situation that existed as on March 2020, coupled with the invocation of the Epidemic Diseases Act, 1897 and the Regulations 2020 thereunder, there cannot be any doubt about the compelling situation in which the Governments and their instrumentalities requisitioned services of doctors and other health professionals to be on the frontline."

The bench critiqued the High Court's distinction between general operational directives and specific COVID duties, arguing it ignored the holistic regulatory intent. They noted contemporaneous Central Government actions—like the PMGKY announcement on March 26 and order on March 28—aligned with state requisitions to assure private practitioners. The FAQs explicitly covered "private hospital staff... requisitioned by States," proving the scheme's broad design.

Crucially, the Court clarified that while requisition exists broadly, individual claims require evidence of the deceased performing COVID-19 duties leading to death. "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," they ruled, remanding factual verification without delving into Dr. Surgade's specifics.

This purposive interpretation aligns with constitutional principles under Article 21 (right to health and life), viewing the scheme as a social welfare measure to honor frontline sacrifices. As the judgment states: "The courage and sacrifice of our doctors remain indelible... the insurance scheme was equally intended to assure doctors and health professionals in the front line that the country is with them."

Legal Implications: Broader Access to Compensation

This ruling has profound implications for administrative and public health law. It establishes that emergency regulations under the Epidemic Diseases Act can imply requisition without formal contracts, prioritizing substance over form in welfare schemes. For insurers and government agencies, it mandates contextual evaluation of claims, potentially reopening thousands of denied petitions from private practitioners nationwide.

In labor and employment law, it reinforces protections for gig-like or ad-hoc health workers during crises, echoing the Supreme Court's 2023 decision in Anoop Baranwal v. Union of India on institutional independence but extending to compensatory rights. The judgment also highlights gaps in the National Medical Commission Act, 2019, and Bombay Nursing Home Registration Act, 2006, urging clearer protocols for future pandemics.

Critically, it addresses equity: Public servants often received seamless benefits, while private doctors faced bureaucratic hurdles. By declaring PMGKY coverage "over and above" other policies, the Court ensures cumulative relief, aiding families' rehabilitation.

Impact on Legal Practice and Future Pandemics

For legal professionals, this decision offers ammunition in similar writs under Article 226, emphasizing affidavits, circulars, and contemporaneous evidence over rigid documentation. It may spur class-action suits for aggregated claims, with NGOs like the Association for Democratic Reforms—mentioned in unrelated sources—potentially pivoting to health rights advocacy.

Broader societal impact includes renewed trust in government assurances during emergencies. As India amends the Epidemic Diseases Act (via the 2020 amendment incorporating COVID lessons), this ruling could influence provisions on compulsory service and compensation, aligning with WHO guidelines on health worker protections.

However, challenges remain: Proving causal links in claims may burden under-resourced claimants, and insurers like New India Assurance could face escalated payouts. The Court wisely limited its scope to interpretation, leaving factual probes to authorities, but advocates must now guide clients on documentation like death summaries, positive test reports, and duty certificates.

In sum, this judgment immortalizes the pandemic's heroism, ensuring "no stone unturned" in honoring those who risked all. As Justice Narasimha noted in reserving the matter, the inquiry focused solely on policy interpretation—a restraint that preserves judicial efficiency while delivering justice.

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