Terror Of ICU Duties During Covid-19 Lead To Heart Attack At Young Age: Rajasthan HC Orders State To Release Compensation To Health Worker's Wife

In a significant decision, the Rajasthan High Court has held that ‘an insurance scheme meant for a health worker’ who was fighting on the front lines during the pandemic requires ‘a wider connotation on the part of the state’.

Therefore, the High Court reached the conclusion that when a health worker was on active Covid-19 duty till the time of his death due to heart attack, other conditions and technicalities under Pradhan Mantri Garib Kalyan Package ‘ought to be construed widely’.

Regarding the application of Pradhan Mantri Garib Kalyan Package, the court observed that the claim pursuant to the death of the health worker in April, 2021 does not come within the ambit of an ordinary accidental claim:

“The Scheme/policy in question has been brought into clearly reveals that the same was not pertaining to an ordinary road accident, nor the same was an accidental cover for life etc. The present Scheme/policy is a policy specifically meant for assuring the health worker that his/her family shall be taken care of while discharging their duties, in the extreme environment of fear of the pandemic while putting his life at risk. The policy was an essential gesture for the health worker in the wind of trauma, while he put his life to imminent risk”

The primary dispute in the writ petition was whether the death of a 36-year-old health worker is covered by the second category of claims under the Scheme, i.e., ‘Personal Accident Insurance Claim Form for accidental loss of life on account of COVID-19 related duty’.

The Division Bench of Justice Pushpendra Singh Bhati noted down in the judgment that the heart attack suffered by the petitioner’s husband, a young nursing officer employed on a contractual basis in the Intensive Care Unit of AIIMS Jodhpur since December 2016, could not be regarded as ‘voluntary or by chance’. The court observed that the ‘disastrous and traumatic pandemic conditions’ might have played an instrumental role in such a young person dying an unnatural death when there was no other prevailing ailments or medical conditions.

“As far as the present case is concerned, it was not a regular disease that caused death of the petitioner’s husband; he expired of heart attack at a young age of 36 years, and the trauma and terror of the ICU duties have definitely played an important role in causing such death due to heart attack”, the court added about the factual matrix of the case.

The court remarked that the current instance was not one where a scheme was introduced for the safety net of ‘risk coverage’ alone; the intention behind the introduction of Pradhan Mantri Garib Kalyan Package by the Ministry of Health and Family Welfare and inclusion of health workers under the scheme on 03.04.2020 was to create ‘a safety network for the health workers’ and deploy it as ‘a financial shield to the family members of the health workers’ who were working in perilous circumstances. It was also pointed out that the death certificate was promptly issued by the AIIMS, Jodhpur on 23-04-2021 that further bolsters the case of the petitioner and his continuous working status in the hospital. Afterwards, death summary of the deceased was prepared on 17-05-2021.

The court, therefore, deemed it fit to set aside the order of Director, Medical & Health Services, Government of Rajasthan that refused to consider the claim for Rs fifty lakhs, citing the documents submitted as insufficient. The High Court has now instructed the respondent to consider the petitioner wife’s application under the Scheme/Package and release the claim amount within a period of three months.

Advocate Lakshya Singh Udawat appeared for the petitioner while Advocates Mukesh Rajpurohit, Dy. SG, Pankaj Sharma, AAG along with Rishi Soni and Jagdish Vyas appeared for the respondents.

Further Observations Made by The Court

The court noted that the husband of the petitioner died while working in a unit filled with Covid-19 patients, especially during the peak of the second wave of the pandemic, as certified by Medical Superintendent, AIIMS, Jodhpur.

The court also briefly stated the purported intention of the legislature and executive in coming up with such a comprehensive scheme during the pandemic. For the welfare of health workers who were providing medical assistance to the Covid-19 patients despite the aggravated risk it posed to their own lives as well as to prevent the ‘collapse of health services’, ‘Pradhan Mantri Garib Kalyan Package: Insurance Scheme for Health Workers Fighting COVID-19’ was introduced by amending Epidemic Diseases Act, 1897, the court noted.

The single judge bench also referred to the FAQs of the Scheme that mention the requirements for claiming the benefits. The court opined that it does not stipulate the production of a covid positive medical test result if claiming accidental loss of life on account of COVID-19 related duty (second category).

The bench also observed that the case laws cited by the respondent state to deny the claim of the petitioner is not applicable since those cases do not pertain to the policy of insuring the health worker in relation to Covid-19.

“…The present claim before this Court is not an ordinary accidental claim, rather it is particularly relating to the claim on account of risk to the health worker, who was working in a very fearful, stressful, and traumatic situation”, the court further remarked.

While construing the term ‘accident’ mentioned in the Scheme the court also pondered about the repercussions of the pandemic on the health sector:

“This Court finds that the perspective of the word ‘accident’ has to be seen with the prism of Covid-19, and not in isolation as during such pandemic, there was a sense of extreme panic, trauma and anxiety. Even in a colony/office where one person would get infected, the entire colony/office would be closed down and all contacts were traced to be quarantined resulting into extreme misery so much so that near and dear ones were deserted by their own family. In the living memory, this was the most trying times for the governance and in particular the health workers”.

Case Title: Susheela W/o Rajesh Kumar v. Union of India Through Its Additional Secretary And Mission Director, National Health And Family Welfare & Ors.

Case No: S.B. Civil Writ Petition No. 6106/2022

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