K.R.Srivats New Delhi | Published on April 08, 2020
Government issued FAQ on Pradhan Mantri Garib Kalyan package clears the air
Fine print matters especially in insurance contracts as several health workers realise to their disappointment in the COVID-19 accident insurance scheme.
It has now dawned on thousands of COVID-19 fighting healthcare workers that the newly-framed insurance scheme (accident insurance scheme) would only cover them for the loss of their life and not any type of expenses incurred on their treatment or during quarantine.
Put simply, the compensation of ₹ 50 lakhs would arise only in the event of loss of life of the health worker due to COVID-19. The scheme rolled out under the Pradhan Mantri Garib Kalyan Package covers loss of life due to COVID-19 and accidental death on account of COVID-19. No expenses on their treatment such as hospitalisation and doctor consultation would get reimbursed if they were to recover after treatment.
This position has been spelt out in the Frequently Asked Questions (FAQs) issued by the government for the Accident Insurance Scheme (for Health Workers fighting COVID-19).
The FAQs also goes on to define ‘Accident’ as sudden, unforeseen and involuntary event caused by external, visible and violent means. The duration of the policy — administered by New India Assurance — is for a period of 90 days, starting from March 30, 2020. There is no age limit for this scheme.
A laboratory report certifying positive medical test is required for loss of life on account of COVID-19. However, this is not required in case of accidental loss of life on account of COVID-19 related duty.
The FAQ has also made it clear that the benefit/ claim under this policy is in addition to the amount payable under any other policies. The entire amount of premium for the accident insurance scheme is being borne by the Ministry of Health and Family welfare. Also, individual enrolment to this scheme is not required.
WHO ARE COVERED?
Public healthcare providers including community health workers, who may have to be in direct contact and care of COVID-19 patients and who may be at risk of being impacted by this are covered under the accident insurance scheme.
Also covered are private hospital staff and retired /volunteer /local urban bodies/ contracted /daily wage /ad-hoc/outsourced staff requisitioned by States/ Central hospitals/ autonomous hospitals of Central/ States/UTs, AIIMS and INIs/ hospital of Central Ministries can also be drafted for COVID 19 related responsibilities.