Gujarat: 60% of insurance claims for health workers settled

Since Covid-19 began, the Gujarat health department has settled 82 of the 141 claims received under Pradhan Mantri Garib Kalyan Package’s (PMGKP) insurance scheme for health workers who died fighting the disease. More than half of the victims were less than 50 years old.

The insurance scheme covers health workers who lost their life due to Covid-19, and also accidental death of health workers on account of Covid-19 related duty, with Rs 50 lakh paid to the claimant of the insured person.

Among the 82 claimants, a majority are staff nurses — 15 of them — followed by 13 doctors, 10 ASHA workers and nine class-4 workers. At least 44 of the 82 deceased were less than 50 years of age, including at least six of them in their 20s.

27 of the settled claims are of those who died this year, all between April and June.

Of the remaining 59 pending claims, verification documents remain to be received by the state health department from the district or hospital authorities for 15 claimants. Claims for 30 others are pending at the level of the insurance company — New India Assurance.

The scheme had seen a break for a month — between March 24 and April 24 — after which it was revived again with effect from April 24, as per a communication dated April 26 by the deputy secretary of Government of India, addressed to additional chief secretaries of health and principal secretaries of health of all states.

While the earlier method for the next of kin of the deceased claiming the insurance money could take up to four to six months, the state government on June 24 issued a communication empowering district collector or municipal commissioner to issue a one-page certificate attesting to the veracity of the claims subject to verification of whether the deceased was on Covid-19 duty, if on duty at Covid-19 designated hospital, and if it was fieldwork, then whether it was specific to Covid-19 services. The district collector/municipal commissioner issued certificate is then sent to the state health department which is then sent to the insurance company.

“Earlier, all documents for verification purposes had to be collected by the district authority or hospital authority which would then be verified by the chief district health officer or hospital superintendent which would then be sent to state level from where we would forward it to the insurance company. The company in turn would conduct its own verification exercise and would seek documents if necessary… With the new verification method, processing of the claim usually takes eight to 10 days,” said a state health department official.

Among the 82 beneficiaries of the package are the next of kin of 24-year-old Pooja Patel, who had joined Covid-19 duty in August 2020 as a staff nurse at Dr ND Desai Faculty of Medical Sciences and Research in Nadiad and on Diwali that year, she was admitted as a patient after an evening of fatigue and weakness. Ten days later, she breathed her last at an Anand hospital. While her family has received the insurance amount of Rs 50 lakh, they are not yet sure what to do with the money.

Pooja’s father, Kirteshkumar Patel, a resident of Uttarsanda town who works with the GST department in Nadiad, does not know what he should do with the Rs 50 lakh claim he has received from the package.

He said, “…When we got her admitted, her oxygen level was 65. She was at the hospital for eight days and on the eighth day they told us we should shift her to a better facility. So we admitted her to a private hospital in Anand. On November 24, she died. I remember she used to be on duty for eight to 10 hours, sometimes handling up to 20-25 patients alone. She would come home with her hands dried and dehydrated from the PPE suit… We received the claim, but we don’t know what to do with it. We have not decided on it yet.”