India’s health workers left without government insurance cover as Covid-19 second wave hits country

On March 26, 2020, two days after enforcing a national lockdown to combat Covid-19, the Central government announced a special insurance scheme for all healthcare workers fighting the pandemic on the frontlines. The insurance cover promised Rs 50 lakh to the family of every health worker who died of Covid-19 while on duty.

One year later, while India is in the throes of a deadly second wave that has stretched healthcare systems to their limits, this insurance scheme has lapsed. So far, the Centre has not made any announcement about extending the scheme, but the Ministry of Health and Family Welfare claims it is talks with public sector insurance company New India Assurance to provide a “new dispensation” for “Corona Warriors”.

The lapsing of the scheme came into focus on Sunday when a letter dated March 24 by Rajesh Bhushan, secretary of the health ministry’s National Health Mission, to chief secretaries of all states and union territories, was circulated on Twitter.

The letter states that the Pradhan Mantri Garib Kalyan Package Insurance Scheme for Health Workers Fighting Covid-19 came to a conclusion on March 24, 2021, and that those eligible for insurance cover up to that period would be given up to April 24 to submit their claims.

The letter did not specify how many health workers had lost their lives to Covid-19 in the year since the scheme was launched and did not mention the total number of claims that the health ministry received from health workers’ families.

It stated, however, that a total of 287 insurance claims had been approved under the scheme in a year.

Officials from the Ministry of Health and Family Welfare were not available on the phone on Sunday. Scroll.in has emailed them queries about the lapsing of the insurance scheme. This report will updated if they respond.

Health care workers and their unions, meanwhile, are angry about the end of the insurance scheme. With India reporting over 2 lakh new Covid-19 cases for straight four days last week, they want the Centre to extend the scheme for the welfare of health workers’ families.

“Right now the second wave is much worse than the first, and it is part of our job to work in this crisis. But if something happens to us, who will be responsible?” said Joldin Francis, the secretary of the Delhi chapter of the United Nurses Association, a national union for medical nurses. “We will write a letter to the government about the need to extend the insurance scheme.”

Rejected claims

In the battle against the Covid-19 pandemic, frontline heath workers include everyone from doctors, nurses, ward boys and paramedics to community health workers such as ASHAs (accredited social health activists), anganwadi workers and sanitation workers.

The Rs 50 lakh insurance scheme has been riddled with problems every since it was introduced last year.

For one, it is a life insurance rather than a health insurance scheme, which means that a health worker needs to die of Covid-19 for their family to get the funds. There is no insurance scheme for Covid-infected health workers who might need financial assistance for hospitalisation or medicines.

“Where is the risk allowance for those who may be sick or recovering?” said AR Sindhu, the general secretary of the All-India Federation of Anganwadi Workers and Helpers. “That should also be given.”

Even as a life insurance scheme, workers and activists have frequently complained about claims being rejected for illogical or unexpected reasons.

For instance, this Scroll.in report from July 2020 highlights how insurance claims by families of four health workers were rejected in the first three months of the scheme. In one case, the family of a nurse could not prove that she was involved in treating a Covid-19 patient; in another, a doctor’s family was told he was not a Central government employee, even though the scheme covers staff of private hospitals too.

“We know of two nurses in our association who died of Covid-19 but their families’ insurance claims have been rejected because they did not work in designated Covid hospitals,” said Joldin Francis. “The hospital may not be only for Covid patients, but these nurses could have easily caught Covid from any other asymptomatic patients they were dealing with.”

According to Sindhu, another reason for rejected claims has been that many state governments did not recognise anganwadi workers as frontline Covid-19 workers. “Besides, many of their deaths in the first three months of the pandemic were not certified as Covid deaths,” she said.

Over the past three months of the scheme, a different problem arose: getting the government to recognise deaths caused by vaccinations as Covid-19 deaths. In January, ASHA worker B Vijayalakshmi died following a dose of a Covid vaccine in Andhra Pradesh. The state government announced the Rs 50 lakh insurance for her family only after the case was heavily publicised in the media.

Inadequate data

Even if the insurance scheme for frontline health workers is now extended, activists believe many of these problems will persist, including the issue of recording deaths and maintaining accurate data.

In February, the health ministry claimed in the Rajya Sabha that a total of 162 doctors, 107 nurses and 44 ASHA workers had died in the line of Covid-19 duty up till that point. However, the Indian Medical Associationclaimed last week that at least 734 doctors alone had died of Covid-19

According to Jibin TC, a nurse and the secretary of the United Nurses Association’s Maharashtra chapter, at least 350 nurses across India lost their lives due to Covid-19. “I believe most of their families must have filed claims for insurance, but the government has not released that kind of data,” said Jibin TC.

In Maharashtra itself, Jibin claims at least 1,700 out of 22,000 member-nurses had contracted Covid-19 in the past year. “Around seven of them died, several months ago, and the last I checked, their families’ claims had been approved,” said Jibin. “However, I do not know if they have received the money in their accounts yet.”

In Andhra Pradesh, Sindhu claims that ASHA and anganwadi union networks estimate that there were at least 150 deaths among their members through the year. Of these, only 10 received the insurance money. “The tragedy is that very few states are actually keeping records of the number of health worker deaths,” she said.

Despite these problems, Sindhu believes there is value in the scheme, given the lack of other welfare options available for health workers in the country. “This scheme has not been implemented properly at all, and many health workers’ families are still fighting to receive their money,” said Sindhu. “But without this scheme, it is going to be very difficult for families to manage if health care workers die.”