Disability Insurance: Premium, Coverage, Benefits

Insurance for Disabled Patients in India

Disabled person has to face many problems such as dependency on others, lesser or no income source etc. Moreover treatment cost and insurance for disability is very high because of which seeking medical care is unaffordable for poor people. Considering this situation, Nirmaya – health insurance scheme was launched by Government of India who also funds this scheme. Here are the details for this scheme:

Coverage

Rs.100,000 (1 Lac) for each disabled person

Premium

There is fixed premium of Rs. 250 irrespective of age and income group. Normally in case of other insurance policies, premium increases with age.

Benefits

Few of the most important benefits are:

  • Pre and post hospitalization expenses are covered however there it carries a cap
  • Pre existing diseases are not excluded
  • People can enter anytime in this scheme
  • No pre-medical test required
  • Cashless claims in all the network hospitals
  • If hospital is not in the network list then payment should be made manually and then application for reimbursement is to be done.
  • Regular medical check-up, therapy, corrective surgery, transportation is also provided

C|Max Knee Massager @ Rs.3250
Hawk Knee Support @ Rs.297
Asi Padded Knee Cap Protector / Support (Pair) @ Rs.899

NIRAMAYA – BENEFIT CHART (ON REIMBURSEMENT BASIS)
Detail Limit (in Rs.)
Hospitalization Limit 1 Lac
Hospitalization 1 Lac
Corrective Surgeries Fifty Thousand
Non-Surgical Fifteen Thousand
Preventive Surgery Fifteen Thousand
OPD Limit Ten Thousand
OPD treatment including tests Five Thousand
Regular Medical check-up for non-ailing disabled. Five Thousand
Ongoing Therapies Ten Thousand
Dental Preventive Dentistry Two Thousand Five Hundred
Alternative Medicine (to be considered within limit of IPD or OPD). Four Thousand Five Hundred
Transportation costs (to be considered within limit of IPD or OPD). One Thousand
Overall Coverage Limit:  Rs. 1,00,000

How to Apply

Person can enrol in this scheme through the nearest organization registered with National Trust. These organizations will then send the application form to Nirmaya. After successful enrolment the person would get covered under this health insurance policy after 2 months of approval. If application is submitted between 01Sep-28Feb, then person is covered from April and when submission is done between 1st March-31st August, the person will get covered from October. E-card (biometric/smart card) is issued in the next month after submission of application.

Claim Procedure

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Completed claim form should be submitted to ICICI Lombard General Insurance Company within 30 days of treatment or after discharge from the hospital at the following address:

ICICI Lombard General Insurance Company

Narain Manzil, 3rd floor,

23, Barakhamba Road, New Delhi – 110 001.

Tel:+91 11 55310657

This scheme after it’s launch in 2008 has turned out be extremely beneficial to the people of India as access to healthcare has become very easy and affordable.

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