TOI Social Impact Awards: Enabling cover for the disabled

NEW DELHI: Apala's twin daughters were born with cerebral palsy. Deserted by her husband, the Delhi schoolteacher had nothing to fall back on when the girls, aged 10, needed surgery recently. Thankfully, she had Niramaya, the health insurance scheme started by the National Trust for the Welfare of Persons with Autism Cerebral Palsy Mental Retardation and Multiple Disabilities. Apala was reimbursed the entire surgery costs of about Rs 60,000.

Niramaya has also helped people such as Raj Kumar, whose 13-year-old son is intellectually disabled. Last August, he spent Rs 2,450 on his son's medicines and was reimbursed Rs 2,000. He had joined the scheme in February last year, paying Rs 500 as premium. "It might not cover everything, but it's definitely a help," says Kumar, a government employee.

Before Niramaya was conceived, persons with the kind of disabilities that National Trust deals with had no health insurance cover. No insurance company was willing to provide them health coverage . "Many treatment options or even surgeries which could improve the quality of life of these persons were never availed of. We decided to address this by designing a scheme with ICICI Lombard and launched it in 2007," explains Poonam Natrajan, chairperson of the National Trust, a statutory body under the ministry of social justice and empowerment. More than 1.20 lakh have registered for the scheme which provides coverage up to Rs 1 lakh per annum. More than 16,400 have so far claimed reimbursement for medicine, therapy or surgery.

Kanta Chand, whose 22-year-old daughter is intellectually challenged, says the claims process wasn't easy. "I spent Rs 7,000 on her treatment, submitted bills for Rs 4,000 and was reimbursed just Rs 2,350. I lost two-three days of work and had to make several calls before I got the money," says the barely literate mother. She had joined the scheme just four months earlier and got back nearly 10 times the premium amount (Rs 250). But, Chand says, "I would have got her treated in a sarkari hospital if I'd known I wouldn't get full reimbursement. Our monthly income is just Rs 4,000."

Clearly, lack of awareness is a problem, especially among the poor. "It's an excellent scheme, but more publicity is needed so that more people can avail of it. It also needs improvement in its administrative structure and greater involvement of the NGOs beyond just registering people. They should explain the scheme well and help people with the reimbursement process," says J P Gadkari, president of Parivaar, a federation of parents' groups and NGOs working with persons with intellectual disabilities in Karnataka.

The scheme does not discriminate on severity of disability or any pre-insurance conditions, and is for all ages. Coverage is provided at a nominal annual premium of Rs 250 for those with a family income up to Rs 15,000 per month and Rs 500 for those above that cutoff. The trust pays the Rs 250 premium for those below the poverty line.

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TOI Social Impact Awards: Enabling cover for the disabled