A comprehensive Health Insurance System for the Disabled. A fight for Insurance rights for the Disabled that was initiated by OASiS in 2005, culminated in the formation of a National Core Committee for designing an Insurance Framework for the Disabled in the country, of which OASiS was a part. With Chief Commissioner Disability (GoI), The National Trust (GoI), and Insurance Regulatory and Development Authority (IRDA), OASiS designed and developed NIRAMAYA scheme, implemented by The National Trust (GoI) for mentally challenged, in 2008.
Providing social security to the disabled and their families has been one of the objectives of the Persons with Disabilities Act 1995. The chapter thirteen of the act contains various schemes to be implemented by the “appropriate Governments” and “local authorities” including financial assistance, insurance scheme for the benefit of the disabled, alternative security scheme where insurance is not possible and unemployment allowance to persons with disabilities registered under special employment exchange.
It is more than eleven years since the act has come into existence. However, this most important provision of the act had not been appropriately implemented and the persons with disabilities had remained without any insurance cover, financial assistance or any other social security scheme.
Organization for Awareness of Integrated Social Security (OASiS), a Non Government social organization in Bhopal started its efforts for social security to all disabled two years back, with a fight for insurance rights for the disabled. People with disabilities have been denied any economic protection from ill health, for long. This has been one of the reasons of their poor health seeking behaviour too. The disabled have been denied Health Insurances because of pre-assumed notions that their disability results in greater health expenses. Some insurances have however been offered selectively, but at unaffordable premiums and unacceptable terms and conditions. Efforts to persuade and convince insurance companies to give health insurances to persons with disabilities had not resulted in any success.
The battle reached its peak during a national workshop on rights for the disabled in Bangalore, where a decision was taken to file public interest litigation in the Supreme Court, demanding equal insurance rights for the disabled in the country. However, before the PIL could be filed, the New India Assurance Company Ltd, Bhopal Division came forward to experiment Health Insurances for the Disabled with OASiS.
The first milestone was reached when on November 29, 2005, the first mentally challenged in the country received Health Insurance (Mediclaim) without any extra premium or extra exclusions. The New India Assurance Company Ltd agreed to provide all disabled (physically and mentally), health insurances at standard premium and terms and conditions as others. They also offered to give accidental insurances for the first year on the basis of their perceived risk and subsequently after analyzing the claims ratio for a year.
This offer from the Insurance Company was shared nationwide with all NGOs working for the disabled, and the organizations were asked to capitalize on this opportunity and get similar offers from the New India Assurance Company Ltd Regional Offices in their region.
The second milestone was reached when on December 10, 2005 in a Press meet, the Collector Bhopal announced free health insurances through OASiS, for all economically weaker disabled in the district, with the premiums being paid by the District Administration.
The third milestone was reached when on February 22, 2006, during the 5th National Meeting of the State Commissioners for Persons with Disabilities in Delhi, a Core Group was formed to formulate a scheme for Health Insurance for Persons with Disabilities. The National Core Group headed by the Chairperson National Trust for the Disabled comprised of Chief Commissioner Disability, Commissioner Disabilities of 10 states of India, Collector Bhopal District and Pradeep Ghosh (Ashoka Fellow and President – OASiS).
In the first meeting of the National Core Group held on July 7, 2006 in New Delhi, the following action plan was drawn:
* Nominate a representative from National Insurance Academy (Pune) to advise and assist in the formulation of the Health Insurance Policy for the Disabled.
* Letter to Ministry of Finance for inclusion of disability, and a non-discriminatory clause in the Insurance Act (under amendment). The clause shall ensure that no disabled is denied any insurance because of his/her disability, and there shall be no discrimination in offering, pricing, acceptance and servicing of insurance policies to the disabled.
* Letter to Secretary Social Justice & Empowerment for taking up with Finance Secretary for framing separate health and general insurance schemes for persons with disabilities and providing for sharing the payment of premium by Govt. of India, the State Governments and Insurance Companies or to give appropriate subsidy packages.
* Commissioner Disabilities of all states to facilitate similar letters through their State Governments to Ministry of Finance and Ministry of Social Justice and Empowerment.
* Letter to Steering Committee and Working Group on Disability, constituted by Planning Commission for Eleventh Plan, for recommending Health Insurance Scheme at national level for Persons with Disabilities.
* Letter to Secretary Health, for conducting national mapping of health resources for the disabled in the country, especially in the rural areas and provide relevant data to Ministry of Social Justice & Empowerment and the National Core Group.
In the second meeting of the National Core Group held on January 12, 2007 in New Delhi:
* A Sub-Committee comprising of OASiS, ALEgION Insurance Services Ltd. and Action for Ability Development and Inclusion, was formed to collect data, list benefits, interact with insurance companies and draft a framework of Life and Health Insurance for Persons with Disabilities.
* The Sub Committee was given a time limit to complete its activities and submit its recommendations in the Third Core Group meeting.
The Sub Committee conducted several workshops with Medical professionals and Disability sector specialists to draft the requirements for an integrated health insurance an life insurance for the disabled. Based on these requirements,
the Sub Committee called a meeting of Actuaries of all General Insurance Companies and another meeting of Actuaries of all Life Insurance Companies and discussed the requirements with them.
Based on these discussions and policy level discussions with IRDA, a Request for Proposal was floated through the Chief Commissioner Disabilities office to all Insurance Companies. The offers were then opened and evaluated by a joint committee formed by GoI and the following newspaper report said it all.
NIRAMAYA – the First comprehensive Health Insurance Scheme for the disabled in the country was launched on 28 March 2008 in Delhi, with National Trust agreeing to pay the Premium for the Economically weaker mentally challenged every year.
The Insurance has been so beneficial for the mentally challenged, that it received the Times Social Impact Award in 2013.
Click here to see THE STORY OF NIRAMAYA