India's first comprehensive health insurance scheme for the physically and mentally challenged, now run by The National Trust.
People with disabilities had been quietly denied health insurance for years, on the assumption that their condition meant higher costs. NIRAMAYA changed that, becoming the first comprehensive health insurance scheme for the disabled in India.
The Persons with Disabilities Act of 1995 had promised insurance and financial assistance, but more than a decade later the provision remained largely unimplemented. Where cover was offered at all, it came with unaffordable premiums and unacceptable terms. In 2005, OASiS began a campaign for insurance rights for the disabled, and what followed was a sequence of milestones.
The New India Assurance Company agreed to insure people with disabilities at standard premiums and terms. The first mentally challenged person in the country received Mediclaim with no extra premium or exclusions.
The Collector of Bhopal announced free health insurance through OASiS for all economically weaker disabled people in the district, with premiums paid by the administration.
A national group was set up to design an insurance framework for the disabled, including the Chief Commissioner Disability, commissioners from ten states, the Collector of Bhopal, and OASiS.
A sub committee worked with actuaries of life and general insurers and with IRDA, and a request for proposal was floated to insurance companies through the Chief Commissioner's office.
The National Trust, a Government of India body, launched the scheme and agreed to pay the annual premium for economically weaker mentally challenged citizens.
NIRAMAYA has since covered around four lakh beneficiaries and proved so valuable that it received the Times Social Impact Award in 2013. It stands as an example of a campaign by one organisation turning into national policy.
The Persons with Disabilities Act of 1995 had, in its thirteenth chapter, obliged governments and local authorities to provide insurance, financial assistance, an alternative security scheme where insurance was not possible, and an unemployment allowance. More than eleven years later that provision remained largely unimplemented.
The campaign reached its peak at a national workshop on disability rights in Bangalore, where the decision was taken to file a public interest litigation in the Supreme Court demanding equal insurance rights. Before it could be filed, the New India Assurance Company’s Bhopal division came forward to experiment with OASiS instead. That offer was then shared nationwide with NGOs working on disability, so they could seek the same terms from regional offices in their own states.
At its first meeting in July 2006, the group agreed to nominate an adviser from the National Insurance Academy, Pune; to write to the Ministry of Finance seeking a non-discrimination clause in the Insurance Act then under amendment, ensuring no disabled person could be denied insurance or discriminated against in offering, pricing, acceptance or servicing; to write to the Secretary for Social Justice and Empowerment about separate health and general insurance schemes with premiums shared between central government, state governments and insurers; to have state disability commissioners send parallel letters through their own governments; to write to the Planning Commission’s Steering Committee and Working Group on Disability for the Eleventh Plan; and to ask the Health Secretary for a national mapping of health resources for disabled people, particularly in rural areas.
A sub-committee of OASiS, ALEgION Insurance Services and Action for Ability Development and Inclusion was formed to collect data, list benefits, talk to insurers and draft the framework. It ran workshops with medical professionals and disability specialists, then convened the actuaries of every general insurer and every life insurer in turn. On the strength of those discussions and policy-level talks with IRDA, a request for proposal went out to all insurance companies through the Chief Commissioner’s office.
Contemporary press reporting noted that the scheme was to be funded from a corpus of about ₹2,400 crore that had accrued to the Ministry of Social Justice and Empowerment from public sector banks, which the Supreme Court had directed be spent for the benefit of disabled people. A three-member expert team (Pradeep Ghosh of OASiS, Dr T V Ramesh of the insurance broking firm Alegion, and Shyamala of AADI) worked with insurers’ actuaries on the design.
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