Saturday, January 30, 2016

Health Insurance for Persons with Disabilities :“Swavlamban Health Insurance Scheme”


Up-till now there was no Health insurance policy for person with disability but now Recently according to press release for Press Information bureau  Health Insurance Scheme for Persons with Disabilities (As Per PWD Act 1995) launched by The New India Assurance Company limited, in Association with Ministry Of Social Justice, Dept of Empowerment of Persons with Disabilities.This insurance is name as “Swavlamban Health Insurance Scheme”

Key Features
1) Sum insured of Rs. 2 lacs on family floater for a period of 12 months.
2) Family size up to 1+3. Primary member is Person with disabilities.
3) Age band 18 - 65 years.
4) Available for persons with disabilities with annual income of Rs. 3 lacs and below on declaration basis in proposal form.
5) No premedical tests.
6) Uniform premium contribution of Rs. 355 per person / family.
7) OPD cover for corrective therapy up to Rs. 10,000 a year for person with disability. For persons with mental retardation and mental illness, OPD cover is Rs. 3000 per annum.
8) No exclusion of pre-existing conditions. However corrective surgery for existing impairment can be done with consent of insurer/TPA.
9) Pre-post hospitalization expenses covered sub to limits.
10) Rest of terms as per standard New India Flexi Floater Group Mediclaim Policy.
11) Persons with multiple disabilities, Cerebral Palsy & autism are not covered under this scheme.


New India will create a network of Hospitals, where the Insured person can get cashless treatment. If any Insured Person wants to take treatment outside network, the permission of TPA is necessary. Such permission is not required in case of emergency hospitalisations.
The policy covers pre-existing Illness. Treatment for pre-existing impairment (for the purpose of this policy, impairment relates to a condition or Illness which caused the Disability as defined in the Act) will be only at the network Hospital and only with the prior approval of the TPA.
At the time of claim, certificate of Disability by the competent authority as defined under the Persons with Disability Act, 1995; has to be submitted to the TPA.

How to Avail ?

For enrollment the beneficiaries have to submit the following documents to nearest New India Assurance Office. Or they can contact National Institute & CRCs, ALIMCO(Artificial Limbs Manufacturing Corporation of India),NHFDC(National Handicapped Finance and Development Corporation)

1) Duly fill proposal form 
2) Payment of premium ( 10 % pf Premium fixed)
3) Income certificate( self attested
4) Photo copy of any govement ID proof,such as Aadhar card,Voter ID ,Driving Licence       etc
5) Passport size photo

6) Photo Copy of Disability certificate

PROCEDURE FOR CASHLESS CLAIMS SETTLEMENT:
Name of TPA: MDIndia Healthcare Services (TPA) Pvt. Ltd.
Toll Free: 1800-233-1166, 1800-233-4505

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