Swavlamban Health Insurance Policy for Disabled People

Swavlamban health insurance policy is an exclusive health insurance policy, designed for people with disabilities (PWDs). The policy was introduced by the New India Assurance Company Limited, in collaboration with the Department of Empowerment of Persons with Disabilities (DEPD) on 2^nd October 2015. The aim of this plan is to offer adequate health insurance coverage to the mentally and physically challenged and the people with hearing-impairment, low vision, blindness, locomotor disability and so on.

New India Assurance Company is a Mumbai based public sector general insurance company. It was established by Sir Dorabji Tata in 1919. The company was nationalized in the year 1973. Based on the gross premium amount collection, New India Assurance Company is the largest general insurance corporation in India.   

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Swavlamban Health Insurance Policy for Disabled People

Features of Swavlamban Health Insurance Policy:

1. An insured person gets a yearly cover of Rs 2 Lakhs.
2. The yearly income of the family of a disabled person must not exceed Rs 3 Lakhs.
3. The scheme is offered to people in the age group of 0-65 years.
4. As Swavlamban health insurance policy is a family floater insurance plan, it also covers the family (spouse and up to two children, but not parents and siblings) of an insured person.
5. If a policyholder is a minor, then his/her legal guardians or parents are covered.
6. No medical checkups are necessary.
7. In case of mental sickness, OPD expenses are covered up to Rs 3,000 a year and in case of corrective therapy, OPD overheads are covered up to Rs 10,000 a year.
8. The plan does not cover individuals with multiple disabilities. They are covered under the Niramaya Health Insurance Policy offered by the National Trust.
9. The plan also covers pre-existing medical challenges.

See Also: Health Insurance Benefits

Premium for Swavlamban Health Insurance Scheme

The New India Assurance Company Limited has fixed a yearly premium of Rs 3,100 plus taxes for hospitalization and OPD coverage. Insured people must pay only 10% of the premium amount, i.e., 357 (including taxes) and the remaining amount is paid by the Government.

How to Get the Policy?

The people with disabilities (PWDs) have to fill a proposal form with an annual premium of Rs 357 and produce 2 passport-size photographs of each family member and the Disability Certificate (according to the PWD Act, 1995) and personal identification proof (Driving license, voter card and Aadhaar Card). The duty filled proposal form has to be submitted to the concerned ICDS (Integrated Child Development Services) Project Office.

See Also: Family Health Insurance Plan

How to Make Claim on the Policy?

The New India Assurance Company Limited has established a network of hospitals to help people avail cashless treatment. A policyholder has to get the permission of the respective TPA (Third-party Administrator) if he/she would like to be hospitalized at a non-covered hospital. No such permission is needed in case of emergencies. While making a claim, you have to show the Disability Certificate to the TPA. Disputes and grievances are handled by the Dispute Resolution Committee.

Note: Private insurance companies do not provide a health insurance plan to those with a 40% plus disability. The government has several health insurance policies to cover such people. The premium amount varies based on age. It could be as low as Rs 250 and as high as Rs 16,000.

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