Scheme Overview (Niramaya)

1. Affordable Health Insurance to PwDs.
2. Health insurance cover of up to Rs. 1.0 lakh.
3. Facility for OPD treatment including medicines, pathology, diagnostic tests, etc., regular medical checkups for non-ailing disabled, dental preventive dentistry, surgery to prevent further aggravation of disability, non-surgical/hospitalization, corrective surgeries for existing disability including congenital disability, ongoing therapies to reduce the impact of disability and related complications, alternative medicine.
4. Transportation costs.
5. No pre-insurance medical tests required.
6. The scheme will be available in the entire country except J&K.

Scheme Description

The scheme envisages delivering comprehensive cover which will:

• Have a single premium across age bands.
• Provide the same coverage irrespective of the type of disability covered under the National Trust Act.
• Insurance cover up to Rs.1.0 lakh, on a reimbursement basis only.
• All persons with disabilities under the National Trust Act with a valid disability certificate will be eligible and included.
• No pre-insurance medical tests.
• Treatment can be taken from any hospital.

Niramaya’s Health Insurance Scheme Benefit Chart

The sub-allocation outlined above may undergo an annual alteration based on the agreement between the National Trust and the Insurance Provider and will be notified on the website.

Eligibility Criteria for PwD

• All PwDs who have at least one of the disabilities under the National Trust Act, 1999 with a valid disability certificate are eligible to apply for the scheme.

Enrolment of Beneficiaries

1. Any eligible person can apply for enrolment under the Scheme in the prescribed format given on the website and submit it to the nearest organization registered with the National Trust or to any other agencies specially entrusted in this regard by the National Trust at any time during the year. On successful enrolment and approval, Health ID No./ card will be issued to each beneficiary and they can print Ecard through the website.
2. There will be a nominal processing fee as determined from time to time which shall be payable to the National Trust.
3. Fresh enrolment may be done throughout the year.
4. Both the fresh enrolment and renewal will be from the enrolment date with the Insurance Company to the end of the financial year.
5. Any beneficiary enrolled during any month of the financial year will be covered upto 31^st March. The enrolment / renewal fee will be full and will be eligible to claim upto Rs.1 lakh.

Premium & other charges

The insurance company shall be selected and premium shall be decided through a transparent process. The premium amount shall be paid by the National Trust in advance to the selected Insurance Company.

II. Enrolment Process

1. RO to send the online application form/proposal.
2. Fill up the Niramaya application form online and upload the scanned documents as required after verification of originals.
3. Submit the duly filled-in form on the National Trust portal.

Pay the application fees online (as detailed in the table).

PwD Enrolment by RO (first approval) process

PwD enrolment process defines the steps to be followed while enrolling for Niramaya for the first time. It also details out the required information and documents at each step and timelines for various activities wherever applicable.

Note: Documents received without application fees shall not be entertained

STEP 3. After the National Trust receives the application form and the documents, these are checked for completion.
If there is any missing information or wrongly submitted information, the RO is given 15 days to submit it again.

STEP 4. On successful enrolment and approval, Health ID No. /card will be issued to each beneficiary.

Communication to RO by the National Trust shall be done within 30 days on receipt of final documents.

STEP 5. Enrolment is completed, and the Health ID card is uploaded online and can be downloaded by the beneficiary online or through RO.

IV. Process of Claim Settlement

Claim Form for settlement, through reimbursement basis only, under Niramaya has to be submitted in the prescribed Claim Form along with relevant vouchers / bills, etc., within 30 days of treatment or discharge from hospital. The claim form can be downloaded from the website and sent to the Third Party Administrator, authorised by the Insurance Company.

Most Important Tip: Please update your mobile number to get updated information about NIRAMAYA on regular basis.

Download Claim Form

Renewal Process

The Niramaya scheme is valid till March 31st of the financial year in which enrolment is undertaken. Beneficiaries are expected to submit
the renewal application three months prior to expiry to continue availing the scheme.