How to make health insurance truly inclusive for people with disabilities

UNIVERSAL WELLBEING: Carefree without discrimination
| Photo Credit:
lakshmiprasad S

I tried for more than seven years to secure health insurance, approaching 9 to 10 companies across private and public sectors. Each time, I faced rejection. The most interesting — and frustrating — part was that these rejections were rarely communicated formally. Companies would simply go cold or refund the money to my account without providing a reason for the denial.

Much later, when I joined the National Centre for Promotion of Employment for Disabled People (NCPEDP) and took up health insurance for people with disabilities in India, I engaged with multiple insurers. I was finally able to get a health insurance policy after a wait of nearly a decade. However, it came with preconditions: a two-year waiting period, a high premium, and coverage capped at just ₹5 lakh. Nevertheless, I was happy and took it as an achievement.

Every person with a disability in this country bears the high cost of exclusion and the added burden of the “cost of disability” — living expenses that include assistive technology, therapies, medication, and more. Inclusive health insurance can address the high healthcare expenditure of an estimated 16 crore Indians with disabilities. Yet, we continue to face inflated premiums and discriminatory clauses that deny protection to those who need it the most.

The Rights of Persons with Disabilities Act (2016) recognises 21 types of disabilities, and Section 24 specifically mandates comprehensive insurance schemes for persons with disabilities. Despite this, most insurance providers do not recognise or cater to disability-specific needs. Private providers rarely reach out to persons with disabilities, and their digital platforms remain inaccessible, effectively denying access to enrolment, information, and grievance redressal. Furthermore, information on existing policies is rarely available in accessible formats such as Braille or Indian Sign Language. This excludes people with disabilities at the very starting point.

While disability is often included in group insurance policies through employers — such as ESIC and corporate health plans — individual applicants face limited choices and significantly higher premiums than those charged for general health insurance policies.

NCPEDP’s recent white paper, ‘Inclusive Health Coverage for All’, shows that 42 per cent of applications are rejected due to the applicant’s disability, while 37 per cent of applicants received no response from providers. This occurs despite circulars issued by the Insurance Regulatory and Development Authority of India (IRDAI) and multiple court mandates for non-discriminatory insurance products. There is little evidence that these violations reach the attention of the regulator or the ombudsman effectively.

Government schemes also face challenges, primarily due to lack of awareness among beneficiaries and non-uniform implementation across states. Ayushman Bharat covers people with disabilities in poor rural households, provided they were counted under the Socio-Economic and Caste Census 2011. There is an urgent need for updated data to effectively support these vulnerable households. The Niramaya scheme, launched by the Department of Empowerment of Persons with Disabilities, covers four types of disabilities, with Kerala recording the highest number of beneficiaries in the last five years. While various states have their own health insurance schemes, they often do not cover disability specifically, highlighting the need for collaborative efforts on a nationwide scale.

The Ayushman Bharat scheme needs to cover all persons with disabilities recognised under the RPwD Act (2016), irrespective of age or income — in line with its recent extension for senior citizens. Additionally, we need standardisation of premiums for disability-specific insurance products, strict adherence to Web Content Accessibility Guidelines, and accessible application formats. Finally, the training and sensitisation of insurance providers are essential. These steps will ensure the effective inclusion of disability in insurance policies and contribute significantly to India’s journey towards universal health coverage.

(The writer is Executive Director, National Centre for Promotion of Employment for Disabled People)

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Published on December 15, 2025