The National Trust : Logo

The National Trust for the Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple Disabilities.

Empowering Abilities, Creating Trust
Menu
...to take India's development journey to newer heights we seek your support, blessings and active participation" signature

NIRAMAYA
(Health Insurance Scheme)

Download Niramaya E-card of the beneficiary

Renewal and Enrollment of beneficiaries under Niramaya is open throughout the year. Kindly contact the nearest Registered Organisation

About the Scheme

  1. Affordable Health Insurance to PwDs.
  2. Health insurance cover of up to Rs. 1.0 lakh.
  3. Facility for OPD treatment including the medicines, pathology, diagnostic tests, etc, Regular Medical checkup 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 impact of disability and disability 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 band
  • Provide same coverage irrespective of the type of disability covered under the National Trust Act
  • Insurance cover upto Rs.1.0 lakh , on reimbursement basis only.
  • All persons with disabilities under the National Trust Act with 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 Revised Benefit Chart (on Reimbursement Basis only w.e.f.April, 2015)

Niramaya' Health Insurance Scheme Revised Benefit Chart
On Reimbursement Basis only (w.e.f. April, 2015)
Section Sub- Section Detail Sub Limit Over all Limit of Section
I Over all Limit of Hospitalization 70,000/-
  A Corrective Surgeries for existing Disability including congenital disability 40,000/-  
  B Non- Surgical/ Hospitalization 15,000/-  
  C Surgery to prevent further aggravation of disability 15,000/-  
II Overall Limit for Out Patient Department (OPD) 14,500/-
  A OPDtreatment including the medicines, pathology, diagnostic tests, etc. 8,000/-  
  B Regular Medical checkup for non-ailing disabled 4,000/-  
  C Dental Preventive Dentistry 2,500/-  
III Ongoing Therapiesto reduce impact of disability and disability related complications 10,000/-
IV Alternative Medicine 4,500/-
V Transportationcosts 1,000/-
OVERALL LIMIT OF THE COVERAGE FOR A PERSON: Rs.1,00,000/-

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

Eligibility Criteria for Registered Organisation(ROs)

All ROs of the National Trust after paying the registration fee of Rs.1000/- could get registration under the Niramaya Health Insurance Scheme of the National Trust for further enrolling the Persons with Disabilities (PwDs) under the National Trust Act.

Eligibility Criteria for PwD

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

 

 

Enrolment Process

I .Enrolment Process

Enrolment of Beneficiaries

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 then can print Ecard through the website.

There will be a nominal processing fee as determined from time to time which shall be payable to the National Trust.

Fresh enrolment may be done throughout the year through National Trust Registered Organizations.

Both the fresh enrolment and renewal will be from the enrolment date with the Insurance Company to the end of the financial year. Any beneficiary enrolled during any month of the financial year will be covered upto 31st 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.
  4. Pay the application fees online (as detailed in the table).
PwD Category Enrolment Fee (In Rs) Required Documents
Below Poverty Line(BPL) Rs. 250/-
  • Disability certificate (self attested) issued from the District Hospital or appropriate Government authority
  • BPL card
  • Address Proof
Non BPL Rs. 500/-
  • Disability certificate issued from the District Hospital or appropriate Government authority (self attested)
  • Address Proof
  • Income certificate of (self attested) the parent/guardian competent authority as issued by the State
PwD with Legal Gurdian (Other than natural parents) Free
  • Disability certificate(self attested) issued from the District Hospital or appropriate Goverment authority.
  • Legal Guardian Certificate issued from the Local Level Committee constituted under section 13 of The National Trust Act, 1999
  • Address Proof

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 activity wherever applicable.

Any eligible person can apply for enrolment under the Scheme in the prescribed format through 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. The PwD will be responsible for paying the application fee as applicable and the RO will be entitled to INR 40 payable by National Trust per form for processing.

STEP 1.Parents/guardian of the PwD will visit the nearest RO for Niramaya enrolment with required documents (as detailed in Step 2)

STEP 2.The RO will follow the process detailed below  for enrolment of the PwD:

  • RO to send the online application form/proposal
  • Fill up the Niramaya application form online and upload the scanned documents as required after verification of originals
  • Submit the duly filled in form on the National Trust portal
  • Pay the application fees online (as detailed in the table)

The following table details the application fee and supporting documents for each category of PwDs.

PwD Category Enrolment Fee (In Rs) Required Documents
Below Poverty Line(BPL) Rs. 250/-
  • Disability certificate (self attested) issued from the District Hospital or appropriate Government authority
  • BPL card
  • Address Proof
Non BPL Rs. 500/-
  • Disability certificate issued from the District Hospital or appropriate Government authority (self attested)
  • Address Proof
  • Income certificate of (self attested) the parent/guardian competent authority as issued by the State
PwD with Legal Gurdian (Other than natural parents) Free
  • Disability certificate(self attested) issued from the District Hospital or appropriate Goverment authority.
  • Legal Guardian Certificate issued from the Local Level Committee constituted under section 13 of The National Trust Act, 1999
  • Address Proof

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. However, if there is any missing information or wrongly submitted information which needs to be submitted again, the RO is given 15 days’ time 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 the Health ID card is uploaded online and can be downloaded by the beneficiary online or through RO.

Enrolment and Renewal Fee

The enrolment / renewal fee is for one year i.e. upto 31st March of next year. This means, every year the renewal of policy has to be done online through www.thenationaltrust.gov.in by beneficiary or NGO and the fee has to be paid as per the applicable rate (fixed by the National trust)directly in the Bank.

Guidelines for Enrolment

Enrolment is being done online by all Registered Organisations. List of Registered Organisations is available on the website.

The applicant is required to submit the duly filled in enrolment form to the registered NGO, along with the following documents :

  1. Disability certificate issued from the District Hospital or appropriate Government authority.
  2. Address Proof.
  3. One Passport size photograph of the Special Need person.
  4. BPL card, if applicable.
  5. Income certificate (Latest IT return, or Income certificate from Tehsildar).
  6. Proof of payment of applicable fee (Bank receipt).
  7. Bank details for settlement of claims.

Claim settlement

IV. Process of Claim Settlement

Claim Form for settlement, through reimbursement basis only, under Niramaya has to be submitted in the prescribed Claim Form alongwith 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.

  1. The Insurance Company for the period 2015-16, is The Oriental Insurance Co. Ltd., DO -20,N-39, Bombay Life Building, Connaught Circle, New Delhi- 110001; and
  2. Third Party Administrator (TPA) is Raksha TPA Pvt. Ltd,
  3. Claim Form may kindly be sent to the Regional Centres of Raksha TPA Pvt. Ltd. For the list click here.
  4. For any query regarding reimbursement of claim, kindly contact :

Head office of Raksha TPA Pvt. Ltd. C/o. Escorts Corporate Centre, 15/5 Mathura Road, Faridabad – 121 003, Haryana. Tel.No.0129 4289999, 18001801444.

Contact persons of Raksha TPA (Oriental Insurance Co.)

Mr. Ravi Seth 9810413456

No Employee Contact No. Email ID
1 Mr. Vikram Jha 7838151509 vikramjha@rakshatpa.com
2 Sh. Balvinder Rana 7838151530 balvinderrana@rakshatpa.com
3 Sh. Anshul Jain 7838151508 anshul@rakshatpa.com

 

Guidelines for Claim Settlement

(a) Copy of Niramaya card or mention Health ID No.

(b) Self-Attested copy of Disability Certificate.

(c) All original prescription papers given by the doctor.

(d) All original bills of Hospital / Medicine / Doctor fee / Therapy fee / Conveyance etc.,

(e) All reports in Original.

(f) Complete bank details of Beneficiary: Account No. / Bank Name / Branch (City & State)

IFSC Code.

(g) Name of Account Holder.

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.

The other way, they can visit the nearest RO registered under Niramaya Scheme with the required documents as given in the table below according to the category for renewal of scheme. The steps to be followed by the beneficiary for renewal through RO are as under:-

STEP 1.Parents/guardian of the PwD will visit the nearest RO for Niramaya renewal         

with required documents (as detailed in Step 2)

STEP 2.The RO will follow the process detailed below  for renewal of the PwD:

  • RO to verify the validity of documents (outlined in the table given below)
  • Click on the renewal link on the Niramaya website
  • Pay the application fees online (as detailed in the table)
PwD Category Renewal Fee (In Rs) Required Documents
Below Poverty Line(BPL) Rs. 50/-
  • Disability certificate (self attested) issued from the District Hospital or appropriate Government authority
  • BPL card
  • Address Proof
Non BPL Rs. 250/-
  • Disability certificate issued from the District Hospital or appropriate Government authority (self attested)
  • Address Proof
  • Income certificate of (self attested) the parent/guardian competent authority as issued by the State
PwD with Legal Gurdian (Other than natural parents) Free
  • Disability certificate(self attested) issued from the District Hospital or appropriate Goverment authority.
  • Legal Guardian Certificate issued from the Local Level Committee constituted under section 13 of The National Trust Act, 1999
  • Address Proof

STEP 3.After receipt of payment, the RO/beneficiary will be notified of the renewal for another year through the website.

Enrolment and Renewal Fee

The enrolment / renewal fee is for one year i.e. upto 31st March of next year. This means, every year the renewal of policy has to be done online through www.thenationaltrust.gov.in by beneficiary or NGO and the fee has to be paid as per the applicable rate (fixed by National trust) directly in the Bank.

Grievance Redressal

In case the RO or the PwD faces any issues with regard to the scheme, the RO or the PwD can either login the issue in the Grievance redressal system in the website or can contact the concerned official or CEO of National Trust on the office phone number.

 

Last Updated On: 18-01-2017

Visitor Counter : 41955