Over 80 pc of Indians with disabilities lack health insurance: NGO white paper

More than four in five Indians with disabilities remain outside the health insurance net, and over half of those who do apply are routinely rejected without explanation, despite legal guarantees of equal access, a new white paper released on Thursday has reported.

The study — 'Inclusive Health Coverage for All: Disability, Discrimination and Health Insurance in India' — was unveiled by the National Centre for Promotion of Employment for Disabled People (NCPEDP) at a roundtable that brought together policymakers, insurers and disability rights advocates.

Drawing on a nationwide survey of more than 5,000 persons with disabilities across 34 states and Union Territories, the paper warns that “deep systemic inequities” continue to exclude nearly 16 crore disabled Indians from both public and private insurance schemes.

According to the findings, 80 per cent of respondents had no form of health insurance, while 53 per cent of those who applied said their applications were rejected. Many reported being refused solely on account of their disability or pre-existing conditions, with particularly steep denial rates among persons with autism, psychosocial and intellectual disabilities, and blood disorders such as thalassaemia.

These practices, the report emphasised, persist despite constitutional protections, the Rights of Persons with Disabilities Act 2016, and repeated directives issued by the Insurance Regulatory and Development Authority of India (IRDAI).

Researchers additionally pointed to unaffordable premiums, inaccessible digital systems, and widespread lack of awareness about existing schemes as key obstacles to securing cover.

At the launch, Manmeet Nanda, additional secretary in the ministry of social justice and empowerment, said the government was working to bolster assistive technology and improve cross-ministerial coordination.

“IRDAI’s role, along with the ministry of health and family welfare and the department of empowerment of persons with disabilities, needs to be very strongly converged and coordinated because this is not a single ministry’s game,” she said, suggesting that insurers could be mandated to meet annual disability coverage targets monitored through digital dashboards.

She also proposed integrating the Unique Disability ID database with insurance processes to track rejections and streamline access.

Calling the findings a “moral and constitutional challenge”, NCPEDP executive director Arman Ali said the persistent exclusion of persons with disabilities from affordable insurance “is more than a systemic failure; it is a violation of rights”.

“Even as the government expands Ayushman Bharat (PM-JAY) to cover all senior citizens aged 70 and above, persons with disabilities remain conspicuously excluded despite facing equal, if not greater, health vulnerabilities,” Ali said.

“There is no principled or policy justification for this gap… India cannot be burdened with the generational ‘cost of exclusion’ of people with disabilities,” he added.

The white paper urges the immediate inclusion of all persons with disabilities under Ayushman Bharat without age or income criteria, aligning with the government’s 2024 expansion for senior citizens.

Key recommendations also include enhanced insurance coverage for mental health, rehabilitation, and assistive technologies; the creation of a dedicated Disability Inclusion Committee within IRDAI; standardised, non-discriminatory premiums across private insurers; and mandatory accessibility in all insurance processes.

The paper further calls for expanded sensitisation programmes for insurers and healthcare providers to ensure disability-inclusive service delivery.

With PTI inputs