Niramaya Insurance Scheme - Nayi Disha
FAQ
|
Bookmark
Like
0 2613

WHAT IT IS

The Niramaya Health Insurance Scheme provides affordable health Insurance to persons with Autism, Cerebral Palsy, Mental Retardation & Multiple Disabilities. It is administered by the National Trust.

Coverage

The Niramaya Insurance Scheme provides a comprehensive insurance cover up to INR 1.0 lakh. It has the following unique features:

  • Single premium across age band
  • Same coverage irrespective of the type of disability
  • No exclusion of pre-existing condition
  • Services covered range from regular Medical Check-up to Hospitalization, Therapy to Corrective Surgery, Transportation.
  • Conditions requiring repetitive medical intervention as an in-patient are covered.
  • Pre & Post hospitalization expenses, subject to limits
  • No pre-insurance medical tests.
  • Reimbursement of claims in case of OPD services from any Qualified Medical Practitioner and for IPD treatment can be taken from a Hospital anywhere in the country.
  • The details of services with financial limits (Benefit Chart) is given at Annexure – ‘A’. This is provided on the website – http://www.niramayascheme.com/niramaya

 

WHO CAN APPLY?

  • All persons with developmental disabilities are eligible and included. There is no ‘selection’ criteria.
  • The scheme is available in the entire country except J&K.

 

WHOM TO APPROACH?

National Trust of India

Enrolment to this insurance scheme can be made through registered organizations, as provided on the link: http://www.thenationaltrust.co.in/nt/index.php?option=com_content&task=v…

For more details, please visit the website – http://www.niramayascheme.com/niramaya

 

HOW TO APPLY FOR THIS SCHEME?

For first time applicants (fresh enrollment):

  • A form is provided on the website : http://www.niramayascheme.com/niramaya.
  • Filled details have to be submitted by eligible applicants to the nearest organization registered with the National Trust
  • There will be a nominal processing fee as determined from time to time which shall be payable to the National Trust.
  • On successful enrolment and approval, Health ID No. / card will be issued to each beneficiary and then can print Ecard through the website.
  • 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. Fresh enrolment may be done throughout the year through our registered organizations.

Renewals

  • The policy can be renewed online at www.niramayascheme.com
  • Fee has to be paid as per the rate (fixed by National trust)
     

    • Fee can be paid by by DD/ NEFT or cash only (not by Cheque) in National Trust (Niramaya) account either
    • Fees can be paid at any Branch of Corporation Bank or State Bank of India.
  • The details of banks are given on the website – http://www.niramayascheme.com/niramaya.

Claims Process

  • Niramaya Insurance does not have a cashless poilicy
  • Claim Form for settlement has to be submitted in the 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, authorized by the Insurance Company.
  • In the claims form, all the fields must be filled and enclose the following documents :
     

    • Copy of Niramaya card or mention Health ID No.
    • Attested copy of Disability Certificate.
    • All original prescription papers given by the doctor.
    • All original bills of Hospital / Medicine / Doctor fee / Therapy fee / Conveyance etc., should be self-attested.
    • All reports in Original.
    • Complete bank details of Beneficiary :
       

      • Account No. / Bank Name / Branch / IFSC Code / Name of Account Holder.

Important Tip : Please update your mobile number on the website of the National Trust by click on link Mobile No., to get updated information about NIRAMAYA on regular basis.

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 Third Party Administrator (TPA) is Raksha TPA Pvt. Ltd,

Claim Form may kindly be sent to the Regional Centres of Raksha TPA Pvt. Ltd. (as provided on the website- http://www.niramayascheme.com/niramaya) The Nirmaya Website provides contact details for the Third Party Administrator (TPA)- http://www.niramayascheme.com/niramaya

Suggested Service Providers
Select your language