Health Insurance for Persons with Disabilities :“Swavlamban Health Insurance Scheme”

Up-till now there was no Health insurance policy for person with disability but now Recently according to press release for Press Information bureau  Health Insurance Scheme for Persons with Disabilities (As Per PWD Act 1995) launched by The New India Assurance Company limited, in Association with Ministry Of Social Justice, Dept of Empowerment of Persons with Disabilities.This insurance is name as “Swavlamban Health Insurance Scheme”

Key Features
1) Sum insured of Rs. 2 lacs on family floater for a period of 12 months.
2) Family size up to 1+3. Primary member is Person with disabilities.
3) Age band 18 – 65 years.
4) Available for persons with disabilities with annual income of Rs. 3 lacs and below on declaration basis in proposal form.
5) No premedical tests.
6) Uniform premium contribution of Rs. 355 per person / family.
7) OPD cover for corrective therapy up to Rs. 10,000 a year for person with disability. For persons with mental retardation and mental illness, OPD cover is Rs. 3000 per annum.
8) No exclusion of pre-existing conditions. However corrective surgery for existing impairment can be done with consent of insurer/TPA.
9) Pre-post hospitalization expenses covered sub to limits.
10) Rest of terms as per standard New India Flexi Floater Group Mediclaim Policy.
11) Persons with multiple disabilities, Cerebral Palsy & autism are not covered under this scheme.

New India will create a network of Hospitals, where the Insured person can get cashless treatment. If any Insured Person wants to take treatment outside network, the permission of TPA is necessary. Such permission is not required in case of emergency hospitalisations.
The policy covers pre-existing Illness. Treatment for pre-existing impairment (for the purpose of this policy, impairment relates to a condition or Illness which caused the Disability as defined in the Act) will be only at the network Hospital and only with the prior approval of the TPA.
At the time of claim, certificate of Disability by the competent authority as defined under the Persons with Disability Act, 1995; has to be submitted to the TPA.

How to Avail ?

For enrollment the beneficiaries have to submit the following documents to nearest New India Assurance Office. Or they can contact National Institute & CRCs, ALIMCO(Artificial Limbs Manufacturing Corporation of India),NHFDC(National Handicapped Finance and Development Corporation)

1) Duly fill proposal form 
2) Payment of premium ( 10 % pf Premium fixed)
3) Income certificate( self attested
4) Photo copy of any govement ID proof,such as Aadhar card,Voter ID ,Driving Licence       etc
5) Passport size photo

6) Photo Copy of Disability certificate

PROCEDURE FOR CASHLESS CLAIMS SETTLEMENT:
Name of TPA: MDIndia Healthcare Services (TPA) Pvt. Ltd.
Toll Free: 1800-233-1166, 1800-233-4505

Expectation in 2015 : A review of 2014 outcome :Technically,Financially,Utility,Government Plan,Policy

Year 2015 is now only a few hours away. In the New Year at the level of utility and technology are going to be many changes. Many new things are coming. They ease the difficulties of our life. Initiatives to reduce the discomfort and make life simpler is always ongoing process. Here I have tried to summarized some of happening of 2014 then will some way down the line help common people.Some of expectation may or may not get complete.

1) GAS connection

Until now it was: If you had to surrender the city replaced the old agency cylinder. Transfer voucher was made. He would give other city agency. There cylinder was again allotted.

Now it would be if the company is the same, the city does not need to change Haegi transfer. Empty cylinder will give new cylinder. 5 kg cylinder distributor get shorty. The larger cylinder should not be able to take the year 36 Shorty cylinder.

2) LED Bulb in Rs 10

The central government to control electricity demand in the Goverment will provide  Rs 400 LED  in just Rs 10

This project will get started in 37 million households in the three districts of Andhra Pradesh . Together with the center and state governments buy these bulbs give them to the public at subsidized prices

3) Smart Gadgets

– Intel is working on a laptop to wireless charging.
– 3D camera will come with a creative desktop. The screening will be a 3D object. It will be helpful in designing creative. The camera will measure the distance from the object.
 – Intel will bring software that will read the biometric sensor on-board. Giving thumb impression you can directly log on laptop and email.
– Windows will launch in May with -10 Cortana feature. Cortana’s Intelligent Personal Assistant. It will operate many things with your voice
-Camera maker Kodak will launch 4G Phone.
– Samsung smartphone will offer folding screen. The smartphone market trend will change.
– Apple,Lenovo and HTC will present its iWatch and  Smartphone. Many companies will bring new gadgets with such variation

4) Online Driving Licence 

Motor Vehicle Act to amend the country will end the current system of the RTO. Under the new system, the whole process of getting a driving license and a permit will be online. And the license will be test driving simulator. Will eliminate corruption and delay. Bring transparency.

   350 e-toll on National Highway
-All 350 e-toll on national highways will start. The government will save Rs 27 crore. 7 thousand crore in the line of vehicles belonging to the fuel left to burn. Payment will be toll from punch cards to save time.

5) Easy  Banking
Debit Card EMI: ICICI Bank has a beginning. Other banks are on track to do the same. So far, the amount of the credit card after the purchase was EMI option to convert.

Fund Transfer: Kotak Mahindra Bank has launched a Facebook-based fund transfer scheme. It is not necessary to send or receive money to the bank account holder. Other banks are going to start in the new year are Interbank Mobile Payments Service.

Secure Transaction: many banks engaged chip debit card holders in 2015 and aims to provide a credit card with photo. This will secure your transactions.

6) Wi-Railway Station
After the New Delhi railway station, 75 new cities will start Wi-Fi. This widens the 400 railway stations. The first 30 minutes will be free Wi-Fi. After 30 minutes will be charged Rs 25 and Rs 35 for 60 minutes.

– Delhi-Agra  High Speed Moving Track has been successfully tested in 2014 Express. It is the distance between Delhi and Agra holds 105 minutes. Now in 2015 this will hopefully get implemented.

7) Mobile Technology

800 Two-tier cities will be  4G facility having speed  between 16 and 18 Mbps. This speed will be three times higher than the 3G. 1.5 million new subscribers is expected join.

– As a result of broadband and 3G Internet rates will be cut from 30 to 40 per cent.

– Increasing demand for 4G-enabled smartphone. This 3G enabled phone can reduce prices by 30 per cent

-Mobile Number Portability  facility may get implemented for INTER CIRCLE by 31 March 2015.

8) Heath 
-The world’s largest health insurance scheme will be launched in India. Every citizen will feature

either a card making every hospital like Mediclaim free treatment will be provided. So far, 14 states have agreed to the plan.
-More generic medicines store will get open in district hospitals, stores will open at ESIC hospitals and railway stations.

Ebola vaccine
-African Countries killer disease Ebola vaccine will get started. GlaxoSmithKline is the clinical trials. The first vaccine will be available in African countries.

9) Smart City

Smart City will be the first case. However, Microsoft’s technical services provided to the public via a project that will scale.

10 ) Labour 

 -Mandatory deduction of 12 per cent from salary may be exempt from the electives. A bill drafted by the Ministry of Labour has taken. This will benefit those, who want full salary without any PF deducation every month.

– Universal for PF account number with the trust account after starting the transfer of non-trust PF institutions will also be online. In July of non-trust transfers in trust accounts has already begun.

-Minimum wages may rise to 15,000

11) Passport 
Passport will eight days instead of three days. Passport will be made in three days. If the address is
not changed if the police verification will not need renewal. E-Passport Service will begin a six-year delay. Everything will be online.

12) Election

  Voting: Indian embassies abroad can provide EVM machine. For  NRIs  for proxy voting will be provided.They  can assign any other person to cast their vote. Voting will also provide immediate visa to visit India
OCI & PIO card will now merge into single card from 7 January

Is you have any grievance with your Insurance company?:Get the solution from IRDA

Have you ever had some problem with your Insurance company you should first approach the insurer’s Grievance Redressal Mechanism as spelt out in the insurance policy document (link to the insurers’ grievance mechanism is available in this website at List of Insurers).

In case the complaint is not fully attended to by the Insurer within 15 days of lodging it, you may use the IGMS for escalating the complaint to IRDA

IRDA has lauched the Integrated Grievance Management System (IGMS). Apart from creating a central repository of industry-wide insurance grievance data, IGMS is a grievance redress monitoring tool for IRDA. Policyholders who have grievances should register their complaints with the Grievance Redress Channel of the Insurance Company first. If policyholders are not able to access the insurance company directly for any reason, IGMS provides a gateway to register complaints with insurance companies.

Complaints shall be registered with insurance companies first and only if need be, be escalated them to IRDA (Consumer Affairs Department). IGMS is a comprehensive solution which not only has the ability to provide a centralised and online access to the policyholder but complete access and control to IRDA for monitoring market conduct issues of which policyholder grievances are the main indicators. IGMS has the ability to classify different complaint types based on pre-defined rules. The system has the ability to assign, store and track unique complaint IDs. It also sends intimations to various stakeholders as required, within the workflow. The system has defined target Turnaround Times (TATs) and measures the actual TATs on all complaints. IGMS sets up alerts for pending tasks nearing the laid down Turnaround Time. The system automatically triggers activities at the appropriate time through rule based workflows.

A complaint registered through IGMS will flow to the insurer’s system as well as the IRDA repository. Updating of status will be mirrored in the IRDA system. IGMS enables generation of reports on all criteria like ageing, status, nature of complaint and any other parameter that is defined.

Thus IGMS provides a standard platform to all insurers to resolve policyholder grievances and provides IRDA with a tool to monitor the effectiveness of the grievance redress system of insurers

IGMS Complaint Logging
You can call the IRDA Grievance Call Centre

Toll Free Number: 155255
Timings: 8 AM to 8 PM — (Monday to Saturday)

How do you use IGMS?
You can make best use of this system by giving accurate information about your  complaint like the policy number, name of the insurer and your contact details. A policyholder can make optimum use of this system by giving accurate information about the complaint like the policy number, name of the insurer, complainant’s contact details etc. It would be useful to keep the policy document ready while registering the complaint online.
 
The Complaint Registration Process involves the following TWO SIMPLE steps

Step 1: Register yourself by entering your details
Step 2: Register your complaint and view its status