Insurance for the Disabled Is Tough, But Don’t Lose Hope Just Now

“He (the client, who did not want identification) was well qualified and was working with a multinational firm as a senior manager. His lower body was paralyzed after an accident, but he still went to work. He had an automatic wheelchair and car. I argued with the underwriters that this disability was not life-threatening. They reconsidered the proposal and issued the policy despite the high mortality rate,” says Sharma.

Thus his client got a unit-linked insurance policy (ULIP) and later managed to get the term too Insurance from a different insurer. But their troubles are not over yet. Now, he is trying to get a health cover, but the insurers are rejecting the offer because of his spinal problem.

missing difference

Anecdotal evidence suggests that insurance penetration is very low among differently abled people, making up more than 2% of the country’s population. While insurance companies issue policies to them, the process takes a lot of time and rejections are high.

“Insurance for the disabled depends on the underwriting norms of various insurers. No insurance company has any specific product for this segment. There is a paucity of data and underwriting is mostly done on qualitative inputs that we have,” says Nikhil Kamdar, Appointed Actuary, Digit Insurance.

Another challenge is finding the right advice and support they need to communicate better with insurers. “The agents themselves are not knowledgeable enough or don’t want to put in the time and effort to firmly present the case of the proposer to the underwriters,” says Sharma.

awareness is important

Financial underwriting is paramount in the case of life insurance. In the case of the disabled, there is also the risk of death. “First, the disabled person must be gainfully employed and have a documented source of income. Second is the extent of the disability. If a person is unable to move or needs assistance with daily tasks, then We will obviously review those cases in a different way. If one’s disability is not deteriorating, does not involve mental abilities or is of a leg injury-like nature, says Attri Chakraborty, chief operating officer, IndiaFirst Life Insurance. If I’m stable, we’ll insure them.

Insurers may issue standard policies without a premium rating if the disability is not going to worsen or harm the person’s ability to earn. In cases where certain health parameters may lead to a higher mortality risk, premiums can be leveled. “In most cases, it is about providing life insurance, not how much incremental premium we should charge,” explains Chakraborty.

on health insurance

There are no health insurance products specifically designed for people with disabilities. In most cases, regular policies are issued after necessary medical underwriting.

“It is assessed whether the individual’s disability should be treated as a pre-existing disease (PED). In case of PED, waiting periods or exclusions may apply,” said Amit Chhabra, Business Head – Health , says policybazaar.com.

“Policies for the differently-abled are not very restrictive. In some cases, for example, if someone has a hearing disability, or speech impairment or a handicap, they can also receive comprehensive policies.”

It is difficult to get health cover in cases where individuals are suffering from 100% physical disability. “There are also some chronic medical conditions which are often incurable or require long-term care and the chances of multiple medical complications arising from this are high in such cases. Hence, individuals may find it difficult to get medical cover in such circumstances,” says Kamdar of Digit Insurance.

Essentially, underwriters attempt to analyze the various system abnormalities that may occur in conjunction with a disability. Star Health and Allied Insurance Managing Director Dr. S. “The underwriting team studies the correlation with other organ systems and accordingly a proposal is accepted or rejected,” says Prakash.

If one is planning to treat a specific disability in the near future, he/she will not get the insurance cover. “Planned treatment may not obviously be covered, but in cases where no specific treatment is required, for example a person has some vulnerability to polio, they can get coverage,” says Prakash. Huh.”

In the case of congenital diseases, while externally visible conditions are generally excluded, all internal conditions are usually covered. “Birth defects that are externally visible such as spina bifida, extra digits, hydrocephalus, limb deficiency, etc., are often excluded. Certain internal congenital anomalies like atrial septal defect (hole in the heart), translocation of blood vessels, bowel movements, etc. can be covered in the new retail policy after a specified waiting period,” says Kamdar.

To be sure, the disabled are covered in group insurance policies from day one, till the time they are excluded permanently. Employees receiving group insurance should inquire from their employers about the cover for their specific disability, if any.

Industry players acknowledge that there is a need to collect quantitative data on disabilities to ensure better penetration and wider coverage for people with disabilities.