First an
introduction. Ms Sucheta Dalal of www.moneylife.in
has been taking keen interest in issues involving disabled veterans. Such support
from citizens from different walks of life is heartening and morale-boosting
for the veteran community. Major D P Singh, a battle casualty who lost his
right leg in a mortar explosion has been bringing to light this issue umpteen number
of times through his NGO ‘The Challenging Ones’.
Speaking at a Moneylife Foundation seminar,
IRDA chairman J Hari Narayan said that the need for various implants is real
and it has to be addressed as disability can happen due to accidents, medical
condition or at birth.
In most cases, medical treatment under
insurance does not cover prosthetics/artificial limb, when in fact, this is
absolutely essential for an amputee to live a normal life. Col (retd) Satish
Mallik, a Kargil war veteran and amputee himself, brought this to the attention
of the insurance regulator at a special meeting organised by Moneylife Foundation
on 16th May. Col Mallik and Lt Col
Prakash represented The Challenging Ones, a not-for-profit organisation that
encourages and helps amputees not only to lead a normal life, but look beyond
and participate in sports and other activities.
Col Mallik said, "There is need to cover
repair and replacement of a prosthesis, if this is deemed appropriate by the
insured's treating physician/prosthetist". He said that at present, only
few mediclaim policies cover prosthetics and out of them only Max Bupa covers
up to the sum insured. While the Employee State Insurance Corporation (ESIC)
does give limited facility for fresh amputees, some group plans cover
prosthetics for even existing amputees. "Individual mediclaim should cover
fresh amputee and possibly existing amputees too", he requested.
Insurance Regulatory and Development
Authority (IRDA) chairman J Hari Narayan immediately acknowledged the need for
mediclaim to cover prosthesis. He said, "The need for various implants is
real and it has to be addressed. Some mediclaim policies cover prosthesis and
there is need for others to cover. We will advice companies about it. There is
increasing need for various types of implants. Disability can happen due to
accidents, medical condition or at birth. Prosthesis is essential part of the
treatment for loss of limb. However, certain embellishments may be viewed as
cosmetics and may not be covered and we too will not support it."
The Challenging Ones NGO gave a memorandum to
the IRDA chairman requesting him to ensure that all insurance providers be
mandated by regulations to offer mediclaim and accident cover policies to cover
the cost of provision of prosthesis/ artificial limbs to the insured person, up
to the sum insured and without any artificial cap.
The memorandum states that "The
exclusions like war and war-like situations, natural calamity, act of terrorism
may also be waived off to cover the provisions of Prosthetics under all
medical/accidental insurance policies. This waiver may be given to the insurer
on an enhanced/additional premium. Worldwide, in countries which have a market
economy, insurance companies are mandated by regulations to provide prosthetic
coverage under Medical/Accident insurance policies".
The Challenging Ones is a platform for the challengers
(people call them physically challenged). It is a peer support group to hold
hands of new amputees. It promotes sports for amputees.