Ravi Khawas, a concerned father from Bangalore, finds himself spending over ₹40,000 each month on essential therapies for his five-year-old daughter, who is on the autism spectrum. These therapies, including speech, occupational, and physiotherapy, alongside an additional ₹10,000 for medical tests and consultations, tally up to ₹50,000 monthly. As insurance coverage for these expenses is lacking, Ravi is struggling to manage these demands, given his experience with third-party insurance that does not cover these expenses. His challenges were compounded when a year ago, a family insurance policy from a private insurer rejected his claim for over ₹1 lakh for Ayurvedic treatment related to his daughter’s gut issues due to non-disclosure of her autism status.
The dire need for better insurance provisions for individuals with autism is echoed by M. Ravichandran, state general secretary of the Confederation of Associations for Persons with Mental Disabilities. He emphasized the necessity of increasing insurance coverage ceilings, illustrating his experience of having a ₹1 lakh coverage limit for his autistic son, where claims processing remain painfully tedious and often disappointing.
The gaps in government insurance schemes such as the Niramaya scheme have also been highlighted by parents. Prem, who has been utilizing the scheme for his mildly autistic daughter, lamented the sluggish claim processes and lack of responsive communication. He noted that although the scheme provides up to ₹1 lakh for various medical services, most of the coverage is allocated for hospitalizations, which few individuals on the autism spectrum require. Therefore, parents often face difficulties as significant portions of resources are directed towards therapies and consultations.
Raja, another parent, stressed the urgent need to increase coverage due to rising living costs. He pointed to the inefficiencies introduced by recent changes in third-party service agents under the Niramaya scheme, which have left many claims unresolved. Meanwhile, Ram highlighted the lack of transparency and accountability in funding patterns, with unclear communication regarding the release of funds further complicating the situation.
In 2017, Tamil Nadu saw the implementation of the Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS) extended to individuals with autism. This initiative has been largely positive, covering multi-modal therapy including speech, occupational, and behavioral therapy up to ₹1 lakh annually. However, administrative hurdles in empanelment approvals and sluggish documentation processes have left many exasperated. Vasuki S., founder of the National Charitable Trust, has been awaiting empanelment approval for her center in Salem for three years.
The successes and challenges noted in institutions such as the Anbalaya in Chennai reflect broader systemic issues. The institution, although benefitting from the scheme, faces cumbersome documentation prerequisites that place additional strain on resources. Arokiamary, the principal, mentioned the necessity of attaching extensive photographic documentation, which detracts from therapy time and can be distressing for the children.
Ravi suspects that better awareness could have provided him some assistance, noting he only discovered the Niramaya scheme a year ago but was unable to apply due to his daughter’s childhood documentation issues. As more parents navigate these convolutions, the call for insurance inclusivity, streamlined processes, and increased support surfaces as a consistent demand from the community.
By highlighting these stories, we illustrate the systemic challenges faced by families seeking comprehensive care for loved ones on the autism spectrum and underline the pressing need for policy reforms and improved support structures within the insurance sector.
Original Source: https://www.thehindu.com/sci-tech/health/disability-insurance-for-autism-still-a-dream-for-most/article69380485.ece
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Publish Date: 2025-03-27 15:34:00
