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Insurance Article

Autistic Kids: Special Insurance for Special Needs?

November 29 2017
Autistic Kids Special Insurance

Taking care of autistic kids is expensive, making a special cover for them a necessity

The number of children living with developmental disabilities like autism is on the rise. Globally, 1 in 68 children are diagnosed with Autism Spectrum Disorder (ASD), as per the statistics from the Centre for Disease Control and Prevention’s Autism and Developmental Disabilities Monitoring Network.

In such a situation, general insurance companies are looking to provide covers for the disease or at least specific add-ons to existing health insurance policies.

Current Situation

Currently, there are very few policies in the health insurance market to cover autism-related expenses. More often than not, parents cover the expenses for the treatment of this disease from their own pocket, and usually also have to create a corpus for their child’s lifetime, since the child may not be able to work.

The Indian government however, has done something to combat this situation. The government offers a health insurance scheme called ‘Niramaya’, which offers a sum assured of up to ₹1 lakh for the treatment and care of children with developmental disabilities like autism, cerebral palsy and so on.

The scheme covers outpatient treatments including those for pre-existing ailments, and expenses for corrective surgeries and non-surgical hospitalisation. It comes at an annual premium of ₹250 for families with a monthly income of less than ₹15,000, and an annual premium of ₹500 for those with a monthly income higher than ₹15,000.

Among private insurers though, there aren’t many schemes that offer a special cover for developmental disabilities. This is because they are not sure of the viability of launching standalone health insurance policies for autism and other such developmental disorders.

Coverage Required

However, the question arises of whether the cover of ₹1 lakh that the government scheme offers is actually enough. You see, ASD affects a child’s development including his/her speech, gestural, non-verbal and social interaction with his/her peers. So, it’s not just paediatrics that needs to be taken care of with ASD; therapy for all the above also becomes necessary.

That is to say, an autistic child would require multi-disciplinary treatment. So, along with regular visits to a paediatrician, they would need assistance and care from a psychiatrist, a counsellor, a special educator, a speech therapist and an occupational therapist. Consulting all of these people is quite expensive, and can lead to the annual cost of treatment being as high as ₹2-3 lakh.

Moreover, children with ASD are accident-prone, and the treatment and care for these accidents further add to the cost of treatment. Therefore, one would require a cover of minimum ₹4-5 lakh to cover the complete cost of treatment for autism.

Mr. Sanjay Datta, Chief - Underwriting and Claims, ICICI Lombard General Insurance, believes that adding a customised offering for autism to an existing health insurance product could go a long way in providing financial relief to parents with autistic children.

Lastly, existing health insurance policies do offer accidental coverage, which can be used as cover for any accidents that an autistic child may get into. Just make sure to read the fine print and understand the types of accidents covered before deciding to purchase one.

Related Article:

A Market for Mental Health Insurance?
The Changing Face of Health Insurance in India

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