On 20 November 2025, the National Centre for Promotion of Employment for Disabled People (NCPEDP) unveiled a landmark white paper titled “Invisible in the Fine Print: Disability, Discrimination and Health Insurance in India” at the Constitution Club of India. The findings are worrying over 80% of India’s 16 crore persons with disabilities have no health insurance.

For a country that aspires to universal health coverage, this indicates a system designed without disabled people in mind.

Real lives behind the data

Consider the story of Thakurdas Mahoto, a man living with 40% disability due to the long-term effects of leprosy. Small injuries turn into chronic ulcers; treatment is constant and costly. Government aid comes only twice a year.

Mahoto attempted to enrol for Ayushman Bharat, only to be told he was ineligible because his name was missing from an old 2011 SECC list. With five children and rising medical bills, he survives without any formal health coverage, like lakhs of other disabled people across India.

Mahoto’s story is not an exception; it is the rule. (Source: The Week)

The survey’s revelations

NCPEDP’s nationwide survey, which involved 5,000+ respondents across 34 states and UTs, found that:

• 80% have no health insurance at all
• 41% of respondents are not aware of Ayushman Bharat
• 53% of applicants were rejected, often with no explanation
• Rejection was highest for people with autism, psychosocial disabilities, intellectual disabilities, and blood disorders
• Even when disability-inclusive products exist, agents often claim “no such policy is available”

The report concludes: these outcomes are not random, they reflect structural discrimination embedded in how insurance is developed, assessed and sold.

The consequences of being uninsured

The consequences of exclusion are devastating. According to the white paper:

• Households with disabled members spend nearly 20% of monthly income on disability-related expenses
• 57% face catastrophic health costs
• Many families who were once above the poverty line fall below it solely due to medical expenses

Insurance is supposed to protect families from financial collapse. For many disabled households, its absence accelerates it.

Why Ayushman Bharat still leaves millions uninsured

Ayushman Bharat (PM-JAY), India’s flagship health insurance scheme, currently does not recognise disability as a category for coverage. Eligibility still hinges on SECC 2011 data, an outdated list that excludes millions.

Ironically, in 2025 the government expanded PM-JAY to include all citizens aged 70+, acknowledging age-related vulnerabilities. Yet people with disabilities, who often face equal or greater medical need, remain outside its automatic coverage.

Only 59% of respondents had even heard of Ayushman Bharat, highlighting massive gaps in outreach and accessibility.

Barriers identified

NCPEDP identifies six recurring barriers:

1. High premiums for disability-inclusive private products
2. Opaque underwriting and arbitrary rejections
3. Digital inaccessibility of insurance websites and claim portals
4. Low awareness, worsened by inaccessible communication
5. Lack of sensitisation among insurers and agents
6. Exclusion of disability-related treatments from standard packages

In some states, like West Bengal, where PM-JAY is not implemented, exclusion is even more severe. Several respondents were rejected despite insurers advertising disability-inclusive policies online.

NCPEDP’s roadmap for change

The NCPEDP white paper lays out a road map for reform, including:

• Universal inclusion of all persons with disabilities under PM-JAY
• Revising insurance forms, medical tests, and underwriting norms to eliminate discriminatory clauses
• Making every public and private healthcare facility comply with Harmonised Guidelines 2021 (physical accessibility)
• Mandating digital accessibility for all insurance portals
• Standardising premiums for disability-specific products
• Requiring insurers to use real cost data before capping benefits
• Creating an IRDAI Disability Inclusion Committee
• Adding disability-segregated data to IRDAI’s annual reports

insurancepe believes that no Indian should be excluded from financial protection because of disability. A large, underserved population represents not only a social obligation on part of the government and the insurance industry, but an opportunity for innovation and growth.

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