Divyangjan Sanjeevani Policy is the insurer's indemnity health insurance product specially created for persons with disabilities, persons affected by HIV/AIDS, and persons with mental illness. It covers in-patient hospitalisation, 537+ day care procedures, AYUSH treatment, cataract surgery, and ambulance charges — with no pre-policy medical check-up required and a 10% discount for buying directly.
the insurer Health· Divyangjan Sanjeevani Policy
"The National Divyangjan Sanjeevani Policy is an indemnity health insurance plan specially created for those who fall into the following categories and who will be covered by the policy as Insured Persons" — confirmed. "Divyangjan" (दिव्यांगजन) is the term used in Indian government policy and law for persons with disabilities. This product is the insurer's dedicated, purpose-built health insurance designed around the specific needs and access barriers faced by this group.
Unlike a standard health policy adapted after the fact, this product's entire eligibility framework is built around having a valid disability certificate — disability isn't an exclusion risk factor here, it's the defining eligibility criterion.
Disability-Specific EligibilityRemoving a common access barrier — many standard health policies require medical tests that can themselves be physically or logistically difficult for some persons with disabilities to complete easily.
Reduces Access Friction"Any person with disabilities, HIV/AIDS, or affected with mental illness can buy this policy." — eligibility extends beyond physical/sensory disability to include HIV/AIDS status and mental illness, conditions frequently excluded entirely from mainstream retail health products.
Broader Than "Disability" Alone"A discount of 10% shall be allowed on the final payable premium for new and subsequent renewals" for direct sale — confirmed by, lowering the cost barrier for a population that, in India, faces disproportionately higher rates of un- or under-employment.
10% Off, New & RenewalA notably high day care procedure count compared to many of the insurer's other retail products (most list 140+) — broader same-day treatment coverage without requiring a 24-hour hospital stay.
High Day-Care Coverage's eligibility table confirms dental treatment coverage — notable since dental treatment (beyond accident-related cases) is excluded on many of the insurer's other standard health products in this series.
Inclusionfrom &
| Criterion | DSPN Terms |
|---|---|
| Age — Adults | Minimum 18 years, Maximum 65 years |
| Age — Children | Newborn to 18 years |
| Core eligibility requirement | Valid disability certificate issued by a competent authority; OR diagnosis of HIV/AIDS; OR diagnosis of mental illness |
| Residency | Resident of India |
| Policy period | 1 year |
| Sum insured | ₹4 lakh or ₹5 lakh, on an individual basis |
| Pre-policy medical check-up | Not required |
| Dental treatment | Covered |
| Purchase channel | Through a broker (e.g. Probitas) or the insurer branch — not available via the insurer's self-service online portal |
from the Rights of Persons with Disabilities (RPwD) Act, 2016 — Legal Context for "Disability Certificate"
India's disability certification framework is governed by the Rights of Persons with Disabilities Act, 2016, which recognises 21 specified disability categories — expanded from just 7 under the earlier 1995 law. A "disability certificate" referenced in this policy's eligibility would typically be issued under this framework by a designated certifying authority.
Under Section 2(r) of the RPwD Act, 2016, a "person with benchmark disability" is defined as someone with not less than 40% of a specified disability, as certified by a designated certifying authority (typically a hospital or state/district-level medical board). This 40% threshold is the standard basis on which disability certificates are issued in India, and is the type of certificate this policy's eligibility criterion most likely refers to. This page provides general legal context only — for the specific disability certificate requirements accepted under this the insurer policy, please confirm directly with Probitas at 022 4302 0000.
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"Reimburse Medical Expenses up to 50% of the Sum Insured as specified in the Policy Schedule for Inpatient Care under the Ayurvedic, Yoga and Naturopathic, Unani, Siddha, and Homoeopathic systems of medicine during each Policy Period." —.
Up to 50% SI"The Company will reimburse Medical Expenses incurred for the Insured Person's Hospitalisation up to the Sum Insured. for Room Rent, Boarding, and Nursing Expenses as provided by the Hospital/Nursing Home, up to a maximum of 1% of the Sum Insured per day." —.
1% SI/Day Room Rent"For a fixed period of 30 days before the date of the admissible hospitalisation. the Company shall indemnify Pre-Hospitalization Medical Expenses incurred." —.
30 Days Prior"For a set period of 60 days following the date of discharge from the hospital, the company will cover any post-hospitalization medical costs incurred in connection with an admissible hospitalisation." —.
60 Days After"Treatment of cataracts up to a maximum of Rs. 40,000 for each eye during a Policy Period." —.
₹40,000 Per Eye"Emergency ground ambulance charges up to Rs 2000/- hospitalization, max 7000/- in a policy." —.
₹2,000/Event, ₹7,000/YearCoverage of 537 listed Day Care Procedures — confirmed by, independently corroborated by's "over 537 daycare procedures."
537+ Procedures"Tax benefits for the premium paid, under Section 80D of the Income Tax Act 1961." —.
80D Eligiblefrom
| Coverage Parameter | Sub-Limit / Term |
|---|---|
| AYUSH treatment | Up to 50% of Sum Insured |
| Modern treatment | Up to 50% of Sum Insured |
| Room rent, boarding, nursing | Up to 1% of SI per day |
| Cataract surgery | ₹40,000 per eye, per policy period |
| Ambulance charges | ₹2,000 per hospitalisation, max ₹7,000 per policy period |
| Pre-existing diseases | Covered after 4 years (48 months) |
| Pre-existing disability | Covered after 2 years |
| Free Look Period | 15 days from receipt of policy document (new individual policies only, not renewals) |
| Sum insured change | Only at renewal, subject to underwriting; waiting period restarts for the increased portion only |
This policy draws a clear distinction between a pre-existing disease (waiting period: 4 years/48 months — the standard the insurer pattern seen across several products in this series) and a pre-existing disability (waiting period: 2 years) — both by. This shorter 2-year wait specifically for pre-existing disability reflects the policy's core purpose: since the policy is bought precisely because the applicant already has a disability, a 4-year wait applied to the disability itself would defeat the product's purpose, hence the shorter, disability-specific term.
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"Pre-existing diseases are covered after a period of 4 years (48 months)" —.
48 Months"Pre-existing disability after a period of 2 years" —. Notably shorter than the disease waiting period, reflecting this product's disability-first design.
24 Monthsfrom
"Any medical care received outside of India." —.
"Circumcision, unless it is required for the treatment of a disease, illness, or accident-related injury." —.
"Reflexology, aromatherapy, acupuncture, acupressure, magnetic therapy, osteopathy, naturopathy, and other modalities" outside the policy's defined AYUSH scope —.
"Lawbreaking, including suicide, self-inflicted injury. including, but not limited to, the use or abuse of any intoxicating substance, including alcohol or drugs." —.
"Immunisation or vaccination, excluding post-animal bite care." —.
"Rest cure, general debility, 'run-down' condition, congenital external illness, disease, or defect." —.
"Hormone replacement therapy, outpatient diagnostic, medical, and surgical procedures or treatments, as well as costs associated with domiciliary hospitalisation, are not covered." —.
"Sexually transmitted and venereal diseases" —. Note this is distinct from HIV/AIDS status itself, which qualifies a person for the policy's eligibility.
"Storage of stem cells." —.
"Contrary to popular belief, the National Divyangjan Sanjeevani policy does not cover maternity or fertility care." —, directly from the FAQ.
"Goods and services for your comfort and convenience, such as television, phones, barber or other guest services, and similar incidental services and supplies." —.
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"Treatment may be received from a network provider with prior authorisation from the Company or its designated TPA." —.
"Fill out the cashless request form provided by the network provider and TPA, then send it to the company or TPA for approval." —.
"The Company/TPA is going to send a pre-authorization letter to the hospital after verification once it has received the cashless request form and pertinent medical information." —.
"If the insured person's request for cashless access is denied, they may still receive treatment on the advice of their doctor and submit their claim paperwork to the company or TPA for reimbursement." —.
"Let your insurance company, i.e., the insurer, know about the procedure and the hospital. Receive treatment and pay for it out of your pocket." —.
"Distribute all hospitalization-related paperwork, including invoices for medical care, prescriptions from the doctor, and other pertinent records." Documents needed: claim form, photo ID, doctor's prescription advising admission, original itemised bills, payment receipts, discharge summary, diagnostic reports, OT notes/surgeon's certificate, implant invoices, MLR/FIR copy where applicable, NEFT details, and KYC where claim liability exceeds ₹1 lakh — all confirmed by.
"Send the required paperwork for reimbursement of pre-hospitalization, daycare, and hospitalisation costs within 30 days of the date of discharge from the hospital. Send the necessary paperwork for post-hospitalization expenses reimbursement within 30 days of the end of post-hospitalization care." —.
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"You can still purchase the plan throughsince it cannot be purchased online through the the insurer official website." —. This is one of the few the insurer health products in this series not available via the insurer's self-service online portal — it's sold through brokers and branches.
Call Probitas at 022 4302 0000 — as an IRDAI-licensed broker (Lic. No. 528), we can guide you through the proposal form, document checklist, and sum insured choice for this specific the insurer product.
Divyangjan Sanjeevani Policy — Frequently Asked Questions
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By submitting you agree to our Privacy Policy and Terms & Conditions. Divyangjan Sanjeevani Policy· the insurer· IRDAI For persons with a valid disability certificate, HIV/AIDS diagnosis, or mental illness, aged 18–65 (children newborn–18). Sum insured ₹4 lakh or ₹5 lakh on individual basis. No pre-policy medical check-up required. Covers AYUSH treatment (up to 50% SI), 537+ day care procedures, in-patient care (room rent up to 1% SI/day), pre-hospitalisation (30 days), post-hospitalisation (60 days), cataract surgery (₹40,000/eye), ambulance charges (₹2,000/event, max ₹7,000/year), dental treatment. Pre-existing diseases covered after 4 years; pre-existing disability after 2 years. 10% discount on premium for direct sale, new and renewal. Section 80D tax benefit available. Does not cover maternity/fertility. Not available for online purchase via the insurer's website — sold through brokers/branches. All terms per the insurer policy document. Probitas Insurance Brokers Pvt. Ltd.· IRDAI Lic. No. 528.