Reshaping the Benefits Strategy: Addressing Disability

Globally, over a billion people—or about one in eight persons—live with disabilities related to vision, hearing, movement, thinking, learning, communication, social interactions and mental health. According to the National Statistical Office report in 2018, 26 million people in India are disabled. Movement (20%), vision (19%) and hearing (19%) are the top disabilities seen in India according to the Ministry of Statistics and Programme Implementation. Given the unique medical needs of disabled individuals, the benefits offered by organizations must be truly inclusive and comprehensive.

THE ROLE OF THE GOVERNMENT  

The rights of persons with Disabilities Act, 2016

This Act paved the way for an expanded definition of disability compared to the earlier version, the PwD Act of 1995, bringing into purview: speech and language disability, specific learning disability, acid attack victims, dwarfism, muscular dystrophy, thalassemia, hemophilia and sickle cell disease. 

The government is tackling disability through research to determine the cause of the occurrence, promotion of various methods to prevent disabilities, screening of children once a year, create awareness, and provide essential medical facilities. It also states that the government shall make insurance covering disabilities for their own employees with disabilities.

REGULATORY FOCUS ON DISABILITY

The Insurance Regulatory and Development Authority of India’s (IRDAI) stance on disability has also been very encouraging towards the goal of inclusion. The regulator has made a provision for insurance coverage for treatment of mental illness, neurodegenerative and neurodevelopmental disorders as well as genetic diseases, thus opening the gates for holistic coverage regardless of medical impediments.

SHIFTING HR PRIORITIES

There is a renewed focus on the representation of disabled individuals in organizations as reflected in their policies around hiring, access and coverage. Rapid digitalization has enabled them to hire from a diverse talent pool that was previously not accessible. As more differently abled individuals enter the corporate workplace, the conversation is now around how to create holistic medical benefits for everyone.

HOW TO DESIGN DISABILITY BENEFITS THAT TRULY BENEFIT?

Traditional insurance models are limited as they do not embrace the specific needs of the disabled. For benefits to be meaningful, they need to address requirements right from prevention to active treatment and rehabilitation. All the aspects of medical care for such individuals should be considered under these five broad categories:

1. Prevention/ early detection: Adequate coverage for antenatal screening; mental health screening, and genetic disorder testing at the time of birth for early intervention.

2. Inpatient treatment: This coverage should be designed keeping in view various aspect such as:

• The age of the child that can be covered.
• Whether all underlying causes like genetic and congenital are covered.
• If there are adequate provisions in the corporate buffer for various disabilities.
• Exclusions preventing corrective treatments.

3. Outpatient treatment and special diagnostics: This is an important benefit element to cater to health maintenance. Typical outpatient elements are consultations, diagnostics, medications and vaccination, but it is important to include special elements like genetic testing of the diseased person / immediate family as well as overseas medical tests if needed.

4. Supporting Aids: Disabled individuals have varying requirements of external devices that can include mobility aid like walkers and wheelchairs, low vision aids and hearing aids. These elements are generally excluded from health insurance but covering them provides essential support for activities of daily living, thus enabling productivity.

5. Home-based medical care:  Many disabled individuals need special care at home. Some examples are: 

• Need-based nursing and doctor visits. 
• Cost of dressing materials, tracheostomy management kits, PEG tube management kits and tube-based nutritional support, home oxygen therapy equipment. 
• Medical alert bracelet costs, remote patient monitoring services. 

6. Rehabilitation: Rehabilitation can include not only medical treatment but other supportive elements like the modification of living space and financial protection. These can be catered by paying close attention to details such as:

• Therapies like occupational therapy, physiotherapy, speech therapy, psychotherapy, behavioral therapies, alternative therapies.
• Nursing care at home.
• Income protection plans and weekly salary benefits.
• Home modifications like shower grab bars, commode chairs, ramps, and other prescribed home modifications.
• Vehicle modification like removable driver seats, raised/lowered roofs, hand controls for brake or accelerator systems, pedal extensions, tie-downs for a wheelchair, etc.

ADVOCATING FOR DISABILITY

While medical benefits are important for disabled employees, there are other ways that organizations can create value for them. To have an inclusive culture, it is imperative for organizations to devise disability-friendly physical and technological infrastructure and ensure access. At the same time, it is also crucial to raise awareness to influence a culture of understanding and compassion. Last, but not least, forming communities can foster comfort, engagement, and positive reinforcement, which can help individuals thrive.

THE ROAD AHEAD

Medical advancements are bringing hope to many individuals dealing with disabilities. Gene treatments, 3-D bio-printed organs, and exoskeletons will be important for future treatments. 

Novel precision medications will lead to lower side effects and more efficiency, and remote management will become more frequent. 

Insurance products will have to evolve to stay relevant and early adopters may have an advantage. Global best practices can be imbibed to develop solutions that provide both short- and long-term insurance support for income reduction or loss occurring from disability.

Employers can play a leading role in driving how the insurance industry addresses the needs of their colleagues.

References:

https://www.who.int/news-room/fact-sheets/detail/disability-and-health

https://www.cdc.gov/ncbddd/disabilityandhealth/disability.html