National Trust schemes explained: Niramaya health insurance and legal guardianship

The National Trust is a statutory body set up under the National Trust for the Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple Disabilities Act, 1999. The Act uses the old term 'mental retardation'; today's term, and the one the Trust's own documents use, is intellectual disability. The Act defines 'severe disability' as 80% or more of one or more of these disabilities.

The Trust covers these four conditions and no others. A child with autism, cerebral palsy, intellectual disability or multiple disabilities can use its schemes; a child whose only diagnosis is a specific learning disability, ADHD or a speech delay cannot, however great the need. Down syndrome is not named, so a child with Down syndrome qualifies through the category the medical board certifies, most often intellectual disability. Global developmental delay in a child under five is certified on a temporary basis; ask the Trust or a registered organisation how it treats that certificate.

The Trust works through organisations registered with it in each area, and its website is now nationaltrust.nic.in. Older pages on the previous domain still appear in searches and may show schemes the Trust no longer lists.

Niramaya pays on reimbursement only: the family pays the hospital, clinic or pharmacy and then claims the money back, up to a yearly limit. That limit, and a lower sub-limit for ongoing therapies, are set out in the Trust's current terms, which were last revised in December 2025. What makes it useful is the list of things it covers, many of which ordinary health policies exclude:

• Outpatient treatment, including regular visits to doctors.
• Medicines and diagnostic tests.
• Ongoing therapies, within their own sub-limit.
• Corrective surgery to prevent a disability getting worse.
• Hospitalisation.
• Dental treatment.
• Treatment under AYUSH systems.
• Transport costs linked to treatment.

There are no medical tests before enrolment, no age bar, and treatment can be taken at any hospital. The policy year runs to 31 March, so cover has to be renewed each year. There is a small yearly enrolment and renewal fee, lower for BPL families and waived for some groups, including people whose legal guardian is not a natural parent. Keep every bill, prescription and therapy receipt with the child's name exactly as it appears on the UDID card, because a mismatch is the easiest way to lose a claim.

Eligibility rests on the UDID card. The Trust's terms make a UDID card for one of the four National Trust disabilities mandatory, and accept a UDID enrolment number with a certificate only for children under seven. If your child does not have a card yet, start there: the UDID card and disability certificate for a child explains the application and the medical board.

1. Get the UDID card, or for a child under seven the enrolment number and certificate.
2. Find the National Trust registered organisation nearest you through the Trust's website, or check whether the site currently allows enrolment directly.
3. Ask what documents they need: usually the UDID card, identity and address proof for the child and parent, photographs, income or BPL documents if you claim the lower fee, and bank details.
4. Enrol and pay the fee through the route the organisation or website gives, and keep the acknowledgement.
5. Note the renewal date: the policy runs to 31 March, so set a reminder for February each year.
6. Keep a claims file: bills, prescriptions, therapy invoices, discharge summaries, each with the child's name matching the card.
7. Submit claims promptly, with copies, and keep the claim reference until the money reaches the account.

Terms, the limit and the fee change, so read the current Niramaya terms on the Trust's website each year before renewing.

The Trust's website and its Citizens' Charter for 2025-26 list several schemes besides Niramaya and guardianship. Each is run by registered organisations, so whether your family can use one depends on whether a centre exists in your district and has a place.

• Disha: early intervention and school readiness for children up to ten, as day care of at least four hours a day.
• Vikaas: day care for children and adults from ten upwards.
• Samarth: respite and residential care.
• Gharaunda: group homes for adults.
• Badhte Kadam: awareness work in the community.

The 2025-26 Charter says no new projects are being sanctioned under Disha, Vikaas, Samarth or Gharaunda and no applications for new centres are being accepted. Existing centres continue, and the Trust posts lists of vacant seats, so it is still worth asking. Older pages mention Sahyogi, a caregiver training scheme, along with Gyan Prabha, Prerna and Sambhav; these are not on the current site, and we could not confirm whether they still run. For a young child, early intervention in India covers the free public options alongside Disha.

Until 18, parents are a child's natural guardians and sign for them without any extra paperwork. At 18 the law treats the young person as an adult. For many young people with autism, cerebral palsy, intellectual disability or multiple disabilities that is exactly right, and they manage their own affairs with support. For others, a bank, a hospital, a registrar or a government office may ask who has the authority to act, and a parent's word is no longer enough.

This is where National Trust guardianship comes in. It is for wards over 18 with one of the four conditions, and it gives a named person legal standing to look after the young adult's interests: operating a bank account, dealing with property, signing documents and giving consent where the person cannot. It is not needed for a minor. Guardianship is not about control: the aim is support, with the young person's own wishes heard in every decision.

Start thinking about it at 16 or 17, when school is ending and the questions about college, work, bank accounts and identity documents begin. Talk to the young person, in whatever way they communicate, about what help they want.

Under Section 14 of the National Trust Act, guardians are appointed by the Local Level Committee in each district, headed by the District Collector. The Trust's summary of the process, as published at the time of writing, sets out these steps; ask the committee's office for the current forms and any local requirements.

1. Confirm the young person is over 18 and has a certificate for one of the four National Trust conditions.
2. Contact the Local Level Committee through the District Collector's office, or ask a National Trust registered organisation to help.
3. Parents apply jointly, or one parent alone in the circumstances the rules specify, in Form A.
4. If parents are not alive or not able to act, ask the committee who else may apply, such as a relative or a registered organisation.
5. Attend the committee's hearing with the young person and the documents it asks for.
6. The committee decides and, if it appoints a guardian, issues the order in Form B. Keep certified copies.

Ask the committee what happens if the guardian's circumstances later change. For a disagreement within the family about who should be guardian, take legal advice.

A guardian is accountable to the Local Level Committee. Within six months of appointment, the guardian must file an inventory of the ward's property, and after that they must file accounts every year. That means keeping records from the first day: bank statements, receipts for what was spent on the ward's care, and papers for any property or investments.

Beyond the paperwork, the duty is to act in the ward's interest and to involve them in decisions as far as they are able. A guardian who is also a sibling or relative should keep the ward's money separate from their own. If the guardian's health, location or willingness changes, tell the committee rather than letting things drift.

Guardianship answers who can act for a young adult. It does not answer what happens to the family's money and home when parents are gone. For that, families usually need a will and often a private trust with named trustees, drawn up with a lawyer, and a letter describing the person's routines and care. Financial planning for a child with special needs sets out the pieces and when to put each in place.

The Trust is one part of a larger set of schemes; the family checklist of government schemes lists the rest. This guide is information, not legal advice. Special Minds introduces vetted special educators and shadow teachers who work with children and teenagers with autism, intellectual disability and complex needs; see autism support in India for how that works.