Pradhan Mantri Suraksha Bima Yojana (PMSBY)

Pradhan Mantri Suraksha Bima Yojana (PMSBY)
Pradhan Mantri Suraksha Bima Yojana (PMSBY)

Pradhan Mantri Suraksha Bima Yojana (PMSBY)

Government through the Budget Speech 2015 announced three ambitious Social Security Schemes pertaining to the Insurance and Pension Sectors, namely Pradhan Mantri Jeevan Jyoti Bima Yojana (PMJJBY), Pradhan Mantri Suraksha Bima Yojana (PMSBY) and an the Atal Pension Yojana (APY) to move towards creating a universal social security system, targeted especially for the poor and the under-privileged. Hon’ble Prime Minister will be launched these schemes nationally in Kolkata on 9th May, 2015.
In light of the fact that a large proportion of the population have no accidental insurance cover, the Pradhan Mantri Suraksha Bima Yojana (PMJJBY) is aimed at covering the uncovered population at an highly affordable premium of just Rs.12 per year. The Scheme will be available to people in the age group 18 to 70 years with a savings bank account who give their consent to join and enable auto-debit on or before 31st May for the coverage period 1st June to 31st May on an annual renewal basis.
Under the said scheme, risk coverage available will be Rs. 2 lakh for accidental death and permanent total disability and Rs. 1 lakh for permanent partial disability, for a one year period stretching from 1st June to 31st May. It is offered by Public Sector General Insurance Companies or any other General Insurance Company who are willing to offer the product on similar terms with necessary approvals and tie up with banks for this purpose. Participating Bank will be the Master policy holder on behalf of the participating subscribers. It will be the responsibility of the participating bank to recover the appropriate annual premium in one instalment, as per the option, from the account holders on or before the due date through ‘auto-debit’ process and transfer the amount due to the insurance company.
Individuals who exit the scheme at any point may re-join the scheme in future years by paying the annual premium, subject to conditions. Further, in order to assure a hassle free claim settlement experience for the claimants a simple and subscriber friendly administration & claim settlement process has been put in place.
To ensure that the benefits of this scheme is brought to every uninsured individual, who holds a bank account, wide publicity was given for this social security measure through electronic media, radio, posters, newspapers advertisements etc. Enrollment forms were widely distributed. Highly publicised Enrollment camps were conducted by Banks, and Insurance Companies, mobilising the entire net work of SLBC Co ordinators, state and district level nodal officers, agents and banking correspondents, thereby fully utilising the reach of these channels, for attracting large scale enrolment in the scheme. Between the date of commencement of enrolment on 01st May till the date of launch of the scheme by the PM on 9th May, 4.42 Crore subscribers were enrolled in the PMJJBY scheme.
The simplified procedures and the documentary requirements and the procedures to be followed in case of a claim under the policy has been widely publicised through posters and advertisements at every location and point of contact which a claimant is likely to get in touch in case of an accident resulting in a claim under the scheme.
An IT enabled, web based system is in the process of being established to keep the claimants informed seamlessly about the progress and status of the claim, till it’s settlement.
Claim settlement will be made to the bank account of the insured or his nominee in case of death of the account holder.
The enrolment drive is continuing without loss of momentum till date. As on 31st May, that is, on the eve of commencement date of the policy, the number enrolled under PMSBY scheme had reached 7.29 Crores.
Immediately after the close of the first phase of enrolments, banks have started the process of auto debit of premium in the accounts of the enrolees and remittance of premium to the insurers. So far premium has been debited to around 65% of the accounts.
The enrollment is open till 31st August and the drive is continuing. Till 18th June 2015 the number of enrolled under PMSBY stands at 7.68 Crore.
The scheme is expected to serve the goal of financial inclusion by achieving penetration of insurance down to the weaker sections of the society, ensuring their or their family’s financial security, which otherwise gets pulled to the ground in case of any unexpected and unfortunate accident.

RULES FOR THE PRADHAN MANTRI SURAKSHA BIMA YOJANA (FOR POLICY YEAR 2016-17)

DETAILS OF THE SCHEME:

PMSBY will be an Accident Insurance Scheme offering accidental death and disability cover for death or disability on account of an accident. It would be a one year cover, renewable from year to year. The scheme would be offered / administered through Public Sector General Insurance Companies (PSGICs) and other General Insurance companies willing to offer the product on similar terms with necessary approvals and tie up with Banks for this purpose. Participating banks will be free to engage any such insurance company for implementing the scheme for their subscribers.

Scope of coverage:

All individual bank account holders in the age group of 18 to 70 years in participating banks will be entitled to join. In case of multiple bank accounts held by an individual in one or different banks, the person would be eligible to join the scheme through one bank account only. Aadhar would be the primary KYC for the bank account.

Enrollment Modality / Period:

The cover shall be for the one year period stretching from 1st June to 31st May for which option to join / pay by auto-debit from the designated bank account on the prescribed forms will be required to be given by 31st May of every year. Joining subsequently on payment of full annual premium would be possible. However, applicants may give an indefinite / longer option for enrolment / auto-debit, subject to continuation of the scheme with terms as may be revised on the basis of past experience. Individuals who exit the scheme at any point may re-join the scheme in future years through the above modality. New entrants into the eligible category from year to year or currently eligible individuals who did not join earlier shall be able to join in future years while the scheme is continuing.

Benefits: As per the following table:

# Table of Benefits Sum Insured
a Death Rs. 2 Lakh
b Total and irrecoverable loss of both eyes or loss of use of both hands or feet or loss of sight of one eye and loss of use of hand or foot Rs. 2 Lakh
c Total and irrecoverable loss of sight of one eye or loss of use of one hand or foot Rs. 1 Lakh

Premium:

Rs.12/- per annum per member. The premium will be deducted from the account holder’s bank account through ‘auto debit’ facility in one instalment on or before 1 st June of each annual coverage period under the scheme. However, in cases where auto debit takes place after 1st June, the cover shall commence from the date of auto debit of premium by Bank.
The premium would be reviewed based on annual claims experience. However, barring unforeseen adverse outcomes of extreme nature, efforts would be made to ensure that there is no upward revision of premium in the first three years.

Eligibility Conditions:

Individual bank account holders of participating banks aged between 18 years (completed) and 70 years (age nearer birthday) who give their consent to join / enable auto-debit, as per the above modality, will be enrolled into the scheme.

Master Policy Holder:

Participating Bank will be the Master policy holder on behalf of the participating subscribers. A simple and subscriber friendly administration & claim settlement process shall be finalized by the respective general insurance company in consultation with the participating Banks.

Termination of cover:

The accident cover for the member shall terminate on any of the following events and no benefit will be payable there under:

1) On attaining age 70 years (age nearest birthday).
2) Closure of account with the Bank or insufficiency of balance to keep the insurance in force.
3) In case a member is covered through more than one account and premium is received by the Insurance Company inadvertently, insurance cover will be restricted to one bank account only and the premium paid for duplicate insurance(s) shall be liable to be forfeited.
4) If the insurance cover is ceased due to any technical reasons such as insufficient balance on due date or due to any administrative issues, the same can be reinstated on receipt of full annual premium, subject to conditions that may be laid down. During this period, the risk cover will be suspended and reinstatement of risk cover will be at the sole discretion of Insurance Company.
5) Participating banks will deduct the premium amount in the same month when the auto debit option is given, preferably in May of every year, and remit the amount due to the Insurance Company in that month itself.

Administration:

The scheme, subject to the above, will be administered as per the standard procedure stipulated by the Insurance Company. The data flow process and data proforma will be provided separately.
It will be the responsibility of the participating bank to recover the appropriate annual premium from the account holders within the prescribed period through ‘auto-debit’ process.
Enrollment form / Auto-debit authorization in the prescribed proforma shall be obtained and retained by the participating bank. In case of claim, the Insurance Company may seek submission of the same. Insurance Company reserves the right to call for these documents at any point of time.
The acknowledgement slip may be made into an acknowledgement slip-cum-certificate of insurance.
The experience of the scheme will be monitored on yearly basis for re-calibration etc., as may be necessary.

Appropriation of Premium:

1) Insurance Premium payable to Insurance Company: Rs.12/- per annum per member
2) Reimbursement of Expenses to BC/Micro/Corporate/Agent by insurer: Rs.1/- per annum per member
3) Reimbursement of Administrative expenses to participating Bank by insurer: Rs.1/- per annum per member
Date of commencement of the scheme is 1st June 2015. The Annual renewal dates shall be each successive 1st of June in subsequent years. The scheme is liable to be discontinued prior to commencement of a new future renewal date if circumstances so require.

Quick Links

APPLICATION FORM FOR PRADHAN MANTRI SURAKSHA BIMA YOJANA
CLAIM FORM FOR PRADHAN MANTRI SURAKSHA BIMA YOJANA

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