CENTRAL GOVERNMENT SCHEMES
Pradhan Mantri Suraksha Bima Yojana (PMSBY)-2015
Launched: 9 May 2015
Main Objective: Provide accidental insurance cover to all Indian citizens
Pradhan Mantri Suraksha Bima Yojana is also a government backed accident insurance scheme in India aimed at increasing the penetration of accidental insurance cover in India. The scheme is open and available to all Indian citizens between the age of 18 to 70 years.
Under the scheme, the policy holder can get a life insurance cover of Rs. 2 Lakh with an annual premium of just Rs. 12 excluding service tax. All the Indian citizens between 18-70 years of age with a saving bank account are eligible to avail the scheme.
About Complete Scheme
Pradhan Mantri Suraksha Bima Yojana (PMSBY) is one of three social security schemes that the government had announced in the 2015 Budget. The other two being Pradhan Mantri Jeevan Jyoti Bima Yojana (PMJJBY) and the Atal Pension Yojana (APY). As of September 12, 2016, nearly 9.6 crore people had enroled under PMSBY, with almost 2 lakh joining it on a weekly basis.
What is PMSBY?
An accident insurance scheme, PMSBY offers a one-year accidental death and disability cover, which can be renewed annually.
What all is covered and for how much
Under PMSBY, the risk coverage available is Rs 2 lakh for accidental death and permanent total disability, and Rs 1 lakh for permanent partial disability. Permanent total disability is defined as total and irrecoverable loss of both eyes or loss of use of both hands or feet or loss of an eyesight and loss of use of a hand or a foot. Permanent partial disability is defined total and irrecoverable loss of an eyesight or loss of use of a hand or foot.
The cover will be in addition to any other insurance plan the subscriber has. The scheme is not a Mediclaim, i.e., there is no provision for reimbursement of hospitalisation expenses following accident, resulting in death or disability.
Important inclusions and exclusions
Accidents, any death or disability (as defined under PMSBY) resulting from natural calamities is covered under PMSBY. While death due to suicide is not covered, that from murder is covered.
Partial disability without irrecoverable loss of an eyesight or loss of use of one hand or foot is not covered. Also, the family gets no insurance benefit if the subscriber commits suicide.
All individual (single or joint) bank account holders in the 18-70 year age group are eligible to join PMSBY. In case you have multiple bank accounts in one or different banks, then you will be eligible to join the scheme through one bank account only.
In the case of a joint account, all holders of the account can join the scheme. Even NRIs are eligible, but if a claim arises, the claim benefit will be paid to the beneficiary/nominee only in Indian currency.
How much is the premium and how to pay
The premium payable is Rs 12 per annum per member and will be deducted from his bank account through an 'auto debit' facility in one instalment on or before June 1 every year. However, in cases where auto debit takes place after June 1, the cover shall commence from the date of auto debit of premium by the bank.
The annual renewal dates shall be June 1 in subsequent years. Even if one gets enroled with more than one bank, the claim, if applicable, will be paid by only one bank and the other premium may get forfeited. The premium will be reviewed based on annual claims experience.
However, barring unforeseen adverse outcomes, efforts would be made to ensure that there is no upward revision of the premium in the first three years. Also, there won't be any policy certificate issued to individual subscribers as the participating banks will be the master policyholders.
Where to buy the scheme from
The scheme is offered/administered through Public Sector General Insurance Companies (PSGICs) and other general insurance companies, in collaboration with participating banks. The banks are free to engage any general insurance company for implementing the scheme for their subscribers.To enrol, you can download the form from http://www.jansuraksha.gov.in/Forms-PMSBY.aspx , and submit it to your banker. Some banks have initiated an SMS-based enrolment process too.
It can be done through net banking also.
A sample process-detail to activate through SMS:
1. Eligible customers will be sent an SMS asking them to respond as 'PMSBY Y'.
2. To enrol for the scheme, customer replies as 'PMSBY Y'.
3. Customer will get an acknowledgement message for receipt of the response.
4. For processing the application, the demographic details and the nominee name, nominee relationship and nominee date of birth will be taken from the details present in the savings account.
5. In case, the nominee details are not available in core banking records, the confirmation will not be taken ahead for processing. Customer may then apply from the nearest branch/net banking.
6. In case, the auto debit of the premium fails due to insufficient funds or other reasons, the insurance cover ceases to be in-force.
A sample process-detail to activate through net banking:
1. Log in to net banking.
2. You will be shown PMSBY at the relevant space.
3. Select the account through which you wish to pay your premium.
4. Policy cover amount, premium amount and nominee details (as per the selected account) will be displayed. You can choose to replicate the savings account nominee or add a new nominee.
5. Click on the following declarations/details:
*Good health declaration.
*Terms & Conditions/Scheme Details/FAQs.
*"I do not hold any other policy of the same".
6. Click on 'Continue'. You will then be shown the complete details of the PMSBY scheme you have registered for.
7. If you are okay with the scheme registration details displayed, click on 'Confirm'.
8. Download the acknowledgement, which carries a unique reference number.
9. Do save the acknowledgement document for future reference.
Initially, for the cover period from June 1, 2015 to May 31, 2016, the subscribers were expected to enrol and give their auto debit option by May 31, 2015, which was extended up to May 31, 2016. Subscribers who wish to continue beyond the first year have to give their consent for auto debit before May 31 for successive years.
The cover is for a one-year period, starting June 1 to May 31. The option to join/pay by auto debit has to be given by May 31 of every year.
Till what period is the cover for
The accident cover of the member will terminate/be restricted in any of the following events:
i. On attaining age 70.
ii. Closure of bank account or insufficiency of balance to keep the insurance in force.
iii. In case a member is covered through more than one account and the premium is received by the insurance company inadvertently, the insurance cover will be restricted to one account and the premium is received by the insurance company inadvertently, the insurance cover will be restricted to one account and the premium will be forfeited.
What to do in case of a claim
PMSBY covers deaths caused by an accident and confirmed by documentary evidence. In case of incidents like road, rail and similar vehicular accidents, drowning, death involving any crime, etc., the accident should be reported to police. In case of incidents like snake bite, fall from tree, etc, the cause should be supported by immediate hospital record.
In case of death of the account holder, the claim can be filed by the nominee/appointee as per the enrolment form or by his legal heir/s in case there is no nomination made by him. The disability claim will be credited in the bank account of the insured bank account holder. Death claims will be remitted to the bank account of the nominee/legal heir(s).