PRADHAN MANTRI SURAKSHA BIMA YOJANA (Accident Insurance) Scheme Details

The Scheme is start­ing from 1st June, 2015.

Details of Prad­han Mantri Surak­sha Bima Yojana Scheme: 

The scheme will be a one year cov­er, renew­able from year to year, Acci­dent Insur­ance Scheme offer­ing acci­den­tal death and dis­abil­i­ty cov­er for death or dis­abil­i­ty on account of an acci­dent. 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 sav­ings bank account hold­ers in the age 18 to 70 years in par­tic­i­pat­ing banks will be enti­tled to join. In case of mul­ti­ple sav­ing bank accounts held by an indi­vid­ual in one or dif­fer­ent banks, the per­son would be eli­gi­ble to join the scheme through one sav­ings 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 sav­ings bank account on the pre­scribed forms will be required to be giv­en by 31st May of every year, extend­able up to 31st August 2015 in the ini­tial year. Ini­tial­ly on launch, the peri­od for join­ing may be extend­ed by Govt. of India for anoth­er three months, i.e. up to 30th of Novem­ber, 2015. Join­ing sub­se­quent­ly on pay­ment of full annu­al pre­mi­um may be pos­si­ble on spec­i­fied terms. 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 sav­ings bank account through ‘auto deb­it’ facil­i­ty in one install­ment 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 first day of the month fol­low­ing the auto debit.

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: The sav­ings bank account hold­ers of the 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 birth day).

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 only and the pre­mi­um 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 3 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 to Insur­ance Com­pa­ny: Rs.10/- per annum per member

2) Reim­burse­ment of Expens­es to BC/Micro/Corporate/Agent : Rs.1/- per annum per member

3) Reim­burse­ment of Admin­is­tra­tive expens­es to par­tic­i­pat­ing Bank: Rs.1/- per annum per member

The pro­posed date of com­mence­ment of the scheme will be 1st June 2015.The next Annu­al renew­al date shall be each suc­ces­sive 1 st 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.