PMSBY The 1 Great Accidental Insurance Scheme

Pardhan Mantri Suraksha Beema Yojna (PMSBY) is a great accidental insurance scheme.

Which is offered by the Central Government of India only at Rs.1 per month or Rs. 12 per yearly premium.

This scheme is a great help to everyone especially the poor and vulnerable class of people. The following points will help you in understanding the whole scheme.

Helpful Points in Understanding the PMSBY Scheme

1. SPECIFICATIONS OF THE SCHEME:

PMSBY will be an Accident Insurance Scheme that will provide coverage for accidental death and disability, including death or disability caused by an accident. It would be a one-year policy that may be renewed year after year.

In order to sell and administer the scheme, Public Sector General Insurance Companies (PSGICs) and other General Insurance companies wanting to offer the product on identical terms and obtain the relevant approvals would partner with banks.

Participating banks will be permitted to contract with any insurance provider of their choice to carry out the scheme’s implementation for their customers.

2. Monetary Benefits of the PMSBY Scheme

As seen in the following table, there are numerous advantages:

	Table of Benefits	Sum Insured
a	Premium Amount on Death	Rs. 2 Lakh
b	Total and irrecoverable loss of both hands or total and irrecoverable of both eyes or feet or loss of sight of one eye or loss of both the foots	Rs. 2 Lakh
c	Total or irrecoverable loss of 1 eyesight or one hand or 1 foot	Rs. 1 Lakh

3. Conditions for Eligibility for PMSBY:

Individual bank account holders of participating banks who provide their consent to join/enable auto-debit in accordance with the above modality will be enrolled in the scheme.

Individual bank account holders of participating banks who provide their consent to join/enable auto-debit in accordance with the above modality will be enrolled in the scheme.

4. The scope of coverage is as follows:

Individual bank account holders in partnering banks who are between the ages of 18 and 70 years old will be eligible to take part in the program.

In the event that an individual has multiple bank accounts with the same or separate financial banks, the individual would only be eligible to participate in the scheme through one of those accounts.

The Aadhar card would serve as the primary form of identification for the bank account.

5. Premium:

Rs.12/- per annum per member, payable in advance. The premium will be deducted from the account holder’s bank account using the “auto-debit” function in one installment on or before the 1st June of each annual coverage term under the scheme on or before the 1st June of the following year.

However, in the event that the auto-debit occurs after the 1st of June, the cover will begin on the date of the bank’s auto-debit of the premium payment.

According to the annual claims experience, the premium would be adjusted. However, efforts will be made to guarantee that there is no upward revision of the premium during the first three years of the policy unless there are unexpected bad outcomes of the extreme kind.

6. Authority and Administration for PMSBY:

Except as otherwise provided here, the scheme will be administered in accordance with the usual method established by the Insurance Company. Separately, the data flow method and data proforma will be made available to you.

In order to recover the required annual premium from account holders within the prescribed time period, the participating bank will use the ‘auto-debit mechanism to collect the money from them.

The participating bank is responsible for obtaining and retaining an enrollment form / auto-debit authorization in accordance with the required form. In the event of a claim, the Insurance Company may request that the claim be submitted.

The Insurance Company retains the right to request these papers at any time without notice.

The acknowledgment slip may be made with an insurance certificate to form an acknowledgment slip-cum-certificate.

The scheme’s experience will be evaluated on an annual basis to see whether any adjustments, such as re-calibration, are required.

7. Premiums are appropriated in the following ways:

Insurance’s Premium: Rs.12/- per annum, each member, payable to the insurance company;

2) BC/Micro/Corporate/Agent expenses are reimbursed by the insurer at a rate of Rs.1/- per annum for each member.

Insurer reimburses Rs.1/- per annum each member for administrative expenditures incurred by the participating bank.

The scheme will go into the date on the 1st of June, 2015. The annual renewal dates will be the first of June of each succeeding year in the following years.

When it becomes necessary, the scheme may be terminated prior to the commencement of new future renewal date, if the circumstances dictate.

8. Mode of enrollment and enrollment period:

A one-year period ranging from 1st June to 31st May will be covered, for which an option to join/pay by auto-debit from a designated bank account will be required to be supplied by the 31st May of each year will be required to be given on the necessary forms by the 31st May of each year.

It would be possible to join at a later date after making complete annual fee payment. But applicants have the option of providing an indefinite or long-term option for enrolment / auto-debit, subject to the scheme’s continuity and the possibility of revision of the conditions based on previous experience.

Individuals who leave the scheme at any point in time may re-join the scheme in subsequent years by following the procedures outlined above.

In addition, new entrants into the eligible group from year to year, as well as currently eligible individuals who did not participate previously, will be entitled to participate in future years as long as the scheme is in operation.

9. Main Policyholder for PMSBY

On behalf of the participating subscribers, the participating bank will act as the Main policyholder.

The administration and claim payment process will be finalized by the relevant general insurance provider in consultation with the participating banks and will be simple and user-friendly.

10. Coverage comes to an end:

When one or more of the following occurrences occur, the member’s accident cover will be terminated, and no benefits will be payable as a result.

1) When one reaches the age of seventy-five years (age nearest birthday).

2) Closing of the account with the bank or insufficient balance to retain the insurance in force.

Insurance cover will be confined to one bank account only in the event that a member is covered through more than one account and the Insurance Company receives the premium for the duplicate insurance(s) mistakenly.

The premium paid for the duplicate insurance(s) will be liable to be forfeited.

4) If the insurance cover is terminated for any technical reason, such as an inadequate balance on the due date, or for any administrative reason, the coverage can be renewed upon receipt of the entire annual premium, subject to any conditions that may be imposed. During this time period, the risk cover will be suspended, and the Insurance Company will have exclusive discretion over whether or not to reinstate the risk cover.

Participating banks will deduct the premium amount from your account in the same month that you choose auto-debit, preferably in May of each year, and remit the amount owing to the insurance company in the same month.

To the point and clear Answer of Some Important FAQ regarding PMSBY

Q1. Can you tell me about the PMSBY scheme’s structure?

Protection against accidental death or disability is provided by this one-year cover Personal Accident Insurance Scheme, which is renewable from year to year and provides protection against accidental death or disability.

Q2. Who will be in charge of offering and managing the PMSBY scheme?

Public Sector General Insurance Companies (PSGICs) and other general insurance companies ready to offer the product with relevant approvals on similar terms, in partnership with participating banks, provide the service and administration for the scheme. Participating banks are able to contract with any general insurance firm of their choice to carry out the scheme’s implementation for their subscribers.

Q3. Can eligible individuals who do not join the scheme in the first year re-enroll in the scheme in later years?

Yes, if the premium is paid by auto-debiting your bank account. In addition, new eligible entrants in subsequent years will be able to join in the same manner.

Q4. Who will be eligible to sign up for the PMSBY service?

Individual (single or joint) bank account holders in participating banks who are between the ages of 18 and 70 years old will be eligible to join. In the event that an individual has multiple bank accounts with the same or other financial banks, the individual would only be eligible to join in the scheme through one of those accounts.

Q5. How much benefit I will receive in PMSBY and what is my Premium Amount?

As seen in the following table, there are numerous advantages:

	Table of Benefits	Sum Insured
a	Premium Amount on Death	Rs. 2 Lakh
b	Total and irrecoverable loss of both hands or total and irrecoverable of both eyes or feet or loss of sight of one eye or loss of both the foots	Rs. 2 Lakh
c	Total or irrecoverable loss of 1 eyesight or one hand or 1 foot	Rs. 1 Lakh

The amount of Premium is Rs. 12/- per annum only.

Q6. What method will be used to pay the premium?

It is necessary to provide written consent prior to enrolling so that the premium can be deducted in one installment from the account holder’s bank account through an “auto-debit” function.

As an alternative, members may give a one-time mandate for auto-debit every year for as long as the scheme is in operation, subject to re-calibration as may be required following an experience of the scheme’s performance.

Q7. What is the enrollment period, as well as the modality of enrollment?

Subscribers were initially required to give and choose an auto-debit option by the 31st May 2015 for coverage beginning on the 1st June 2015 and ending on the 31st May 2016, however, this deadline was later extended until the 31st May 2016.

Subscribers who wish to continue their subscription after the first year will be required to give their consent for auto-debit on or before each successive May 31st for the following three years unless they are opt-out.

Delayed renewal after this date may be possible upon payment of the entire annual premium, subject to the terms and conditions that may be established by the insurer.

Q8. Is it possible for those who have left the scheme to rejoin?

Individuals who withdraw from the scheme at any time may re-join the scheme in subsequent years by paying the annual premium, subject to any conditions that may be imposed.

Q9. When does the accident cover assurance contract expire and how does it work?

If any of the following circumstances occur, the member’s accident cover will be terminated or restricted in accordance with the terms of the policy:

I. Upon reaching the age of 70 years (age neared birth day).

It is possible to lose your insurance coverage if you close your bank account or don’t have enough cash on hand.

Insurance cover will be confined to one account in the event that a member is covered by more than one account and a premium is received by the insurance provider mistakenly. The premium would be forfeited in this instance.

Q10. Are non-resident aliens (NRIs) eligible for coverage under the PMSBY?

Any NRI who has an eligible bank account with a bank branch situated in India is eligible to purchase PMSBY insurance through this account, provided that they cover all of the terms and conditions of the scheme. The claim benefit, on the other hand, will be paid to the beneficiary/nominee exclusively in Indian currency in the event of a claim being filed.

Q 11. Is it possible to take PMSBY and PMJJBY at the same time?

Yes, both PMSBY & PMJJBY Insurance Schemes can be taken at the same time. PMJJBY is a term life insurance benefits scheme by the Government of India.

Q12. Will this cover be in addition to any cover provided by any other insurance scheme under which the subscriber may be insured?

Yes, you can take the benefit of other insurance schemes also in addition to this scheme.

Q13. Who would be the policyholder in charge of the scheme’s Master policy?

The Master policyholders will be the banks who are participating part in the programme. PSGICs And the selected insurance company, in consultation with the participating bank, have finalized a simple and subscriber-friendly administration and claim settlement process that is both efficient and user-friendly.

Q14: How would the insurance premium be allocated?

The insurance premium payable to PSGIC / another insurance company is Rs.12/- per annum per member; the reimbursement of Expenses to BC/Micro/Corporate/Agent by the insurer is Rs.1/- per annum per member; and the reimbursement of administrative expenses to participating bank by the insurer is Rs.1/- per annum per member.

Q15. Will this cover be in addition to any cover provided by any other insurance scheme under which the subscriber may be insured?

Yes.

Q16. Is it possible for all joint bank account holders to participate in the scheme by using the same bank account number?

In the event of a joint account, all of the account holders are eligible to join in the scheme provided they meet the eligibility requirements and pay the premium at the rate of Rs.12 per person per annum by automatic debit.

Q 17. What are the roles and responsibilities of the Bank and the Insurance Company?

I. The scheme will be governed by PSGICs or any other General Insurance company that is ready to offer the insurance in collaboration with a bank or group of banks.

If an account holder chooses to pay their annual premium in one installment, the participating bank will be responsible for collecting the necessary amount from them on or before the due date using the “auto-debit” mechanism and transferring the funds to the insurance company.

Iii. The participating bank must obtain and preserve an enrolment form, and auto-debit authorization form, and a Consent cum Declaration form in the appropriate proforma, as necessary. In the event of a claim, the PSGIC / insurance company may request that the claim be submitted. PSGIC / Insurance Company additionally reserves the right to request these papers at any moment without prior notice or explanation.

Q 18.Do natural disasters such as earthquakes, floods, and other natural calamities, as well as other natural convulsions, cover under the purview of the PMSBY? In terms of suicide and murder, what is the coverage like?

Because natural calamities are in the nature of accidents, any death or disability (as defined under PMSBY) that occurs as a result of such natural calamities is likewise covered under the PMSBY policy.

While death as a result of suicide is not covered, death as a result of murder is covered.

Q19. Is there any provision for reimbursement of hospitalization expenditures incurred as a result of an accident resulting in death or permanent disability?

No.

Q20. What is the method of payment for the amount of the claim?

The Disability Claim will be credited to the insured bank account holder’s bank account. Claimants who die will have their death benefits deposited into the bank account of their nominee or legal heir (s).

Q21. Are the legal heirs of the insured entitled to the benefit of the insurance if the insured is missing and death has not been confirmed?

PMSBY provides coverage for accidental deaths that have been shown by documentary evidence to have occurred.

If a person has a partial impairment without experiencing an irreversible loss of vision in one eye or the loss of use of one hand or foot, what type of benefit will be payable?

There will be no payment of benefits.

Q22. What types of bank accounts are eligible for PMSBY subscriptions?

All bank account holders, with the exception of institutional account holders, are eligible to participate in the PMSBY scheme.

Q23. Who is eligible to receive an insurance benefit in the event of the death of the bank account holder who signed the enrolment form.

Upon the death of an Account Holder who has enrolled in the scheme, a claim can be lodged by the nominee/appointee listed on the enrolment form, or by the legal heirs in the event that no nomination has been made by the account holder who has subscribed to the scheme.

Q.24. If the account holder commits suicide, will his or her family be entitled to an insurance benefit?

No. In case of suicide, this insurance benefit can not be taken.

Q.25. Can an Account holder receive a claim from more than one bank where he has enrolled and where he has had premiums deducted from his account?

No, the insured/nominee will only be eligible for one claim during their lifetime.

Q.26. Are PMSBY policies introduced and handled in collaboration with foreign insurance companies?

In India, there are no international insurance companies that are directly involved in the business. Several international insurers have formed joint ventures with Indian enterprises under the provisions of the Insurance Act and the IRDA Regulations, in which the foreign insurers’ ownership participation is limited to 49 percent.

Q.27. Is it required to report accidents to the police and get an accident report number in order to be eligible for payments under the policy?

It is important to report accidents to the authorities in cases such as road, rail, and similar motor accidents, drowning, and death involving any type of crime, among other things. A medical record from the hospital should be obtained as soon as possible in the case of an occurrence such as a snake bite or a fall from a tree.

q-28. In light of the fact that Public Sector General Insurance Companies (PSGICs), who are government-owned corporations, could have administered this government-sponsored scheme, why are foreign insurance companies affiliated with PMSBY?

In India, there are 21 general insurance companies that are licensed by the Insurance Regulatory and Development Authority of India (IRDAI) to do general insurance business in the country.

All of these businesses are permitted to join in order to foster competition and provide better prices and services to clients. Furthermore, they are all insurance businesses based in India.

Their foreign partners, if any, have just a 49 percent share in these enterprises, which is within the limits of the law. However, public sector general insurance companies (PSGICs) continue to be the major insurers involved in the administration of the scheme.

Q.29. Will the PMSBY scheme, which is being aggressively advertised and sold in big numbers, result in huge profits for the foreign insurance corporations that have formed joint ventures with Indian organizations to establish general insurance companies and operate this insurance cover?

In India, only Indian insurance companies, as specified by the Insurance Act, are permitted to conduct business. The policyholder funds of all such insurance businesses operating in India, including those with foreign partners, that fall under the 49 percent cap are required to be invested in India and cannot be invested outside of India, according to the legislation.

The premium charged for PMSBY has been calculated using actuarial calculations that take into account all risk variables, current mortality rates, and adverse selection, among other considerations. As a result, the scheme does not have the potential to generate large amounts of wealth. In reality, there is a strong desire to raise the premium.

Q.30. Is it feasible to take legal action against international insurers in India if the claims are not settled in accordance with the terms of the policy?

In India, there are no international insurance companies that are directly involved in the business. According to the regulations, there exist firms that operate as joint ventures with Indian enterprises, with foreign insurers’ stakes limited to 49 percent of the total equity.

These are, by definition, insurance businesses based in India. All of these businesses are governed by Indian law, and there is no prohibition on bringing legal action against them.

Q.31. Is it possible that premium rates will be raised in the future, or that the companies would cease the schemes?

Insurance is no different than any other product. While rates may rise in the future, with 21 general insurance companies operating in India, prices are anticipated to remain stable in the short term due to the intense rivalry among them.

The design of the PMSBY cover, as well as the pricing structure, are intended to make the scheme financially feasible, and there is minimal danger of it being phased out. In any case, even if a certain company goes out of business, banks have a plethora of additional partners with which to collaborate.

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