Pmsby (Pradhan Mantri Suraksha Bima Yojana): Eligibility, Coverage & Benefits

The authorities keep coming up with beneficial welfare schemes for citizens belonging to different strata of society. The Pradhan Mantri Suraksha Bima Yojana is one such scheme. It is an Accident Insurance policy that was discussed in 2015’s budget speech. It was launched two months later in May 2015. Read ahead to know more about this government-backed insurance scheme. 

Contents

• Features and Benefits of Pradhan Mantri Suraksha Bima Yojana
• Coverage of Pradhan Mantri Suraksha Bima Yojana
• What’s Not Covered in Pradhan Mantri Suraksha Bima Yojana?
• What are the Eligibility Criteria for Pradhan Mantri Suraksha Bima Yojana?
• Documents Required for PMSBY
• Banks Participating in PMSBY
• How to Enrol and Register for Pradhan Mantri Suraksha Bima Yojana
• Pradhan Mantri Suraksha Bima Yojana Premium
• Claim Process of PMSBY
• How to Renew PMSBY
• How to Check Pradhan Mantri Suraksha Bima Scheme’s Application Status
• Pradhan Mantri Suraksha Bima Yojana (PMSBY) Vs Pradhan Mantri Jeevan Jyoti Bima Yojana (PMJJBY)
• PMSBY Toll-Free Number
• Health Insurance Companies Providing PMSBY Scheme:
• Pradhan Mantri Suraksha Bima Yojana Online Registration:
• Subscribing to PMSBY: SMS vs. Internet Banking
  • Subscribing via SMS
• Subscribing via Internet Banking
  • PMSBY Premium
  • Conditions for Ending Pradhan Mantri Suraksha Bima Yojana Coverage
• Step-By-Step Guide For Claim Settlement
• The Bottom Line
• Frequently Asked Questions:

What is the Pradhan Mantri Suraksha Bima Yojana?

The Pradhan Mantri Suraksha Bima Yojana (PMSBY) is an accident insurance scheme launched by the Government of India. It is also known as the PM Rs. 12 Insurance Scheme. The social security scheme is directed towards people belonging to the lower-income category. This is because unlike several other health insurance policies offered by commercial companies, this scheme does not charge a higher premium.

The policy offers insurance coverage against death, total disability, and partial disability. The insurance premium of Rs. 12 (excluding service tax) for the policy shall be deducted from the policyholder's registered bank account. People in the age group of 18 to 70 can avail the benefits of PMSBY by providing their Aadhaar card as a Know Your Customer (KYC) document.

Detailed Policy Terms and Conditions

Knowing an insurance policy's terms and conditions is crucial for making wise judgements about it. Policies can include certain jargon, such as "total disability" and "partial disability," which directly affects claim eligibility and payout.

Total Disability

This word describes a situation whereby a sickness or disability renders the policyholder totally unable to work or engage in any kind of activity. For example, the policyholder might be qualified under this provision if an accident causes the permanent loss of movement or cognitive ability. Most policies provide exact standards, including medical evidence, for obtaining payments under total disability.

Partial Disability

Under partial disability, a medical condition causes the insured to be unable to perform some but not all of their job tasks. A surgeon might be eligible for partial disability compensation, for instance, if they lose dexterity in one hand but can still perform administrative tasks. Generally speaking, the benefit levels under this phrase are less than those for total disability.

Exclusions

Policies sometimes include exclusions—situations whereby claims are not liable. Typical exclusions can be pre-existing conditions not revealed during policy purchase, self-inflicted damage, or injuries from high-risk hobbies (such as skydiving).

Waiting Periods and Other Conditions

Several policies enforce a waiting period—a period before benefits start following a claim. Benefits could also be limited in terms of maximum length or value.

Knowing these words guarantees openness and helps to prevent surprises during the claim process. Always review the insurance document carefully, then ask your insurer or financial adviser for an explanation.

Features and Benefits of Pradhan Mantri Suraksha Bima Yojana

The PMSBY gives people from the lower-income group a chance to insure themselves against unfortunate events that can lead to death or disability. Here are the features and benefits of the government scheme:

Coverage of Pradhan Mantri Suraksha Bima Yojana

Here’s a table highlighting the cover offered by the PMSBY.

Note: Definition of total and partial disability will be as per the policy’s terms and conditions.

What’s Not Covered in Pradhan Mantri Suraksha Bima Yojana?

As mentioned in the above section, the PMSBY is an accident and disability insurance policy. It covers a policyholder in case of death and disability. However, there are certain restrictions related to the cause of death and the nature of the disability. Death by suicide is not covered. Non-permanent disabilities (partial disability without irrecoverable loss) shall not be covered unless specified otherwise.

What are the Eligibility Criteria for Pradhan Mantri Suraksha Bima Yojana?

You must meet specific requirements regarding PMSBY details to avail the benefits of the PMSBY. Here’s a list of such eligibility requirements.

• The minimum age requirement for being part of the scheme is 18 years.

• The maximum PMSBY age limit to avail this scheme is 70 years.

• Interested potential policyholders must have an active savings bank account.

• The applicant’s saving bank account should be integrated with the person’s Aadhaar card.

• If the Aadhaar details are not linked to the mentioned bank account, a copy of the card should be sent along with the application.

• Payment of the premium of Rs. 12.

Documents Required for PMSBY

• Proof of Identity: You will need to provide valid proof of identity. This can typically be your Aadhaar card, which serves as a widely accepted and recognized identification document in India.

• Aadhaar Card: Your Aadhaar card is a crucial document for this application. It is used for verification purposes and ensures that your identity is properly confirmed during enrollment.

• Contact Information: You will be required to furnish accurate contact information, including your current address and phone number. This information helps in communication and ensures you receive updates related to the insurance scheme.

• Nominee Details: It's important to provide details about your chosen nominee. The nominee is the person who will receive the insurance benefits in case of an unfortunate event. Ensure these details are correctly filled out to avoid any complications later.

• Application Form: The PMSBY application form is available in multiple languages, including English, Hindi, Bengali, Marathi, Oriya, Telugu, Tamil, and Gujarati. You will need to fill out this form with all the necessary details accurately.

• Aadhaar Card Copy: If your Aadhaar card is not already linked to your savings bank account, you may need to submit a copy of it along with your application form. This ensures that your identity is correctly associated with your bank account.

Banks Participating in PMSBY

Here’s a list of banks that are a part of the PMSBY.

• Allahabad Bank

• Axis Bank

• Bank of India

• Bank of Maharashtra

• Bharatiya Mahila Bank

• Canara Bank

• Central Bank

• Corporation Bank

• Dena Bank

• Federal Bank

• HDFC Bank

• ICICI Bank

• IDBI Bank

• IndusInd Bank

• Kerala Gramin Bank

• Kotak Bank

• Oriental Bank of Commerce

• Punjab and Sind Bank

• Punjab National Bank

• South Indian Bank

• State Bank of Hyderabad

• State Bank of India

• State Bank of Travancore

• Syndicate Bank

• UCO Bank

• Union Bank of India

• United Bank of India

• Vijaya Bank

Also, read: Arogya Sanjeevani Health Insurance

How to Enrol and Register for Pradhan Mantri Suraksha Bima Yojana

You can enrol yourself for the PMSBY by approaching an affiliated bank or an insurance company. The Pradhan Mantri Suraksha Bima Yojana form or the PMSBY form can also be downloaded from the government’s Jansuraksha website. It is available in multiple languages:

The registration process can be initiated via the respective internet banking facility or by sending a message on the onboarding organization’s toll-free number.

Here’s how you can activate the policy using the SMS facility.

• Step 1 – Receive activation SMS.

• Step 2 – Reply to the activation SMS with ‘PMSBY Y’.

• Step 3 – Receive a message acknowledging the receipt.

• Step 4 – The bank will manage the processing information from the back-end of the savings account.

Here’s how you can activate the policy using the internet banking facility (PMSBY Online Apply).

• Step 1 – Login to the internet banking account.

• Step 2 – Click on Insurance.

• Step 3 – Identify the account to be used for paying the premium amount.

• Step 4 – Check details and confirm.

• Step 5 – Download receipt and note the stated reference number.

Pradhan Mantri Suraksha Bima Yojana Premium

The PMSBY premium is Rs. 12 for a year. It will be auto-debited from the registered bank account of the policyholder. There is a possibility that the premium will be reviewed as per the annual claims experience.

Claim Process of PMSBY

You can raise a claim against the PMSBY in case of partial or total disability. In case of death, your nominee can file a claim. If there is no nominee, then the claim amount shall be given to the legal heir of the deceased policyholder. Here’s the claim process.

• Step 1 – Policyholder/nominee should reach out to the bank or the insurance company from where the policy was purchased to raise a claim.

• Step 2 – Obtain claim form and fill it. It will include details such as name, address, contact information, details of the hospital, etc. The PMSBY’s claim form can be downloaded from the Jansuraksha website for free. The form is available in multiple languages such as Punjabi, Telugu, etc.

• Step 3 – Submit the filled form with the relevant supporting documentation such as disability certificate or death certificate in case the claim is raised by the nominee.

• Step 4 – The insurance company will confirm the details.

• Step 5 – If the documents turn out to be proper, the claim amount will be transferred to the specified bank account and the claim will be settled.

Also, read: Nominee in Health Insurance

How to Renew PMSBY

You can renew PMSBY by enabling the auto-debit facility. This way the premium will be automatically debited from your bank account and the policy shall be renewed. The scheme can be renewed on an annual basis. The policy duration is between June 1 to May 31. Therefore, the policy should be renewed before the end of May. If you don’t want to renew, you will have to send a cancellation request to the respective bank.

How to Check Pradhan Mantri Suraksha Bima Scheme’s Application Status

You can check PMSBY’s account status by following these steps.

• Step 1 – Visit your bank’s website.

• Step 2 – Login using internet banking.

• Step 3 – Visit the appropriate PMSBY section.

• Step 4 – Enter the bank account number.

• Step 5 – Enter PMSBY application number.

• Step 6 – Click Submit.

• Step 7 – Check status.

Pradhan Mantri Suraksha Bima Yojana (PMSBY) Vs Pradhan Mantri Jeevan Jyoti Bima Yojana (PMJJBY)

In the year 2015, the Government of India announced three Social Security Schemes for the welfare of the country’s poor and underprivileged citizens. PMSBY and PMJJBY are a part of those three schemes, the third one being Atal Pension Yojana. These schemes are directed towards financial inclusion. The two insurance schemes aim to offer financial security to the weaker sections of the society. Here’s a table distinguishing between PMJJBY and PMSBY.

Also, read: Insurance for COVID-19

PMSBY Toll-Free Number

The PMSBY customer care number is 1800-180-1111/1800-110-001. It is a national-wide toll-free number. You can get the state-wise toll-free number on Jansuraksha’s website.

Health Insurance Companies Providing PMSBY Scheme:

• Bajaj Allianz

• Cholamandalam MS

• ICICI Lombard

• New India Assurance

• Universal Sompo

• United India Insurance

• National Insurance

• Reliance General Insurance

Pradhan Mantri Suraksha Bima Yojana Online Registration:

• Step 1: To enroll in the Pradhan Mantri Suraksha Bima Yojana (PMSBY), individuals have the option to visit any of the participating banks or health insurance companies. 

• Step 2: Many well-known banks facilitate subscribers in obtaining the policy through their Internet banking services.

• Step 3: Subscribers can access the scheme by logging into their internet banking accounts and completing the enrollment process.

• Step 4: Alternatively, subscribers can send a message from their registered mobile number to the toll-free numbers provided by the banks and insurance companies.

This process simplifies access to the PMSBY, making it easier for individuals to secure insurance coverage for their well-being and financial security.

Subscribing to PMSBY: SMS vs. Internet Banking

Subscribing via SMS

• Activation SMS: To initiate the process, individuals must first receive an activation SMS. This message typically contains instructions on how to proceed.

• Response 'PMSBY Y': Upon receiving the activation SMS, the subscriber needs to respond with 'PMSBY Y' to confirm and activate the scheme.

• Acknowledgement Message: After confirming their intent to enrol, subscribers will receive an acknowledgement message. This message serves as a confirmation of their enrollment.

• Bank Processing: The subscriber's bank will then take care of the processing from the back end, linking the PMSBY to their savings account

Subscribing via Internet Banking

• Login to Internet Banking: Start by logging in to your respective bank's internet banking account using your credentials.

• Access the Insurance Section: Within the internet banking interface, locate and access the "Insurance" section. This is where you can manage your PMSBY enrollment.

• Choose Premium Payment Account: Select the bank account through which you want to pay the insurance premium. Ensure that this account has sufficient funds to cover the premium amount.

• Review and Confirm: Carefully review all the details you've entered to ensure accuracy. Once satisfied, confirm your selection to proceed with the enrolment.

• Download Confirmation Receipt: Following confirmation, you can download the confirmation receipt. This receipt is essential as it contains your reference number, serving as proof of your PMSBY subscription via internet banking.

PMSBY Premium

Like any other government-initiated scheme, the PMSBY is available to every Indian citizen for a nominal price of ₹12 per year. The amount is deducted directly from the insured's linked savings bank account on an annual basis.

1st June of each year, this premium is deducted.

Conditions for Ending Pradhan Mantri Suraksha Bima Yojana Coverage

The Pradhan Mantri Suraksha Bima Yojana (PMSBY) coverage concludes in the following situations:

• Upon reaching the age of 70.

• In case the savings account does not maintain the minimum balance to cover the ₹12 annual premium.

• For individuals with multiple accounts, the premium is deducted from one account, and any additional premiums are forfeited.

• If the auto-debit transaction for the premium amount fails.

• When the insurance coverage is terminated due to technical issues or insufficient funds, it can be reinstated after paying the outstanding premium in full.

Step-By-Step Guide For Claim Settlement

Navigating the claim-settling process can be easy if you are well-prepared and follow the correct procedures. Here is a comprehensive handbook including advice to help one avoid typical mistakes.

1. Understand Policy Terms

Review your policy to learn eligibility, coverage, and exclusions before you submit a claim. Make sure the claim fits the policy's purview to prevent denials.

2. Notify the Insurer Promptly

Tell your agent about the claim right away. Many regulations specify exact times for incident reporting. Delaying notifications could cause problems or denial.

3. Fill Out the Claim Form Accurately

Finish the claim form precisely. Check for mistakes twice since differences could slow down the process. For proof, supply policy details and contact information.

4. Submit Required Documentation

Prepare all necessary documents, such as:

• Proof of loss (e.g., medical reports, police FIR, or accident details).

• Policy number and a copy of the insurance policy.

• Identification documents (ID proof or address proof).

• Original bills or receipts for reimbursement claims.

Frequently overlooked documents include:

• Original copies of treatment summaries.

• Employer certification for work-related claims.

• Secondary documents, like affidavits, for accidental loss.

5. Respond to Queries Promptly

Over the assessment process, insurers could ask for further data. Respond fast to prevent delays.

6. Track the Claim Status

Follow up often via the insurance company's customer service or online portal. Tracking lets one find and fix problems early on.

7. Potential Challenges

Common challenges are missing papers, inaccurate information, or non-disclosure of pre-existing conditions. Clear recordkeeping and careful entry validation will help you avoid these.

Following these guidelines and maintaining open lines of contact with your insurer will help guarantee a better claim settlement procedure.

The Bottom Line

The Pradhan Mantri Suraksha Bima Yojana is an important accident insurance scheme used by the government of India. Charging only Rs. 12 annually makes insurance accessible to economically weaker sections. The scheme covers accidental death, permanent disability, and partial disability up to Rs. 2 lakhs and 1 lakh, respectively. Though not without limitations, the PMSBY has benefited millions, providing much-needed financial security against accidents. Overall, it is a commendable effort towards the welfare and inclusion of all Indian citizens.

Frequently Asked Questions:

What is the minimum age to apply for PMSBY?

The minimum age for eligibility under PMSBY is 18 years.

Does PMSBY require a medical check-up?

No, there is no medical examination or test required to enrol for PMSBY coverage.

What is the premium payment process?

The premium payment process relies on the auto-debit facility. The policyholder must approve of this while enrolling for the scheme.

Is the PMSBY premium the same for all age groups?

Yes, the standard premium payable is Rs. 12 per annum, irrespective of age or occupation.

What documents do I need to submit to raise a PMSBY claim?

Key documents needed are an accident/disability certificate from the hospital, a Death certificate (for the nominee), Identity proof, PMSBY policy details, and FIR if applicable.

Are joint account holders eligible for the scheme?

Yes, joint account holders are also eligible for the scheme.

Can I have multiple PMSBY policies from different insurers?

No, a person can be covered under only one PMSBY policy at any point in time.

Is there any provision to get tax benefits under PMSBY?

No, tax benefits are not provided under PMSBY currently. Premium paid and claims received are not exempt under income tax provisions.

Is it possible to be a part of the scheme for a year, leave it for a couple, and then rejoin again?

It is possible to rejoin the scheme.

Does PMSBY cover accidents that occurred while traveling abroad? 

PMSBY policy provides coverage only for accidents occurring within the geographical boundaries of India.

When will the policy be terminated?

The policy will be terminated if the registered bank account is closed, the balance is insufficient, the policyholder reaches the age of 70 and if multiple banks have debited the premium (the only one will be allowed). The policy can be cancelled by the individual by getting in touch with the participating bank.

Does the scheme cover death by murder?

Yes, death by murder is covered as per the scheme. Note that suicide is not covered.

Is death or disability due to natural calamities covered?

Yes, death or disability due to natural calamities mentioned in the terms and conditions is covered.

Is it possible for a Non-resident Indian to be a part of this scheme?

Yes, a non-resident Indian can also be a part of this scheme. The claim amount shall be paid in Indian currency.

Will the policy reimburse expenses related to the hospitalisation in case of an accident?

No, reimbursement of expenses is not supported by the scheme.

 Is a police FIR necessary while applying for a claim under the scheme?

The answer varies from one case to another. For example, if the accident is caused because of a car accident, a police FIR is needed. It is not needed for disability due to falling from a tree. For that, hospital records should suffice.

Where can I view details of PMSBY scheme hospitals in my city?

Empanelled hospital's information for cashless facilities can be checked on the insurer's website or by contacting a toll-free number.

Is there a possibility that the Rs. 12 premium can increase in the future?

There is a possibility of price rise.

Can I opt for PMSBY Online Apply facility?

Yes, you can do so using internet banking.

What is the other name for the PMSBY scheme?

The PMSBY scheme is also known as Pradhan Mantri (PM) 12 Rs. Insurance and PMSBY 12 Rs. Policy.

Can I continue PMSBY after changing my job? 

Yes, PMSBY coverage can be continued seamlessly by renewing the policy even after changing jobs, location, etc.

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