The scheme is a one year cover Personal Accident Insurance Scheme, renewable from year to year, offering protection against death or disability due to accident.
The benefits payable under the scheme on death or disability due to accident are as follows:
| Table of Benefits | Sum Insured |
| Death | Rs. 2 Lakh |
| 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 |
| Total and irrecoverable loss of sight of one eye or loss of use of one hand or foot | Rs. 1 Lakh |
Premium payable is Rs.20/- per annum per member.
Accident means a sudden, unforeseen and involuntary event caused by external, violent and visible means.
The premium will be deducted from the account holder’s bank / Post office account through ‘auto debit’ facility in one instalment, as per the consent given by the subscriber at the time of enrolment.
The scheme is offered / administered through the Public Sector General Insurance Companies (PSGICs) and other general insurance companies willing to offer the product with necessary approvals on similar terms, in collaboration with participating Banks. Participating banks are free to engage any such general insurance company for implementing the scheme for their account holders/subscribers.
All individual (single or joint) account holders of participating banks / Post office, in the age group of 18 to 70 years are entitled to join. In case of multiple accounts held by an individual in one or different banks/ Post offices, the person is eligible to join the scheme through one bank / Post office account only.
The cover shall be for one-year period stretching from 1st June to 31st May. At the time of enrolment, subscriber has to submit his option on the prescribed form, to join / pay by auto-debit from the designated individual bank / Post office account, until further instructions, an amount of Rs.20/- (Rupees Twenty only) per annum, or any amount as decided from time to time, which may be intimated immediately if and when revised, towards renewal of coverage under the scheme. Delayed enrolment / renewal subsequent to this date will be possible on payment of annual premium.
Yes, new eligible entrants can also join in future years on payment of premium through auto-debit. However, risk cover would start from the date of auto debit of premium from the subscriber’s account.
Individuals who exit the scheme at any point may re-join the scheme in future years by paying the annual premium, subject to conditions that may be laid down. However, risk cover would start from the date of auto debit of premium from the subscriber’s account.
Participating Banks/ Post office are the Master policy holders for the scheme. A simple and subscriber friendly administration & claim settlement process has been finalized by PSGICs / other insurance companies in consultation with the participating banks / Post office.
The accident cover of the member shall terminate / be restricted accordingly on any of the following events:
Appropriation of Premium:
Note: The amount of commission payable to Business Correspondents, agents, etc. as specified in item 2) saved in case of voluntary enrolment by an accountholder through electronic means shall be passed on as a benefit to the subscriber by correspondingly reducing the amount of the Insurance Premium payable specified in item 1).
Natural calamities being in the nature of accidents, any death / disability (as defined under PMSBY) resulting from such natural calamities is also covered under PMSBY. While death due to suicide is not covered, that from murder is covered.
In case of a joint account, all holders of the said account can join the scheme provided they satisfy its eligibility criteria and pay the premium at the rate of Rs.20 per person per annum through auto-debit.
All bank account holders other than institutional account holders are eligible for subscribing to PMSBY scheme.
Any NRI having an eligible bank account with a bank branch located in India is eligible for purchase of PMSBY cover through this account subject to fulfilment of the terms and conditions relating to the scheme. However, in case a claim arises, the claim benefit will be paid to the beneficiary/ nominee only in Indian currency.
In case of death of the account holder/subscriber who enrolled in the scheme, claim can be filed by the nominee/appointee as per the enrolment form or by the legal heir/s in case there is no nomination made by the subscriber bank account holder.
Disability claim will be credited in the bank account of the insured bank account holder / subscriber. Death claim will be remitted to the bank account of the nominee / legal heir(s).
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.
PMSBY covers deaths due to accident as confirmed by documentary evidence only
No benefit will be payable.
No. The insured/ nominee shall be eligible for one claim only.
There are no foreign insurance Companies directly operating in India. As permitted by the Insurance Act and IRDA Regulations there are some foreign Companies in joint ventures with Indian companies, where the stake of foreign insurers is restricted to 74% only.
Only Indian Insurance Companies as defined in the Insurance Act can operate in India. The policy holders’ funds of all such insurance companies operating in India including those with foreign partners within the 74% cap are to be invested in India as per regulations and cannot be invested abroad. The premium charged for PMSBY has been worked out based on actuarial calculations by considering all risk factors, current mortality rates and adverse selection. Thus, there is no scope for any huge profits accruing from the scheme.
There are 21 general insurance companies operating in India, who are licensed by IRDAI to carry on general insurance business in India. To promote competition and better pricing and service to customers, all these companies are permitted to participate.
Moreover, they are all Indian insurance companies. Their foreign partners, if any, have only a stake in these companies within the stipulated 74% cap. However, Public Sector General Insurance Companies (PSGICs) are still the primary insurers involved in operation of the scheme.
There are no foreign insurance Companies directly operating in India. As permitted by the regulations there are Companies operating as joint ventures with Indian companies, where the stake of foreign insurers is restricted to 74% only. By definition, these are Indian insurance companies. All these companies are subject to Indian laws and there is no bar against proceeding legally against them.
Insurance is like any other product. While rates can go up in future, with 21 general insurance Companies operating in India, due to competition among them, prices are likely to remain stable. It is expected that with the design of the PMSBY cover and it’s pricing, the scheme will be viable, and there is little chance of discontinuing. In any event, even if a particular company discontinues, banks have several other options to tie up with.