Mukhyamantri Ayushman Accident Insurance Scheme

Why was the Mukhyamantri Ayushman Accident Insurance Scheme Introduced

Before the introduction of the Mukhyamantri Ayushman Accident Insurance Scheme, families in Rajasthan had been experiencing great economic insecurity due to unforeseen accidents that led to death and permanent disability. Even though state health insurance schemes had been providing funds for medical treatment during hospitalisations, they did not have any provision of direct economic security.

To fill this gap, the Rajasthan State Government has come up with this special accident insurance plan. As a part of the state's overall health scheme, it ensures that the family of the victim gets financial compensation immediately.

Key Highlights - Mukhyamantri Ayushman Accident Insurance

Who is Eligible for Mukhyamantri Ayushman Accident Insurance

Beneficiaries of Health Scheme: All households and individual persons covered under the Mukhyamantri Ayushman Aarogya Yojana (formerly Chiranjeevi Swasthya Bima Yojana).

Employees of the Government: All households covered under the Rajasthan Government Health Scheme (RGHS).

Employees of the Power Department: Power sector employees who were born before 1st January 2004. As the line workers and field Electricians often have to work in a high-risk environment, this creates a safety net for these employees.

What Mukhyamantri Ayushman Accident Insurance Covers

The Mukhyamantri Ayushman Accident Insurance Scheme (Mukhyamantri Ayushman Durghatana Bima Yojana) pays compensation according to the severity of the injury or death caused by an insured accident.

Financial Benefits Structure

The following is a comprehensive breakdown of the compensation amounts payable, along with the eligibility criteria for each category of compensation, and the incidents that are covered:

Accidental Incidents Covered under Mukhyamantri Ayushman Accident Insurance

Benefits can be paid for death or permanent disability that results from one of the following accidental incidents:

• Transport Accidents: Road, rail, or air accidents.
• Falls: Fall from a height or falling of heavy objects on the individual from a height.
• Building Collapse: Collapse of the house or building.
• Electric Shocks: Electric shock and electrocution.
• Chemical Accidents: Chemical exposure and spraying of chemicals on the individual.
• Water and Fire Accidents: Drowning and burns.

What Mukhyamantri Ayushman Accident Insurance does not Cover

• Natural deaths, illness or death resulting from medical conditions.
• Deliberate self-injury, suicide or attempted self-injury.
• Injury or death that results from unlawful, criminal or drug/alcohol abuse behaviour.
• Normal medical expenses (which are covered by normal health insurance and not accident insurance).

Documents Required for Mukhyamantri Ayushman Accident Insurance

• Jan Aadhaar card (deceased and the head of the family): serves as a primary proof of State residency.
• Death certificate (if any): official government-issued record confirming the date, place, and cause of death of the insured individual.
• First Information Report (FIR),Marg report or Panchnama: Police reports and legal site inspection records that establish the official timeline and authentic accidental nature of the incident.
• Postmortem report / hospital death summary: Medical documentation verifying the exact clinical cause of death resulting from an accident.
• Permanent Disability Certificate issued by the Competent State Medical Board: a formal medical assessment issued by a competent State Medical Board detailing the percentage and extent of permanent physical loss or disability.
• Bank Account details of Jan Aadhaar: bank account information of the family head to enable direct financial disbursement via Direct Benefit Transfer (DBT).

How to Apply Step by Step for Mukhyamantri Ayushman Accident Insurance

Step 1: Login into the Portal

• Go to the official website of the Rajasthan SSO portal, or go directly to the MADBY Portal.
• Login through the SSO ID of any family member who has been registered through the Jan Aadhaar Card.

Step 2: Login into Claim Portal

• Go to the Citizen Apps (G2C), and search for MADBY / SIPF (State Insurance & Provident Fund).
• Choose ‘Submit New Claim / नया दावा करें'.

Step 3: Start the Claim Process

• Click on Submit New Claim
• Select the details of the injured family member auto-filled through your linked Jan Aadhar Card.
• Select Type of Accident (Road/Train/Air accident, Falling from height, Electric shock, Drowning, Fire, Chemical exposure, etc.)

Step 4: Upload Required Documents

Upload the necessary documentation as per the claim:

For Accidental Death Case:

• Death Certificate
• FIR / Marg Report / Panchnama
• Post Mortem Report / Hospital Death Certificate

For Permanent Total Disability:

• Certificate of Permanent Total Disability as issued by an authorized Medical Board
• Hospital discharge report/diagnosis reports
• FIR / Police Report (if any)

Step 5: Review & Submit

• Verify all details, linked bank account numbers (linked via Jan Aadhar), and uploaded documents.
• Submit the claim via e-Sign / OTP authentication using the registered mobile number.
• Save the generated Claim Application Reference Number for future tracking.

How to Submit an Accident Claim Online

In case of any accident which leads to death or disability, a claim needs to be lodged on the official SIPF CMS Portal within 60 days from the date of occurrence of the accident:

• Access the portal with SSO ID or Jan Aadhaar credentials of the claimant.
• Complete the online claim form submission form available on the SIPF accident portal.
• Submit all mandatory documents (FIR, post-mortem certificate, disability certificate, etc.).
• The claim amount is directly released into the bank account of the head of the family registered with Jan Aadhaar after departmental approval.

Helpline and Support

Other Government Health Insurance Schemes

State Government Schemes

• Mukhyamantri Ayushman Arogya Yojana (MAAY): A health insurance program which offers cashless coverage and provides secondary and tertiary care facilities to patients.
• Rajasthan Government Health Scheme: Astate health insurance scheme that provides medical cover to state government employees, pensioners, and their dependents.
• Mukhyamantri Nishulk Dawa Yojana: Scheme of Rajasthan wherein essential medicines, surgical instruments, and sutures are provided.

Central Government Health Schemes

• Pradhan Mantri Suraksha Bima Yojana: Ahealth insurance plan that offers coverage up to ₹2 lakh for accidental death or permanent disability.
• Ayushman Bharat Scheme PM-JAY: Central health insurance scheme providing cover of up to ₹5 lakh per family per annum.
• Central Government Health Schemes (CGHS): Central Scheme providing cover to government employees and pensioners.
• Employees' State Insurance Scheme (ESIC): This scheme provides cover for the health, maternity and disability of workers.