Pradhan Mantri Suraksha Bima Yojana (PMSBY)

Why was Pradhan Mantri Suraksha Bima Yojana Introduced

Before PMSBY, most Indians, especially those in rural areas or with low incomes, could not afford to protect their families from the financial impact of accidental death or disability. Private accident insurance was available, but it was too expensive for many people.

The Government of India launched PMSBY on 9 May 2015, alongside the Pradhan Mantri Jeevan Jyoti Bima Yojana (PMJJBY, a life insurance scheme) and the Atal Pension Yojana (APY, a pension scheme), as part of a broader push to extend low-cost social security to the largely uninsured population. The scheme complements other Government initiatives by providing accident insurance, while schemes such as Ayushman Bharat PM-JAY, Mukhyamantri Jan Arogya Yojana (HIMCARE), and Rajiv Aarogyasri Health Scheme provide financial protection by covering hospitalisation and eligible medical treatments for beneficiaries.

Key Highlights

Who is Eligible for Pradhan Mantri Suraksha Bima Yojana

• Any Indian resident or non-resident Indian between 18 to 70 years of age can apply, provided they hold a savings bank account.
• The applicant must give consent for the annual premium to be auto-debited from their account; manual, one-time payments outside this system are not accepted.
• A person is generally intended to hold PMSBY cover under only one bank account at a time.

What Pradhan Mantri Suraksha Bima Yojana Covers:

PMSBY is designed specifically to provide financial protection against accidental death and specified permanent disabilities. The amount paid depends on the nature of the loss.

What PMSBY Excludes

• Death or disability from illness or disease, since PMSBY is accident insurance, not life or health insurance.
• Suicide or self-inflicted injury.
• Any accident that occurs while the policyholder is committing a crime or breaking the law.
• Accidents caused by intoxication from alcohol or drugs at the time of the incident.
• Disabilities that existed before enrolment.
• If your policy had lapsed, for example, the auto-debit failed one year because your account didn't have enough balance, and it was never renewed, then the claim gets rejected.

How to apply for PMSJBY

Option A: Apply Through Net Banking

1. Log in to your bank's net banking site or application and navigate to the insurance/social security schemes section.
2. Select "Pradhan Mantri Suraksha Bima Yojana (PMSBY)" from the list of schemes.
3. Your name, date of birth, and account number will be pre-filled. Enter your nominee's name, relationship, and date of birth.
4. Tick the consent declaration for the annual auto-debit of ₹20, and submit. You'll receive an SMS/email notification with your certificate number, which will be sent to you. You can save the certificate number for future reference or to claim it.

Option B: Apply Through a Bank Branch or Post Office

1. Visit your branch/post office and obtain the PMSBY enrolment form (this is also available for download on the jansuraksha.gov.in website or your bank's website).
2. Enter your personal information, account number, nominee details and sign the auto-debit mandate to authorise annual deductions of Rs 20.
3. Submit the form, along with your Aadhaar and proof of account to the bank official or business correspondent. Enrolment typically takes a few working days, and you will receive an acknowledgement.

Documents Required for Pradhan Mantri Suraksha Bima Yojana

• An existing savings bankor post office savings account (in your own name).
• Aadhaar card, linked to the account, for identity verification (mandatory at most banks).
• PAN card or other KYC document, if not already on file with your bank.
• Nominee details: full name, date of birth, relationship, and address.
• A signed auto-debit/ECS mandate authorising the annual premium deduction.
• Registered mobile number, for OTP verification and receiving your certificate.

Claim Process for PMSBY

If the insured person dies or becomes permanently disabled in an accident, the nominee (or the insured person, in the case of disability) can file a PMSBY claim. The steps are simple, though the documents vary by claim type.

Step 1: Inform the bank or post office. Report the accident as soon as possible. For death claims, the nominee or legal heir does this.

Step 2: Get the claim form. Collect the PMSBY Claim-Discharge Form from the bank, post office, or insurer, and fill it in with the insured's, nominee's, and accident details.

Step 3: Submit within 30 days. File the form with supporting documents as soon as you can.

Step 4: Attach the right documents.

For death claims:

• FIR/police report (if applicable)
• Post-mortem report (if applicable)
• Death certificate
• Claim-cum-Discharge Form
• Nominee's KYC and bank details

If the claimant isn't the registered nominee, proof of legal heirship is also required. For disability claims:

• Disability certificate (from a Civil Surgeon or appropriate authority)
• Hospital/medical records
• Discharge summary (if applicable)
• Claim-cum-Discharge Form
• Insured person's bank details

Step 5: Bank and insurer verify. The bank checks the account and enrolment, then forwards it. The insurer confirms the cover was active and the claim qualifies.

Step 6: Claim settled. Once approved, payment goes to the nominee/legal heir (death) or the insured person (disability), directly to the bank account.

How to check PMJBY Claim Status

• You can contact the bank branch where you filed the claim; the claims desk will be able to answer your questions about the status of your claim.
• Be sure to quote the claim reference or acknowledgement number given to you when you filed the claim.
• In addition, you can contact the insurer (LIC or the empanelled general insurer) directly, quoting the reference number.
• Claims must be processed within 30 days of receipt of all documents. As a result, after 30 days, you should inquire about the status of your claim.

What to Do If a Claim Is Rejected (grievance redressal process)

1. Request the reasons for the rejection in writing from the bank or the insurer.
2. Rectify the documents and resubmit the missing or incorrect documents, if any
3. File a complaint with your bank's Grievance Redressal Officer or Nodal Officer, quoting your claim number.
4. Escalate it to the insurer's grievance cell if it is not resolved.
5. Approach the Consumer Commission under the Consumer Protection Act as a last resort if your grievance is still not resolved.

PMSBY Helpline and Contact Details

PMSBY and Other Government Insurance Schemes

• Pradhan Mantri Jeevan Jyoti Bima Yojana (PMJJBY) – A central government life insurance scheme that provides a life cover of ₹2 lakh in case of the insured person's death due to any cause.
• Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) – India's flagship government health insurance scheme offering cashless hospitalisation cover of up to ₹5 lakh per family per year for eligible economically vulnerable households.
• Ayushman Vay Vandana Card (AB PM-JAY for Senior Citizens) – Provides cashless health insurance coverage of up to ₹5 lakh per year for all eligible senior citizens aged 70 years and above, irrespective of their income.
• Employees' State Insurance (ESI) Scheme – A social security and health insurance scheme that provides medical care, sickness benefits, maternity benefits, disability compensation, and dependent benefits to eligible workers in the organised sector.