How to claim Insurance Benefits under PMJJBY & PMSBY?

PMJJBY is a Life Insurance coverage plan (like a Term plan). This plan covers both natural and accidental death risks. The maximum sum assured offered under this Govt Scheme is Rs 2 Lakh. The premium is Rs. 330 per year, or less than one rupee per day, for the age group 18-50.

PMSBY is a Personal Accident Insurance Scheme. Under this scheme, if the insured dies due to an accident, the nominee of the insured will get Rs 2 Lakh as death benefit. If there is any total disability due to accident, the insured will get Rs 2 Lakh, and for partial disability, the risk cover is limited to Rs 1 Lakh.

In this post let us understand – How to claim insurance benefits under Pradhan Mantri Jeevan Jyoti Bima Yojana (PMJJBY)? How to claim insurance benefits under Pradhan Mantri Suraksha Bima Yojana (PMSBY)? What are the required documents to claim insurance under PMJJBY & PMSBY?

PMJJBY – Insurance Claim settlement Procedure

Under PMJJBY insurance scheme, the Death claim benefit of Rs. 2,00,000/- will be settled by the concerned Insurance Company. Below is the claim settlement process under PMJJBY ;

Steps to be taken by the Nominee:

1)The nominee has to approach the Bank wherein the Member (Life insured / Policyholder) was having the ‘Savings Bank Account’ through which he / she was covered under PMJJBY, along with the death certificate of the member.

2)Nominee has to collect Claim Form and Discharge receipt, from the Bank or any other designated source like insurance company branches, hospitals, insurance agents etc.,

3)Nominee has to submit duly completed Claim Form, Discharge Receipt, death certificate along with photocopy of the cancelled cheque of the nominee’s bank account (if available) OR the bank account details to the Bank wherein the Member was having the ‘Savings Bank Account’ through which he / she was covered under PMJJBY. (In case the Nominee is a minor, the Guardian / Appointee may fill claim form and discharge receipt)

4)Upon receipt of death intimation, the Bank will check whether the cover for the said member was in-force on the date of his death. If the policy is in active status, Bank will verify the Claim Form & the nominee details from the records available with them. Bank will then submit – the completed claim form, death certificate, discharge receipt and cancelled cheque to the designated office of the concerned Insurance Company.

5)Maximum time limit for Bank to forward duly completed claim form to Insurance Company is thirty days from the submission of the claim to it.

6)Insurance company will then verify if the Claim form is complete in all respects and all the relevant documents have been attached. If the claim is admissible, the designated office of the insurer shall check whether the member’s coverage is in force and no death claim settlement has been effected for the Member through any other account. In case any claim has been settled, then the Nominee shall be intimated accordingly with a copy marked to the Bank.

7)In case the coverage was in force and no claim has been settled for the said member, payment shall be released to the Nominee’s bank account and a communication shall be sent to the nominee with copy marked to the Bank.

8)Maximum time limit for Insurance Company to approve claim and disburse money is thirty days from the receipt of the claim from the Bank.

9)In case where the claim form is directly submitted to any office of the insurer by the claimant, then the insurer’s office would forward the same to the concerned bank of the deceased account holder immediately to get necessary verification etc. done from the bank concerned. The concerned Bank Branch will forward the Claim Form to the designated office of the Insurance Company for processing the claim.

(Download…PM Jeevan Jyoti Bima Yojana Claim form & discharge receipt)

PMSBY – Insurance Claim Settlement Procedure

The insurance benefits under PMSBY are as below;

The above insurance benefits will be settled by the concerned Insurance Company. Below is the claim settlement process ;

1) Immediately after the occurrence of an accident which may give rise to a claim under the policy, the insured or the nominee (in case of death of the insured) shall contact the bank branch where the insured person held the underlying Bank Account from which the premium for the policy was auto debited and submit a duly completed claim form.

2) The claim form may be obtained from the above bank branch or any other designated source like insurance company branches, hospitals, insurance agents etc., including from designated websites.

3) The Claim form shall be completed by the insured or, as the case may be, by the nominee and submitted to the above bank branch preferably within 30 days of the occurrence of the accident giving rise to the claim under the policy.

4) The Claim form shall be supported, in case of death of the insured, by the Original FIR/ Panchnama, Post Mortem Report and Death Certificate and in case of permanent disablement, by Original FIR/ Panchnama and a Disability Certificate issued by a Civil Surgeon. A discharge certificate in the enclosed format shall also be submitted by the claimant / nominee.

5) The authorized official of the Bank shall check the account / auto-debit particulars and verify the account details, nomination, debiting of premium / remittance to insurer and certify the correctness of the information given in the claim form, and forward the case to the insurance company concerned within 30 days of the submission of the claim.

6) Insurer will verify and confirm that premium has been remitted for the insured and the insured is included in the list of insured persons in the master policy.

7) Claim shall be processed by the insurance Company which has issued the master policy for the Bank within 30 days of its receipt from the Bank.

8) The admissible Claim amount will be remitted to the Bank Account of the insured or the nominee, as the case may be.

9) In case of death of an insured who has not named his/ her nominee the admissible claim amount shall be paid to the legal heirs of the insured on production of Succession Certificate/ Legal Heir certificate from the Competent Court/ authority.

10) Maximum time limit for Bank to forward duly completed claim form to Insurance Company is thirty days and maximum time limit for Insurance Company to approve claim and disburse money thereafter is thirty days.

(Download.. PM Suraksha Bima Yojana Scheme Claim form)

If you have taken these insurance schemes or helped someone in enrolling for these schemes, inform your nominee (or explain to them) about the procedure to claim insurance benefits under PMJJBY & PMSBY.