What is the Pradhan Mantri Suraksha Bima Yojana (PMSBY Scheme)?

Knowing about government insurance programmes benefits those interested in ensuring financial coverage for themselves and their families. One such scheme is the Pradhan Mantri Suraksha Bima Yojana, commonly known by its acronym PMSBY. 

With this government-backed scheme, people can get financial coverage for accidental death or permanent damage. If you are planning to invest in such schemes, here is everything you need to know about PMSBY.

According to reports, around 2.5% of India’s total GDP is allocated to health. This inevitably makes it challenging for people belonging to the economically weaker section to access proper treatment.

PMSBY is a social security scheme announced in India’s 2015 budget. Considering that a significant portion of the Indian population does not own proper insurance, this scheme provides monetary assistance to the policyholder’s family members.

Wondering how much you can obtain under this scheme?

Well, with a nominal premium amount of Rs. 20 per annum, you can get substantial coverage up to Rs. 2 lakhs for accidental demise and permanent disability. Check out the features and advantages it includes to know how the scheme can be beneficial for you.

Even though this scheme focuses on helping out the majority of people belonging to the economically-weaker section, it also has a specific set of restrictions related to the cause of death. 

For instance, in case the insured person commits suicide, the beneficiary will not be eligible for a claim. However, beneficiaries of insured individuals falling victim to murder are eligible to claim financial benefits from this scheme.

Death or disability caused due to natural calamities, such as floods, earthquakes, and more are also covered under this scheme.

As mentioned earlier, this scheme provides financial coverage if  the sole earning member of a family dies in an accidental death or becomes permanently disabled. To make use of these impeccable benefits the Government-backed scheme offers, you should know the PMSBY eligibility criteria and if you can meet them.

Here it goes:

• There are certain instructions regarding the PMSBY age limit. People falling under the age group of 18-70 years will be eligible for this particular scheme. 
• Generally, all individual bank account holders (both joint and single account) can apply for this scheme. However, those who are having multiple bank accounts in multiple banks can only apply through one account. 
• In case of joint account holders, both the account holders will be benefited from this scheme’s features. 
• People residing outside India can also apply for this scheme; however, during the claim process, a nominee will receive the funds in Indian currency only.

Every policyholder is supposed to pay Rs.20 per annum, where the amount gets auto-debited from the linked bank account. The Government has allotted this nominal amount for encouraging more people to opt for this scheme.

Detailed documentation and form fill-up process for PMSBY

Even though most government-backed schemes follow a lenient documentation procedure, you must complete basic paperwork to apply for benefits under this initiative. The following are some of the necessary documents - 

• Please complete the PMSBY application form and provide all the necessary details, such as name, Aadhaar number, and contact details, including detailed information about the selected nominee. 
• Even though you are already submitting your UID details with the application form, you need to provide a copy if your card details need to be linked to your bank account.

You can register for this policy using SMS and internet banking facilities. Here is how you can apply using the first one: 

• Step 1: You can simply text the onboarding organisation’s toll-free number to activate the facility. 
• Step 2: You will receive the activation SMS; reply to that text with ‘PMSBY Y’. 
• Step 3: You might receive another message acknowledging the receipt, which is how the registration is completed. 

Apart from the PMSBY enrolment process through SMS, you can also use the Internet banking facility to complete the same within a few seconds. All you have to do is:

• Step 1: Log in to the net banking account of your chosen financial institution and click on the insurance option.
• Step 2: Choose the account you want to use to pay for the premium of PMSBY.
• Step 3: Check all the details before confirming and download the confirmation receipt afterwards. 

Apart from this easy registration process, the claim settlement process is equally simple and subscriber-friendly.

If such unfortunate incidents occur, a beneficiary can follow the below-mentioned procedure to raise a claim against the PMSBY scheme. 

• Step 1: Start by reaching out to the insurer from where this policy has been purchased.
• Step 2: Generally, the insurance company will ask you to fill out the claim form to provide details like name, details of the hospital, contact information, etc. The form is also available on the Jansuraksha website; you can simply download and fill it up.
• Step 3: Check the list of supportive documents you need to submit along with the form. In most cases, it is either the death certificate or disability certificate insurers seek. 
• Step 4: After confirming the details, the insurance company will transfer the claim amount to the linked bank account and settle the claim.

Know about:

• Cashless Claim in Health Insurance
• Reimbursement Claim in Health Insurance

The steps below show the process by which you can view the beneficiary list under the PMSBY scheme:

• Step 1: Visit the PM Suraksha Bima Yojana's official website.
• Step 2: Click the Beneficiary List link once the home page loads.
• Step 3: You must choose your state when a new page opens. After that, you must decide on your district.
• Step 4: Choose your block at the end. You will see the beneficiary list on your screen.

The PMSBY scheme is subject to termination due to various reasons. The PMSBY scheme is automatically terminated due to the following reasons:

• The policy's account will be closed following the beneficiary's 70th birthday. 
• The account will also be closed if there are insufficient funds in the bank or post office account to cover the annual premium. 
• The insurance coverage will be limited to one account, and the money may be forfeited if the beneficiary enrols in this scheme from multiple accounts and pays the yearly premium. 
• The insurance coverage ends if the required premium amount is not paid by the deadline.

Empanelled hospitals have agreements with insurance providers to offer cashless treatment under PMSBY. To find a hospital under the Pradhan Mantri Suraksha Bima Yojana (PMSBY), follow these steps:

• Step 1: Contact Your Insurance Provider: Contact the insurance company or the bank where you have the PMSBY policy. They can provide a list of empanelled hospitals.
• Step 2: Visit the PMSBY Website: Check the official PMSBY or insurance company website. They often have a list of network hospitals or a hospital locator tool.
• Step 3: Call Customer Support: Contact the customer support of your insurance company or your bank. They can guide you to the nearest empanelled hospitals.
• Step 4: Check with Local Health Services: Visit local health departments or community health centres; they might have information on PMSBY network hospitals.

Know about: Digit's Cashless Network Hospitals

Under the Pradhan Mantri Suraksha Bima Yojana (PMSBY), the hospitalisation process involves verifying that the hospital is empanelled with your insurance provider. You should inform the insurance desk about your PMSBY coverage during the hospitalisation. The hospital will then initiate the cashless treatment, verifying your policy details with the insurer. 

Ensure all necessary documents, such as ID proof and policy details, are provided. For planned admissions, pre-authorisation may be required, while in emergencies, treatment can commence immediately, followed by post-facto documentation. After treatment, the hospital will coordinate directly with the insurer for settlement.

The PMSBY scheme has many terms and conditions that the beneficiary must follow if they have the scheme. The following points are such terms:

• This scheme's length has been set at one year. 
• It is refundable annually. 
• This plan provides insurance in the event of an accident or physical impairment. 
• Public-sector general insurance companies will initially offer this program. The participating banks may hire such a firm to implement it for their clients. 
• Beneficiaries of this scheme can be anyone between the ages of 18 and 70. 
• One savings account can be used to benefit from this initiative for those who have had a savings account for more than a year. 
• A single savings account can be used to benefit from this policy by individuals who have multiple savings accounts.
• Only when the annual subscription has been paid can beneficiaries of this scheme take advantage of its benefits. 
• If the beneficiary cannot continue the scheme after paying the premium, they may reapply for it.

If you need any help or you have any queries related to the scheme, then you can call the given toll-free number:

Helpline number: The PMSBY customer care number is 1800-180-1111/1800-110-001. It is a nationwide toll-free number.

Despite being one of the fastest-growing economies in the world, India is still struggling to ensure quality healthcare for all. Most of the key components associated with the health sector, such as proper nutrition, safe water, basic sanitation, etc., are often ignored. 

The arrival of Government-affiliated insurance schemes like the Pradhan Mantri Suraksha Bima Yojana scheme has helped people to handle such situations after a significant loss.