The times are unprecedented and uncertain than we ever thought. The hospitals are overwhelmed and people are losing their dear ones. As it is hard to see your loved one succumbing to the ubiquitous virus, it adds up to the miseries to those who have lost their sole earning member of the family. At this point in time, it is important to realise the importance of health insurance in such unpredictable times. Here we discuss the government health insurance claim under Pradhan Mantri Jeevan Jyoti Bima Yojana.
What is Pradhan Mantri Jeevan Jyoti Bima Yojana(PMJJBY)?
Launched on May 9, 2015, Pradhan Mantri Jeevan Jyoti Bima Yojana (PMJJBY) offers Rs 2 lakh term insurance cover to bank account holders in the age group of 18 to 50 years. If your dear one whom you have lost happened to buy this policy in the financial year 2020–21, the nominee/heir may apply for the claim.
PMJJBY will be an Insurance Scheme offering life insurance cover for death due to any reason. The second wave of COVID-19 across India has wreaked havoc and the number of deaths increases, experts have advised people to go in for the Pradhan Mantri Jeevan Jyoti Bima Yojana (PMJJBY), a one-year life insurance scheme, renewable each year.
The scheme would be offered/administered through LIC and other Life Insurance companies willing to offer the product on similar terms with necessary approvals and tie-ups with Banks for this purpose. Participating banks will be free to engage any such life insurance company for implementing the scheme for their subscribers.
What is the scope of coverage?
All individual account holders of participating banks in the age group of 18 to 50 years will be entitled to join. In case of multiple bank accounts held by an individual in one or different banks, the person would be eligible to join the scheme through one bank account only. Aadhar would be the primary KYC for the bank account.
The cover shall be for the one year period stretching from 1st June to 31st May for which option to join/pay by auto-debit from the designated individual bank account on the prescribed forms will be required to be given by 31st May of every year. Delayed enrollment with payment of full annual premium for prospective cover is possible.
For subscribers enrolling for the first time on or after 1st June, the insurance cover shall not be available for death (other than due to accident) occurring during the first 45 days from the date of enrolment into the scheme (lien period) and in case of death (other than due to accident) during lien period, no claim would be admissible. However, deaths due to accidents will be exempt from the lien clause and paid for.
Benefits and premium
In future years, new entrants into the eligible category or currently eligible individuals who did not join earlier or discontinued their subscription shall be able to join while the scheme is continuing subject to the 45 days lien period described above.
Rs.2 lakh is payable on a member’s death due to any cause. A Premium of Rs.330/- per annum per member to be paid. The premium will be deducted from the account holder’s bank account through the ‘auto debit’ facility in one instalment, as per the option given, on or before 31 st May of each annual coverage period under the scheme. Delayed enrolment for prospective cover after 31st May will be possible with full payment of the annual premium. The premium would be reviewed based on annual claims experience. However, barring unforeseen adverse outcomes of extreme nature, efforts would be made to ensure that there is no upward revision of premium in the first three years.
Individual bank account holders of the participating banks aged between 18 years (completed) and 50 years (age nearer birthday) who give their consent to join/enable auto-debit, as per the above modality, will be enrolled into the scheme.
Can you buy the policy now?
One can buy the policy any time during the year. The premium will be paid on a pro-rata basis. This feature was allowed w.e.f. the policy year 2018–19. Thus, if the enrolment takes place during the months of,
June, July & August — Annual premium of Rs 330 is payable
September, October and November — 3 quarters of premium at Rs 86; i.e. Rs. 258 is payable
December, January and February — 2 quarters of premium at Rs, 86 i.e. Rs 172 is payable
March, April and May — 1 quarterly premium at Rs 86 is payable
The full year’s premium at Rs 330 would be payable at the time of renewal under the scheme.
As many as 10.27 crore people are enrolled in PMJJBY as of March 31, 2021. The government data says 2,50,351 claims were received in FY21, of which 2,34,905 claims were disbursed.
“This is a very useful life insurance scheme in the current circumstances. There is surely a lack of awareness of the product. Regulators like the Reserve Bank of India and the Insurance Regulatory and Development Authority of India should ensure that such products are given more preference,” said Suresh Parthasarathy, financial planner and founder of myassetsallocation.com, according to the Hindu report.
Consumer activist T. Sadagopan advised the banks to create more awareness. Banks should send out reminders for renewal premium payment and open help desks for processing claims. The proof required for the settlement of claims are death certificates and bank statements with the premium debit proof, the Hindu report reads.