Group Accident Insurance Scheme under PMMSY: Medical Treatment - Gujarat
State: Gujarat
Ministry: null
Department: Agriculture, Farmers Welfare and Cooperation Department
Category: Agriculture,Rural & Environment, Banking,Financial Services and Insurance
Beneficiary Type: Individual

The scheme aims to provide financial assistance to fishermen/fishermen's families in case of death or injury. Through this scheme, insurance coverage for Medical Treatment is provided to eligible fishers.

Benefits:
**Sr. No.****Name of Component****Standard of assistance**1. Medical Treatment₹25,000/-<br>

> **Mode of Disbursement:**

- The claim amount is deposited directly into the claimant&#39;s, nominee&#39;s, or legal heir&#39;s savings account via Direct Bank Transfer (DBT).

<br>

> **Expected Time of Disbursement:**

- The insurance company will settle the claim within 15 working days of receiving the complete claim documentation. If a claim is not settled within this period, the insurance company will pay a simple interest of 10% on the admissible claim amount from the date of document submission until the payment date.

<br>

<br>

<br>

<br>

<br>

Eligibility:
1. The applicant must be a fisher, which includes fishermen, fish workers, fish farmers, and any other person directly involved in fishing or fisheries-related activities.
1. The applicant must be between 18 and 70 years old.
1. The insured person should not have been 71 years of age on the date of the accident.
1. The applicant must be approved by the State/Union Territory (UT) fisheries department.
1. At the time of a claim, the claimant or insured fisher must be verified and certified by an &quot;Appropriate Authority&quot;.
1. The applicant should have registered himself in the concerned district office.

<br>

Application Process:
[Offline]
Fishers or their legal heirs must submit the required documents to the concerned district office for assistance.
The claim details must be intimated within 90 days of the accident via one of the following recognised communication methods:
Letter to the Insurance Company/NFDB Insurance Cell/Intermediary.
Email to support@pmmsygais.com.
Through the IT & ITES platforms provided by the intermediary.
Via the NFDB Toll-Free Number (1800-425-1660).
To the "Appropriate Authorities".

Documents Required:
Documents (duly filled in all respects) common to all claims:Intimation Form
Claim Form
Cancelled Cheque of claimant/insured/nominee/legal heir/s (or) copy of first page Bank Pass Book of claimant/insured/nominee/legal heir/s (or) copy of bank account statement of claimant/insured/nominee/legal heir/s duly attested by a gazetted officer along with self attestation
Certification by the Appropriate Authority
Any one of the IDs as mentioned, in the list of acceptable documents as proof of identity and proof of address from the general public in the country, by the Government of India. Any one of the acceptable IDs as proof of identity and address issued by the Government of India
With respect to the requirement/s of claim documents or certificates, the law of the land in correlation to the customs and traditions of the geography shall prevail over the documents specified in this agreement.
Other documents required for specific kinds of accidents:Road/Railway Accident: First Information Report (FIR) or Railway Protection Force (RPF) report, Spot Panchnama, Inquest Panchnama, Post Mortem Report, Valid Driving License (if the insured was driving), and Death Certificate.
Drowning: First Information Report (FIR)/Police Report, Post Mortem Report, Spot Panchnama, Inquest Panchnama, Death Certificate, and statements from two witnesses.
Missing at Sea: A declaration by the family and a certificate from an Appropriate Authority.
Fire: First Information Report (FIR)/Police Report, Post Mortem Report, and Death Certificate. If the body is completely charred, a declaration by a family member and a certificate from an Appropriate Authority are required.
Poisonous Substances: First Information Report (FIR)/Police Report, Post Mortem Report, Viscera Report, Forensic Lab Report, and Death Certificate.
Lightning/Electric Shock: First Information Report (FIR)/Police Report, Post Mortem Report, Inquest Panchnama, Spot Panchnama, and Death Certificate.
Machinery: First Information Report (FIR)/Police Report, Post Mortem Report, Spot Panchnama, Inquest Panchnama, and Death Certificate.
Murder: First Information Report (FIR), Spot Panchnama, Inquest Panchnama, Post Mortem Report, Death Certificate, and Final Police Report (if necessary).
Falling from Heights/Naxalite Murder/Riots: First Information Report (FIR)/Police Report, Spot Panchnama, Inquest Panchnama, Post Mortem Report, and Death Certificate.
Animal-related Injury (e.g., snake bite, rabies): A certificate from a registered medical practitioner confirming the cause of death/disablement. If available, also include First Information Report (FIR)/Police Report, Inquest Panchnama, Post Mortem Report/Forensic Lab Report, Viscera Report (if not concluded from the Post Mortem Report), and Death Certificate.
Additional Documents for Specific ClaimsAccidental Hospitalisation: Original consolidated hospital bill with a breakup of each item, original payment receipt, corresponding prescriptions, treating doctor's certificate, copy of MLC, and original detailed discharge summary.
Note: Certified or true copies of the First Information Report (FIR) and Post Mortem Report are required, not the originals.