GAISGUJ1

Group Accident Insurance Scheme under PMMSY: Accidental death or Permanent Total Disability Gujarat

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

State Cash

States / UT: Gujarat

Nodal department: Agriculture, Farmers Welfare and Cooperation Department

Scheme for: Individual

Scheme profile

DBT (direct benefit transfer): No

Categories: Agriculture,Rural & Environment, Banking,Financial Services and Insurance

Sub-categories: Insurance

Target beneficiaries: Individual

Tags: Accident, Death, Disability, Fishermen

Details

The scheme "Group Accident Insurance Scheme under PMMSY" with a component "Accidental death or Permanent Total Disability" is introduced by the Agriculture, Farmers Welfare and Co-operation Department, Government of Gujarat. Insurance of Fishers is one of the sub-components of the PMMSY, and it provides insurance coverage to fishers, which includes fishermen, fish workers, fish farmers, and other individuals directly involved in fishing and related activities. The sub scheme offers coverage for death, permanent total disability (PTD). The National Fisheries Development Board (NFDB) and M/s Oriental Insurance Company Limited (OICL) implement the scheme. The premium cost is shared between the Central and State Governments, with no contribution from the beneficiary. The implementing agency of the scheme is the Commissioner of Fisheries.

Objective of scheme:

To financially assist the fisherman/fisherman's family in case of death/injury.

Benefits

Sr. No. Name of Component Standard of assistance Minimum Time Limit (in Years) for Reclaiming Benefits 1. Accidental death or Permanent Total Disability₹5,00,000/-Once to the legal heir after death 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). 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

*Sr. No.Name of ComponentStandard of assistance*Minimum Time Limit (in Years) for Reclaiming Benefits1. Accidental death or Permanent Total Disability₹5,00,000/-Once to the legal heir after death

Mode of Disbursement:

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

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.

Eligibility

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.
The applicant must be between 18 and 70 years old.
The insured person should not have been 71 years of age on the date of the accident.
The applicant must be approved by the State/Union Territory (UT) fisheries department.
At the time of a claim, the claimant or insured fisher must be verified and certified by an "Appropriate Authority".
The applicant should have registered himself in the concerned district office.

Exclusions

The scheme does not cover claims for death, injury, or disablement resulting from:

Suicide or attempted suicide.
Self-inflicted injury.
Pregnancy, childbirth, or related consequences.
Pre-existing physical or mental defects or infections.
Influence of intoxicating liquor or drugs.
Venereal diseases or insanity.
Engaging in aviation or ballooning, except as a passenger on a licensed aircraft.
Committing a breach of law with criminal intent.
Ionizing radiation or radioactive contamination from nuclear fuel or waste.
Nuclear weapons material.
Service in the armed forces.
Murder by an immediate beneficiary or nominee.
War, invasion, civil war, rebellion, or other hostilities.
Natural death.
Funeral or ambulance charges (except for accidental hospitalisation claims).
Weekly compensation or child education funds.

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".

Note: All claim documents must be submitted within 180 days of the accident.

Clarifications

Additional points from the scheme information published on myScheme (not legal advice).

What is the scheme is about?: The Group Accident Insurance Scheme (GAIS) is a component of the Pradhan Mantri Matsya Sampada Yojana (PMMSY) that provides insurance coverage to fishers, fish workers, fish farmers, and others involved in fishing-related activities
What does the Accidental Death or Permanent Total Disability (PTD) benefit cover?: The scheme provides a benefit of ₹5,00,000/- for accidental death or permanent total disability.
What is considered a "Permanent Total Disability" under this scheme?: Permanent Total Disability is defined as an injury that, within 12 months of the accident, is the sole and direct cause of the insured person being permanently, totally, and absolutely disabled from engaging in any occupation or employment.
Who is eligible for this benefit?: Eligible individuals are men and women fishers between the ages of 18 and 70, as approved by the State/UT fisheries department. The insured person must not have completed 71 years of age on the date of the accident.
What is the policy's duration?: The insurance cover is valid for a period of 12 months.
How is the premium paid for the insurance?: The entire premium amount is paid by the Central and State Governments, with no contribution from the beneficiary.
How do I report a claim for accidental death or permanent total disability?: The claim must be intimated to M/s Oriental Insurance Company Limited (OICL) within 90 days from the date of the accident.
What documents are required to file a claim?: Common documents include the Intimation Form, Claim Form, a cancelled cheque or bank passbook copy, Certification by an Appropriate Authority, and a government-issued ID. Additional documents, such as the First Information Report (FIR) and Post Mortem Report, are required for specific accidents.
Where do I submit the claim documents?: All hard copies of the insurance claim documents should be sent to the Insurance Cell at the National Fisheries Development Board (NFDB) after being uploaded to the PMMSY-GAIS MIS Portal.
How long does it take for a claim to be settled?: The insurance company will settle a claim within 15 working days of receiving all complete documentation.
What happens if the insurance company delays the claim payment?: If an admissible claim is not settled within 15 days, the insurance company will pay a simple interest of 10% on the claim amount from the date of document submission until the date of payment.
Will the claim be paid to the family or the insured person?: The payment is made directly to the claimant, nominee, or legal heir's savings account via Direct Bank Transfer (DBT).
Are there any exclusions to the accidental death or PTD coverage?: Yes, the policy does not cover death or disability resulting from suicide, self-inflicted injury, pre-existing conditions, drug or alcohol use, criminal acts, or war. Natural death is also not covered.
What is the role of the State/UT Fisheries Department in the claims process?: The State/UT department is responsible for identifying and verifying the fishers to be insured, forwarding claim intimations, and ensuring all claim documents are verified and submitted on time.

Official links

References

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Accident Death Disability Fishermen

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Documents Required for Government Schemes

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Aadhaar Card
Income Certificate
Caste Certificate (if applicable)
Residence Proof
Bank Account Details
Educational Certificates (for student schemes)

How to Apply for Government Schemes?

The application process for government schemes may be online or offline depending on the scheme. In most cases, you can follow these steps:

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Collect required documents
Fill the application form
Submit the application online or at the relevant office
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