(Pradhan Mantri Fasal Bima Yojna(PMFBY) /Weather Based Crop Insurance Scheme(WBCIS)
Section2: Personal Accident Insurance
(Coverage as per Pradhan Mantri Suraksha Bima Yojana-PMSBY)
Details of Scheme:
The scheme will be a one year cover,renewable from year to year,Accident Insurance Scheme offering accident al death and disability cover for death or disability on account of an accident.There will be no change in the existing relationship structure of Bank-insurance company which was established for PMSBY andhereal so the premium will be submitted to the insurance company with which bank is already tied up.If the farmer has already availed this section in the form of PMSBY,he/she need not to choose this section again.However,he/she is required to provide the detail of the policy which will be captured in proposal cumdeclaration form under PMFBY.
Scope of coverage:
All farmers eligible for crop insurance under PMFBY/WBCIS in the age 18 to 70 years will be entitled to join. In case of multiple saving bank accounts held by an individual in one or different banks, the person would be eligible to join the scheme through one savings bank account only. Aadhar would be the primary KYC for the bank account.
Enrollment Modality / Period:
For new enrolments, the cover shall be provided for one year period starting from the date of enrolment or 1st June, whichever is later and the cover will end on next 31st May under PMFBY. New entrants into the eligible category from year to year or currently eligible individuals who did not join earlier shall be able to join in future years while the scheme is continuing.
Rs.12/- per annum per member. The premium will be deducted from the account holder‟s savings bank account through „auto debit‟ facility in one installment with in the cut off dates as mentioned under PMFBY.
Master Policy Holder:
As mentioned in PMSBY, Participating Bank will be the Master policy holder on behalf of the participating subscribers.
Termination of cover:
The accident cover for the member shall terminate on any of the following events and no benefit will be payable there under
Administration of PMSBY:
PMSBY, subject to the above, will be administered as per the standard procedure stipulated by the Insurance Company. The data flow process and data proforma will be provided separately.
It will be the responsibility of the participating bank to recover the appropriate annual premium from the account holders within the prescribed period through „auto-debit‟ process
Enrollment form / Auto-debit authorization in the prescribed proforma shall be obtained and retained by the participating bank. In case of claim, the Insurance Company may seek submission of the same. Insurance Company reserves the right to call for these documents at any point of time.
The experience of the scheme will be monitored on yearly basis for re-calibration etc., as may be necessary.
Appropriation of Premium:
Section 3: Building and Contents Insurance (Fire & Allied Perils)
The indemnity under this section is based on fixed sum Insured basis (maximum liability of the insurer will be sum insured or actual loss whichever is less)
The Company will indemnify the Insured in respect of loss of or damage to the Buildings/ Contents whilst contained in the insured premises by:
Enrollment of Farmers: The farmers shall provide the basic details of their home and dwellings in the proposal form. It shall include complete address of the house. The Sum insured has been capped at Rs.50,000 for building and Rs.20,000 for contents.
Claim process methodology:
The Company shall not be liable in respect of:
Section 4: Agriculture Pumpset Insurance (Upto 10 Horse Power)
The Insurance covers the Centrifugal pump sets (electrical and diesel) upto 10 Horsepower capacity which are used for agricultural purposes only.
Scope of Cover:
Enrollment of Farmers:
The farmers shall provide the electrical and mechanical specifications of the pump set in the proposal form. It shall include complete details of the pump set such as serial number, make, model and specifications. The Sum insured has been capped to Rs.25,000. Agriculture pump sets of age upto 7 year can be covered under this section.
Claim process methodology
The liability of the Company under this Section in respect of any item of property sustaining damage for which indemnity is provided, shall cease if the same item is kept in operation without being repaired to the satisfaction of the Company.
Note : Submersible Pumps will be added in the cover subsequently
Special Exclusion to Agricultural Pump set Insurance:
Section 5: Student Safety Insurance
Schedule of Benefits (for Parent/ Student): SI per student
If at any time during the currency of this policy the parent / guardian/ student named in the schedule shall sustain any bodily injury resulting solely and directly from accident caused by external violent and visible means and if such injury shall within six calendar months of the occurrence be the sole and direct cause of death or total and irrecoverable loss of two limbs or two eyes or 100% Permanent Total Disablement (permanently totally and absolutely disable the parent /guardian from engaging in any employment or occupation of any description whatsoever) then the company shall pay to the insured Student or parent / guardian as the case may be the capital sum insured stated in the schedule.
If at any time during the currency of this policy the insured Student shall sustain any bodily injury resulting solely and directly from accident caused by external violent and visible means and if such injury shall within six calendar months of the occurrence be the sole and direct cause of death or total and irrecoverable loss of two limbs or two eyes or 100% Permanent Total Disablement (permanently totally and absolutely disable the insured student from engaging in any employment or occupation of any description whatsoever) then the company shall pay to the parent / guardian or insured Student as the case may be the capital sum insured stated in the schedule of benefits.
If at any time during the currency of this policy the insured Student shall sustain any bodily injury resulting solely and directly from accident caused by external violent and visible means resulting into irrecoverable loss of one limb or one eye, then the company shall pay to the parent / guardian or insured Student as the case may be 50% of the capital sum insured stated in the schedule of benefits. However, if such injury shall within six calendar months of the occurrence be the sole and direct cause of death, remaining 50% of the capital sum insured shall be payable to the parents/guardian as the case may be.
In case of death of both student and the parent / guardian named in the schedule of the policy resulting solely and directly from same accident caused by outward, violent and visible means, within six calendar months of its occurrence then the company shall pay the legal heir of the parent / guardian sums stated in the schedule.
Subject to the terms, conditions & exclusions the Company undertakes that if during the period stated in the Policy any insured student sustains any bodily injury through accident, and takes treatment at any Nursing Home/Hospital in India as an inpatient, the Company will pay to the Insured Person such expenses as are reasonably and necessarily incurred subject to the limits prescribed but not exceeding the Sum Insured during the period of insurance stated against that person in the policy upon submission of supporting documents with bills.
Age Limit: Students: 5-25 years, parents: 18-70 years
Section 7: Agricultural Tractor Insurance
This section will be provided as per the provisions, terms, exceptions, conditions and endorsements of standard Motor Insurance Policy related to Agriculture tractor and trailers
Covers the insured against loss or damage to the Agriculture Tractor by fire, explosion, self-ignition or lightning, burglary, housebreaking, theft, riot and strike, earthquake, fire and shock, inundation, typhoon, hurricane, storm, tempest, cyclone, hailstorm, frost, landslide/rockslides by accidental external means, malicious act, terrorism activity while in transit by road, rail, inland waterway. Also provides coverage against death or permanent disablement of the driver, due to an accident while driving the Tractor insured during any one policy period
Subject to a deduction for depreciation at the rates mentioned below in respect of parts replaced:
Age wise Sum Insured and Premium: (the rates are subject to change as per IRDAI regulations and the below table is for illustration purpose only):
Please note that applicable service tax will be applied to above mentioned premium amounts
Legal Liability to Third Parties: - Compensates for death/ bodily injury to third parties in the event of tractor being involved in an accident as per M.V. Act, 1988.
Enrollment of farmers: A farmer can opt for comprehensive cover or Third Party cover only. In case of comprehensive cover, it is important to inspect the vehicle before insurance. Post receipt of satisfactory inspection report of tractor, an Own damage cover will be provided. Comprehensive cover for Agriculture tractors of age up to 10 year and power up to 45 HP can be provided while there will not be any age limit for third party cover.
For comprehensive cover, a farmer will submit his existing policy and registration certificate to avail the benefit of no claim bonus. However for Third Party cover, only Registration certificate is needed. Banks will take special care to submit previous insurance policy and/or registration certificate to insurance companies while submitting the proposal cum declaration form. In case of break in the existing policy under comprehensive cover, insurance company will arrange for a pre insurance inspection. The coverage can be provided only after satisfactory inspection report.
For tractor trailers, farmers have to declare the same in the proposal form and only Third party cover can be offered. It will have separate premium amount in addition to the premium paid for tractor. Only one trailer can be covered.
Separate Certificate of Insurance for this section only will be provided by insurance companies.
Claim process methodology:
General Conditions and Definitions for All Sections
Misdescription: This Policy shall be void and all premium paid hereon shall be forfeited to the Company in the event of misrepresentation, misdescription or non-disclosure of any material particular.
Reasonable Care: The Insured shall take all reasonable steps to safeguard the property insured against any loss or damage. The Insured shall exercise reasonable care that only competent employees are employed and shall take all reasonable precautions to prevent all accidents and shall comply with all statutory or other regulations.
Fraud: If any claim under this Policy shall in any respect be fraudulent or if any fraudulent means or devices are used by the Insured or any one acting on the Insured‟s behalf to obtain any benefit under this Policy, all benefits under the Policy shall be forfeited
Arbitration: : In case of a dispute, a committee mentioned in the succeeding para will decide on the issues under sections 2 to 7. The participating insurance company and officials of banks may form members of the committee. The decision of the committee will be binding to all.
Contribution: In the event of any loss damage liability or expenses covered by this Policy there shall be any other insurance covering the same loss damage liability or expenses, whether effected by the Insured or not this Policy shall pay only so much of the excess of such loss damage liability or expenses as is not recoverable under such other insurance subject always to the limitations of this Policy.
Indemnity: The Company may at its option reinstate/replace or repair the property or premises lost or damaged or any part thereof instead of paying the amount of the loss or damage or may join with any other insurer in so doing but the Company shall not be bound to reinstate exactly or completely but only as circumstances permit and in reasonably sufficient manner and in no case shall the Company be bound to expend more in reinstatement than it would have cost to reinstate such property as it was at the time of occurrence of such loss or damage and not more than the Sum Insured by the Company thereon.
Grievance Redressal Mechanism: To address any grievance/ complaint under the scheme, a committee consisting of District Agriculture Officer (Nodal Officer), representatives of implementing insurance company and bank/ financial institution shall be constituted. The working of the grievance committee will be monitored by District Level Monitoring Committee (DLMC) under the chairmanship of District Magistrate.
Observance of Terms and Conditions: : The due observance and fulfillment of the terms, conditions and endorsement of this Policy in so far as they relate to anything to be done or complied with by the Insured shall be a condition precedent to any liability of the Company to make any payment under this Policy.
General Exclusions: The Company shall not be liable in respect of:
1. Loss or damage, liability or expenses whether directly or indirectly, occasioned by happening through or arising from any consequences of war, invasion, act of foreign enemy, hostilities (whether war be declared or not) civil war, rebellion, revolution, insurrection, mutiny, military, or usurped power or civil commotion or loot or pillage in connection herewith.
2. Loss or damage caused by depreciation or wear and tear
3. Consequential loss of any kind or description.
4. a) Loss or damage directly or indirectly caused by or arising from or in consequence of or contributed to by nuclear weapons material.
The excess/deductible will be applicable as following:
Notices and Claims
Any notice, direction or instruction given under this Policy shall be in writing and delivered by hand, post, or facsimile to:
Universal Sompo General Insurance Co. Ltd
Express IT Park, Plot No. EL - 94, T.T.C. Industrial Area, M.I.D.C., Mahape, Navi Mumbai-400710
Toll Free Numbers: 1-800-224030 (For MTNL/BSNL Users) or 1-800-1024030 or 1-800-2004030
Landline Numbers: (022) 27639800 or (022) 41582900 or (022) 41582999 or (022) 39133700 (Local Charges Apply)
Fax Numbers: (022) 41582929 or (022) 41582939
Note: Please include Your Policy number for any communication with us.
In the unfortunate event of any eventuality resulting into a claim on this Policy, please intimate the mishap IMMEDIATELY to Our Call Centre at Toll Free Numbers on 1-800-22-4030 (for MTNL/BSNL users) or 1-800-102-4030 or 1-800-200-4030 (other users) or on chargeable numbers at +91-22-27639800/+91-22-41582900/+91-22-41582999/+91-22-39133700. Please note that no delay should be allowed to occur in notifying a claim on the Policy as the same may prejudice liability.
In case of any discrepancy, complaint or grievance, please feel free to contact us within 15 days of receipt of the Policy.
You may also contact the Branch from where You have bought the Policy or the Complaints Coordinator who can be reached at Our Registered Office
You may also contact on Our - Toll Free Numbers: 1 - 800 - 224030 (For MTNL/BSNL Users) or 1 - 800 – 2004030 or on chargeable numbers at +91-22-27639800/+91-22-39133700; and also send us fax at: (022) 39171419
If the issue still remains unresolved, You may, subject to vested jurisdiction, approach Insurance Ombudsman for the redressal of Your grievance.
The updated details are also available on: http://www.irdaindia.org/ins_ombusman.html
The details of Insurance Ombudsman are available below:
That rebate of premiums shall be allowed only in accordance with the details given in the prospectus or table of premium rates or, as the case may ne, the relevant document, and that an offer or acceptance of any other rebate shall be an offence under Section 41 of the Insurance Act, 1938”.