YSR Bima is a group personal accident insurance scheme. The scheme provides financial assistance to the families of Below Poverty Line (BPL) families in case of the death or disability of the primary breadwinner.
A person who is the primary source of income for a Below Poverty Line (BPL) family in the state of Andhra Pradesh, India. These individuals are identified by their Aadhaar card and rice card numbers, and their data is captured by the GVWV&VSWS authority.
Age: 18 years to 70 years
Accident
A sudden, unforeseen, and involuntary event caused by external, visible, and violent means (wholly unexpected, not intended, or designed)
Accidental Death
Death caused solely and independently of any other cause by bodily injury.
This means that the death must be caused directly by the bodily injury, and there cannot be any other contributing factors. For example, if someone is in a car accident and dies from blood loss, the death would be considered to be a death resulting from bodily injury. However, if someone is in a car accident and sustains a minor injury, but then dies from a heart attack a few days later, the death would not be considered to be a death resulting from bodily injury.
Bodily Injury
Accidental physical bodily injury caused solely and directly by external, violent
Visible Cause
Accidental physical bodily Injury solely and directly caused by external, violent visible cause
Bima Benefits
| Loss | Percentage of Capital Sum Insured |
|---|---|
| Accidental death | 100% |
| Total and irrecoverable loss of sight of both eyes, or of both hands, or of both feet, or of one hand and one foot, or of sight of one eye and loss of use of one hand or one foot | 100% |
| Permanent, Total and Absolute Disablement of the Insured from engaging in any employment or occupation of any description whatsoever | 100% |
| Total and irrecoverable loss of sight of one eye, or of one hand, or of one foot | 50% |
| Total and irrecoverable loss of use of one hand or one foot without physical separation | 50% |
| Loss of hearing in both ears | 50% |
| Loss of speech | 50% |
Funeral Expense Cover
The funeral expense cover is a reimbursement benefit that is paid to the Commissioner of Labour or the implementing agency of the government to cover the cost of the insured person’s funeral expenses, up to a maximum of Rs. 10,000/-.
In order to claim the funeral expense cover, the nominee must provide an undertaking stating that they have received Rs. 10,000/- cash from the government for last rites expenses. This amount will be deducted from the total claim amount that is paid to the nominee.
Eligibility
- A person must be identified as a primary bread earner of a rice card holder by the designated department of the Government of Andhra Pradesh.
- The person must have a registered Aadhaar number and rice card number with the SERP Authority of Andhra Pradesh State during the tenure of the policy.
Exclusions
- Suicide or attempt of suicide
- Self-inflicted injury
- Pregnancy or childbirth
- Pre-existing physical or mental defects, infections
- Bleeding from inner organs
- Aviation, other than as a passenger
- Organized Motor Racing
- War, including Civil War
- Natural Death
- Terrorism; except attack by Naxalites
- Under any influence of alcohol or Drugs
- Arising out of any breach of law or misfeasance
- Service in armed forces
- Nuclear radiation or nuclear weapons materials
- Murder by immediate beneficiary
TYPES OF ACCIDENTS /INCIDENTS
- Road accidents
- Railway accidents
- Drowning accidents
- Fire accidents
- Accidents due to handling of poisonous substances or electrical shock
- Accidents while working with labor machinery
- Murder
- Accidents or deaths due to falling from heights
- Snake bites, scorpion bites, animal bites, or any other animal injury resulting in death or loss of limb(s)
- Murder by Naxalites
- Riots
- Any other accidents
Documents Required for Insurance Claim in Case of Accidental Death
- First Information Report (FIR)
- Spot Panchnama
- Inquest Panchnama
- Post-Mortem Report, confirming the exact cause of death
- Valid Driving License for deceased person (if applicable)
Documents common to all claims for Group Personal Accident Insurance in Andhra Pradesh
- Duly filled Oriental Insurance company GIC Claim form signed by claimant
- Proof of Age: Aadhaar Card or any other document as specified in the notification u/s-7 of the Aadhar Act.
- Copy of the Rice Card.
- Death Certificate issued by Municipal Department (or) Disability Certificate issued by Civil Assistant Surgeon.
- Copy of Bank Passbook (or) Cancelled Cheque for Bank Account Details of the Nominee / beneficiary.
Documents required for death claim
- First Information Report (FIR)
- Spot Panchnama
- Inquest Panchnama
- Post-Mortem Report, confirming the exact cause of death.
- Viscera Report (if viscera preserved)
- Final Police Report (wherever necessary)
- Hospital Treatment Papers
- Medico-Legal Certificate (where the insured is hospitalized or treated in any hospital)
Additional documents required for permanent total disability claim:
- Medical Practitioner’s Certificate or Dispensary Notes and Certificate showing reasons for becoming handicapped or non-functioning of organ OR
- Certificate of Primary Health Centre/Sub District Health Official, with the counter signature of District Civil Surgeon.
- Recent Photo of insured confirming the physical disability.
