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1 A PRESENTATION By ORIENTAL INSURANCE. PRADHANMANTRI SURAKASHA BIMA YOJNA  As a measure towards financial inclusion of the poor in the national mainstream,

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Presentation on theme: "1 A PRESENTATION By ORIENTAL INSURANCE. PRADHANMANTRI SURAKASHA BIMA YOJNA  As a measure towards financial inclusion of the poor in the national mainstream,"— Presentation transcript:


2 PRADHANMANTRI SURAKASHA BIMA YOJNA  As a measure towards financial inclusion of the poor in the national mainstream, the government launched the “ Pradhan Mantri Jan Dhan Yojna” (PMJDY) on 24 th August, 2014  One of the benefits under the scheme is providing Personal Accident Insurance Coverage of Rs.2 lacs to Account Holders.

3  The Oriental Insurance Company Ltd." earlier known as "The Oriental Fire & General Insurance Co. Ltd" was incorporated at Bombay on 12th September, 1947.Has a vast network of 1900 offices  The Premium Income from Indian Operations has reached the level of Rs.7127 crores with a Global Premium of Rs.7282 Crores in the year 2013-14.  Recorded a PBT of Rs.660.73 Crores and PAT of Rs.460.29 Crores in 2013-14.  Having PAN India Bancassurance tie up with Two Major Banks namely Punjab National Bank and Oriental Bank of Commerce.  Procured a Premium of Rs.182 Crs. from Punjab National Bank and Rs.62 Crs. from Oriental Bank of Commerce with a total Bancassurance Premium of Rs.256 Crs. P R O F I L E

4  1 st Public Sector General Insurer to implement Core Insurance Solution.  Our system has E-mail & SMS integration for real time updates of various transactions for all Stake Holders.  Facility to renew policies Online.  Online Grievance Redressal Mechanism in line with IGMS (Integrated Grievance Management System) of IRDA.  Customer can also register Grievances on OICL Portal.  Call Centre support for prompt and efficient Customer Service. TECHNOLOGICAL ADVANTAGE

5 PROPOSED GROUP PERSONAL ACCIDENT POLICY Table of benefitsSum Insured DeathRs.2 lacs Total and irrecoverable loss of both Eyes or loss of use of both Hands or Feet or loss of sight of One Eye & loss of use of Hand or FootRs.2 lacs Total and irrecoverable loss of Sight of One Eye or loss of use of one Hand or FootRs.1 lac This insurance will pay to the insured (or in case of death, to the Nominee) the amount shown against the table of benefits, if the insured sustains any bodily injury resulting from Accident caused by External, Violent and Visible means, Snake Bite, Drowning and Unprovoked Murder or such bodily injury within twelve months of its occurrence.

6 MODALITIES OF ENROLMENT / UNDERWRITING  Initially an Group Personal Accident Policy for a period of one year shall be issued. The policy will be for all existing Bank Account Holders under this initiative for a sum insured of Rs.2 lacs for which a premium of Rs.12 + applicable service tax per Bank Account Holder will be payable to the Insurance Company by the Bank.  The cover will incept for all such Account Holders from the date of payment of Premium to the Insurer.  Bank will provide KYC details of all Account Holders, name of the Nominee and Bank Account details in Excel file at inception for issuance of Group Policy.  In case of Joint Account, two separate polices to be issued for Account Holders for which individual Premium of Rs.12+ service tax will be payable for each Account.

7  Similar Excel file will also be provided by the bank for monthly additions in the Group Policy. All new Account Holders during the month will be covered w.e.f. 1 st of the succeeding month on receipt of premium for all such new Account Holders.  Bank necessarily has to provide Nominee details to facilitate payment of Claims.  In absence of Nominee details, claim amount to be transferred to the Beneficiary Account Holder.  A bi-lingual pamphlet giving details of Broad Coverage, Exclusions, Dos and Don’ts, premium, Claims Procedure, Details of the Nodal Office of the Insurer will be supplied to the bank to be given to the Account Holder at the time of opening of account. MODALITIES OF ENROLMENT / UNDERWRITING

8 DOCUMENTS REQUIRED FOR SIMPLIFIED PROCESSING OF CLAIMS Death Certificate Copy of FIR/Final report wherever applicable Post Mortem Report / Panchnama wherever applicable Account Holder information certified by Bank Disability Report from Civil Surgeon, wherever applicable.

9 MODALITIES FOR ADMINISTRATION OF CLAIMS OPTION 1 : Claims to be handled through Banks. All original documents (FIR, Death Certificate and Post Mortem Report) to be collected and retained by the Bank Branches. Insurance Company will send the Claim Settlement amount to the concerned Bank Branches by ECS.

10 MODALITIES FOR ADMINISTRATION OF CLAIMS OPTION 2: Intimation and Claim Documents can be given to Bank. Claim to be processed by the Nodal Office of the Insurer. Payment to be made to the Beneficiary / Nominee on Monthly basis by way of ECS / NEFT to the Account-holder.

11 FORMAT – SIMPLIFIED CLAIM FORM Claim No._____________________ Bank Branch Name & Code__________ Policy No.__________________________________ N _1. Name in Full__________________________________ Address______________________________________ ______________________________________ Contact Number_______________________________ 2 2. Name of the Bank with address_____________________ ______________________________________________ Saving Account No._______________________________ 3.3. 3. A) When did the accident / death occur? State Day, Date and Hour B) B) Where did it occur? C) Give full particulars of the cause of death / injuries sustained. B) 4. Give name and address of the attending Doctors 5. State where and when a Medical or other Officer of the Company can visit you, if necessary. 6. Have you previously claimed or received compensation under an Accident Policy? If so, give Particulars. 7. A) Are you insured elsewhere? B) If so, give the name of each Company or Insurer. A) B) 8. A) In case of Death, Original FIR / Post Mortem Report/ Death Certificate to be attached. B) In case of Disability, Disability Certificate from Civil Surgeon to be attached. This form is issued without admission of liability and must be completed and returned within 7 days after its receipt. I HEREBY DECLARE and warrant the truth of the foregoing particulars in every respect, and I agree that if I have made, or if shall make false or untrue statement, suppression or concealment, my right to compensation shall be absolutely forfeited. Dated _______________________ Signature_______________________________________ (Claimant)

12 LIST OF MEMBERS ENROLLED UNDER PRADHAN MANTRI SURAKSHA BIMA YOJNA Forming Part of Master Policy No.______________________________ Nomine e Sl.N o. Name of the Member Aadhar No. wherever availableAge Contact Number Saving Bank Account No. Na me Relatio nship

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14 FORMAT – CERTIFICATE OF INSURANCE (To be issued to the Members covered under Pradhan Mantri Suraksha Bima Yojana by the Partner Insurance Company ) Name of the Master Policy Holder: ___________________________________Bank Master Policy No. : _____________________________________________________ Name of the Insured: Shri / Smt.__________________________________________ ( Name in Full) Date of Birth (As per Aadhar): __________________ Company ID______________ Saving Bank Account No. : ______________________________________________ Aadhar No. : __________________________________________________________ Date of Entry into the Scheme:___________________________________________ Premium Rs.12/- (Rupees Twelve only) per annum Frequency of Premium: Yearly Nominee : __________________________Relationship_______________________ This is to certify that the above member is covered under the scheme of insurance effected under the above master policy. Insurance benefits are available to the member subject to the conditions specified in the policy documents. Signature of the Issuing Official Date: _____________________ Note : 1) This certificate is primarily issued to create awareness about insurance affected in the life of the member. It does not confer any legal rights on the nominee/or any other person to claim the benefits under the policy. The benefits will be payable only to the authorised person specified in the policy and subject to the fulfillment of the conditions specified therein. 2) For informing about lodging of claims under the Scheme, please contact the bank.

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