All About Aam Aadmi Bima Yojana

The Aam Admi Bima Yojana is a social security scheme, launched on the 2nd of October, 2007 by the government of India. Its purpose is to provide financial aid along with social security to the country’s rural population, who otherwise have no access to healthcare and medicine.

The society’s poor and weaker sections rarely avail insurance coverage against deaths and disablements, despite the fact that they are more prone to natural/accidental deaths and disablements. Their families suffer huge financial crises when the sole breadwinner of the family faces such contingencies. It is for such a population, that the government has started the scheme.

The Aam Admi Bima Yojana was merged with the Janashree Bima Yojana later to provide a wider scope of coverage to the individuals.

Features of the Scheme

Here are some of the important features of the scheme:

• The scheme covers accidental death, natural death, permanent disability (due to an accident) and permanent total disability caused by an accident.
• It covers members who come in the 48 groups that have been identified to be covered by the scheme.
• The amount of coverage is fixed and it depends on the contingency suffered.
• The lump sum coverage amount is paid in case of a claim.
• Implementation of the scheme is done through a nodal agency. This agency can be a state government, a union territory, a department of central ministry, a registered NGO, or an institutionalized arrangement.
• One can buy the scheme through LIC or the Life Insurance Corporation of India, which is the only insurance company offering the scheme presently.

This scheme is very beneficial as it covers natural calamities such as floods and earthquakes, and has an easy enrolment process. It has coverage for women too, wherein it provides maternity benefits along with coverage for female-headed households.

Eligibility: Who is Covered Under the Scheme

The parameters which decide if you are covered under the scheme are as follows:

• Only one member of a family is covered. S/he should be either the earning member or the family head (as chosen by the family being covered).
• The age of the insured needs to be between 18 and 59 years.
• S/he should be from a BPL (below poverty line) family (with a maximum annual income of Rs. 1,00,000) or a family above the poverty line but belonging to the vocational group (identified under the scheme) or to the rural landless household.
• Members belonging to the identified 48 vocational groups can be covered.

Some of these groups can be named as beedi workers, fishermen, handloom and khadi weavers, cobblers, lady tailors, carpenters, leather and tannery workers, handicraft artisans, forest workers, textile, toddy tappers, slat growers, safai karamcharis, agriculturists, rural poor, anganwadi teachers, overseas Indian workers, sheep breeders, construction workers, plantation workers, coconut processors, etc.

One may note here, that the applicant should not be covered under any other social security schemes such as Employee’s State Insurance Scheme, National Pension Scheme, or any other government-run life insurance scheme.

The following are not covered under this scheme:

• Individuals employed in the organized sector (such as government employees) and those working in private companies with Provident Fund
• Income taxpayers
• Individuals who aren’t their families’ primary breadwinners

Coverage Under the Aam Aadmi Bima Yojana

The scheme covers the following instances:

• Accidental death
• Natural death
• Accidental permanent total disability
• Accidental permanent partial disability (loss of a limb or sight of one eye)

A free additional coverage benefit, called Scholarship Benefit, is also provided for up to two children of the insured. The children need to be studying in classes 9 to 12.

Here is the coverage amount for each benefit:

• Accidental death: Rs. 75,000
• Natural death: Rs. 30,000
• Accidental permanent total disability: Rs. 75,000
• Accidental permanent partial disability: Rs. 37,500
• Scholarship Benefit: Rs. 100/month/child

The scheme does not cover disability or death arising out of:

• Insanity or mental disorders
• Attempted suicide or self-inflicted injuries
• War or related perils
• Pregnancy or childbirth
• Participation in dangerous/adventurous sports
• Chemical, biological or radioactive weapons
• Criminal acts or acts that breach the law
• Medical expenses incurred due to an accident

Premium Under the Scheme

The premium is shared between the state and central governments in a 50:50 ratio. While the total premium is Rs. 200/person/annum, Rs. 100 of it is borne by the central govt., Rs. 30 by the state government, and the remaining Rs, 70 by the beneficiary (the insured individual). ECS or electronic clearance system or some other mode of payment is used to deduct the premium amount from the beneficiary’s bank account.  

Documents Required to Avail the Scheme

The eligible individuals need to submit the following documents to get the benefits of the scheme:

• Aadhar Card as proof of identity
• Age proof (such as birth certificate, school leaving certificate, passport)
• Address proof (such as electricity bill, driving license, passport)
• Bank account details (account number and IFSC code should be provided)
• An income certificate indicating the annual income of the applicant, issued by the competent authority
• Occupation proof, such as a work ID card

Making a Claim Under the Aam Aadmi Bima Yojana

The process through which one makes a claim under this scheme depends on the type of contingency. The claims are settled by the LIC through direct NEFT to the beneficiary’s bank account. In case NEFT isn’t available, approval is obtained from a competent authority and the amount is credited. The claim can also be paid through an account payee cheque or any mode chosen by LIC, once the approval has been obtained.

The different types of claims and their respective procedures are as follows:

Claim procedure for accidental or natural death

• Upon the death of the insured, the nominee needs to make a death claim on LIC
• A death claim form is to be filled and submitted along with the death certificate to the designated personnel of the nodal agency
• The agency’s designated officer will then check and verify the claim form, after which, the form is submitted with the death certificate and a certificate stating the insured’s eligibility

The documents needed for the death claim include a claim form, the original death certificate and an attested copy of that death certificate.

In case of accidental death, additional documents to be submitted include a copy of FIR (with the local police), post-mortem report, police inquest report and the final report of the police.

Claim procedure for disability

In case of disability, the documents required to be submitted include documentary proof of accident and a medical certificate issued by the government civil surgeon/qualified government orthopaedic. The certificate certifies whether it’s permanent total or partial disability.

Claim procedure for a scholarship benefit

• An application form is to be filled out and submitted to the nodal agency
• The agency identifies the students and submits the list of students to the Pension & Group Scheme unit of LIC. The list contains names of students, names of their schools, their classes, names of the insured members, NEFT details, policy number of the master policy and the membership numbers of the insured members.
• Finally, the scholarship amount is credited to the insured’s bank account. The payments are done on a half-yearly basis each year on the 1st of January and July.

Conclusion

By March 2015, 32.75 lakh lives had been covered under the Aam Admi Bima Yojana. Claims paid that year amounted to more than Rs. 14.43 lakhs and covered 42000 policies. Coming to the scholarship claims, they were paid to around 6.20 lakh children which amounted to over Rs. 41.81 crores.

The scheme has very low premiums. It is expected to improve the living standards of the rural population/unorganized sector of India by supporting them in times of unforeseen events. The scheme ultimately helps the country’s economy grow.