Process Claims In 7 Days For Govt Insurance Schemes: Minister To Insurance Firms

Previously, an insurer had 30 days’ time to process these claims. Also the FM has insisted that the entire claim settlement process between banks and insurance companies should be end-to-end digitised.

There are delays due to paper transmission and to enhance the enhancing the speed of sanctioning of claims under PMJJBY and PM Suraksha Bima Yojana (PMSBY), a virtual meeting had been chaired by the finance minister. She said that there should be a process for claim documents transmission via email and digital modes like mobile application.

An API-based mobile application for claim transmission has been asked to be implemented by public sector insurance companies by June 2021. Launched in May 2015, the PMJJBY and PMSBY are part of the Jan Suraksha Yojana scheme of the PM Modi-led government. While with an annual premium of Rs 330 for a cover of Rs 2 lakh, PMJJBY is a pure term insurance policy. PMSBY is an Rs 2 lakh cover accident insurance policy with annual premium of Rs 12.

For the claims, attending doctor’s certificate & certificate issued by DM/authorized officer is to be considered. Shortly, we can see simplified forms and claims process issued. A total of 4,65,000 claims of value Rs. 9,307 crore have been paid under the PMJJBY. At a disposal rate of 99 percent, 1,20,000 claims have been paid amounting to Rs. 2,403 crore, since April 1, 2020 onwards till date.

She added that the companies should especially during pandemic period, be sympathetic while providing services to nominees of deceased policy holders Referring to PMSBY, the minister said 82,660 claims for 1,629 crore have been paid since May 31, 2021. Registration under PMJJBY stands at 103 million subscribers and under PMSBY at 234 million subscribers. Saturday’s meeting would continue to simplify and speed up the process of applying for these programs.

“These pledges provide much-needed financial assistance to those nominees who have lost loved ones close to them, and government measures will improve the flexibility and speed of the process,” Sitharaman said.

Garib Kalyan health insurance

The progress made under the Pradhan Mantri Garib Kalyan Package (PMGKP) Insurance Scheme for Health Workers Fighting COVID-19 was also reviewed by the FM during the meeting.

As on date, a total of 419 claims amounting to Rs 209.5 crore have been paid and disbursed in the account of their nominees said the data. A new system shall be put in place whereby a simple certificate from the District Magistrate (DM) and endorsed by the nodal state health authority will be sufficient to process these claims, as previously there were delays arising out of states sending documents.

FM also cited the example of Ladakh where a claim was settled within four hours of receiving the DM certificate and has urged others to adopt the same approach in future. The finance minister also instructed the provinces to prioritize the applications of COVID-19 for health workers first and make the most of this simplified approach.

These application funds provide much-needed financial assistance to those nominees who have lost loved ones close to them, and government measures will improve the simplicity and speed of the process. Moneycontrol has previously reported that Finance Minister Nirmala Sitharaman has asked the Insurance Regulatory and Development Authority of India (IRDAI) to direct companies to prioritize COVID-19 applications.

Sitharaman also said there were reports that some hospitals were denying cashless insurance. Following this, IRDAI sent a circular to insurance companies asking them to expedite the payment of COVID-19 claims. Insurers are currently in the process of reviewing their performance standards with hospitals. Errant hospitals may be downsized even on a wireless network.

Source: Trak.in