Insurance
Contact for any Query To Yogesh Kumar IRS Officer 2013 Batch at : yogeshg4@gmail.com

AAM ADMI BIMA YOJANA, a Social Security Scheme for rural landless household was launched on 2nd October, 2007 at the hands of the then Hon'ble Finance Minister at Shimla. The head of the family or one earning member in the family of such a household is covered under the scheme. The premium of Rs.200/- per person per annum is shared equally by the Central Government and the State Government. The member to be covered should be aged between 18 and 59 years.
Benefits
On natural death Rs. 30000/-
On Death due to accident/on permanent total disability
due to accident (loss of 2 eyes or 2 limbs)
Rs. 75000/-
On partial permanent disability due to accident (loss of one eye or one limb) Rs. 37500/-
A separate fund called "Aam Admi Bima Yojana Premium Fund" has been set up by Central Govt. to pay the Govt. contribution. Fund is maintained by LIC. A free add-on benefit in the form of scholarship to children is also available under the Scheme.
Janashree Bima Yojana (JBY) was launched on 10th August 2000. The Scheme has replaced Social Security Group Insurance Scheme (SSGIS) and Rural Group Life Insurance Scheme (RGLIS). 45 occupational groups have been covered under this scheme
No. Occupation No. Occupation
1 Beedi workers 24 Hilly area woman
2 Brick kiln workers 25 Food stuffs like khandsari/Sugar
3 Carpenters 26 Textile
4 Cobblers 27 Manufacture of food products
5 Fishermen 28 Manufacture of paper products
6 Hamals 29 Manufacture of leather products
7 Handicraft Artisans 30 Printing
8 Handloom Weavers 31 Rubber and coal products
9 Handloom & khadi weavers 32 Chemical products like candle manufacture
10 Lady tailors 33 Mineral products like earthern toys manufacture
11 Leather Tannery workers 34 Agriculturists
12 Papad workers attached to SEWA 35 Transport drivers association
13 Physically handicapped self employed persons 36 Transport karmacharis
14 Primary milk producers 37 Rural poor
15 Rickshaw pullers/Auto Drivers 38 Construction workers
16 Safai karmacharis 39 Fire crackers workers
17 Salt growers 40 Coconut processors
18 Tenduleaf collectors 41 Aanganwadi Workers/Helpers
19 Scheme for urban poor 42 Kotwal
20 Forest workers 43 Plantation workers
21 Sericulture 44 Woman associated with SHG
22 Toddy tappers 45 Sheep breeders
23 Power loom workers
It provides life insurance protection to people who are below poverty line or marginally above poverty line. Persons between aged 18 years and 59 years and who are the members of the identified 45 occupational groups are eligible to be covered under the Scheme
Benefits
On natural death Rs. 30000/-
On Death/Total permanent disability due to accident Rs. 75000/-
On partial permanent disability due to accident Rs. 37500/-
The premium for the scheme is Rs. 200/- per member, 50 % premium under the scheme is met out of Social Security Fund set up in the year 1988-89 which is maintained by LIC. The balance 50% premium is borne by the member and/ or Nodal Agency.
The scheme was launched on 31st December, 2001. Scholarship as a free add-on benefit is provided under both Janashree Bima Yojana and Aam Admi Bima Yojana to maximum of two children of the beneficiary studying between 9th to 12th standard (including ITI courses) @ Rs. 100 per month for each child payable half yearly on 1st July and 1st January, every year. The benefit is without any additional premium.

For meeting the expenditure on Scholarship benefit under Aam Admi Bima Yojana a separate Fund has been set up by Govt. of India called "Aam Admi Bima Yojana Scholarship Fund. Fund is maintained by LIC of India. For Jana Shree Bima Yojana scholarship expenditure is paid out of Social Security Fund.

Apart from above two schemes, the earlier old Social Security Schemes namely Social Security Group Scheme, Integrated Rural Development Programme (IRDP), Swarnjayanti Gram Swarojar Yojana(SGSY) for the existing lives continued to be administered by LIC. These schemes are closed for the new lives from the year 2000 onwards.
"Jeevan Madhur" a simple savings related life insurance plan for low income persons was launched in 2006. On surviving to the date of maturity, sum assured is paid alongwith vested bonus if any. On death of the policy holder, death benefit amount equal to the total premiums payable during the entire term of the policy will be paid alongwith vested bonus if any. "Jeevan Mangal", LIC's second Micro Insurance product, was launched in 2009. It is a term insurance plan with return of premiums paid on maturity, provided the policy is in force. On death during the term of the policy, the sum assured under the basic plan is payable, provided the policy is in force.
VPBY meant for senior citizens aged 55 years and above was launched on 14.7.2003. Under the scheme the pensioner gets an effective yield of 9% per annum on the investment. The difference between the effective yield of 9% paid to the pensioner and that earned by LIC is compensated as subsidy to LIC by the Government of India.
The four public sector general insurance companies have been implementing Universal Health Insurance Scheme for improving the access of health care to poor families. The scheme provides for reimbursement of medical expenses upto Rs.30,000/- towards hospitalization floated amongst the entire family, death cover due to an accident @ Rs.25,000/- to the earning head of the family and compensation due to loss of earning of the earning member @ Rs.50/- per day upto maximum of 15 days. The Universal Health Insurance Scheme (UHIS) has been redesigned targeting only the BPL families. The premium subsidy has been enhanced from Rs.100 to Rs.200 for an individual, Rs.300 for a family of five and Rs.400 for a family of seven, without any reduction in benefits.
The Government of India introduced the scheme from Rabi 1999-2000 season to protect the farmers against losses suffered by them due to crop failure on account of natural calamities. The scheme is currently implemented by Agriculture Insurance Company of India (AICIL). The scheme is available to all the farmers, loanee and non-loanee, irrespective of size of their holding. The scheme covers all food crops (cereals, millets and pulses) and oil seeds and Annual commercial/ horticultural crops. At present, 10% subsidy on premium is available to small & marginal farmers. NAIS is presently being implemented in 24 States and 2 Union Territories except in States of Punjab & Arunachal Pradesh. Nagaland has given consent to implement the scheme and Rajasthan has decided to implement WBCIS in place of NAIS. Since the inception of the scheme and until up to 31.03.11 about 176 million farmers have been insured, covering an area of 269 million hectares for a sum insured value of Rs. 2,21,213 crore, against a premium of Rs. 6589 crore. Claims to the tune of about Rs. 22190 crore have been reported so far benefiting nearly 47.6 million farmers representing a claim ratio of 1:3.37.


Claims are automatically calculated based on shortfall in the current season yield obtained from crop cutting experiments conducted by State Governments under General Crops Estimation Survey (GCES) as compared to threshold yield and settled through the rural banking network. The Company is making efforts to bring the remaining States/ UTs into the fold of NAIS.
Pilot MNAIS was launched for implementation in 50 districts during Rabi 2010-11 season. Modified NAIS has many improvements over NAIS like the insurance unit for major crops has been lowered down to village / village Panchayat, minimum indemnity level has been raised to 70%, threshold yield is based on past seven years' yield excluding a maximum of two calamity years, pre-sowing and post-harvest loss are covered. Besides these, On-account payment of claims during the season and payment of claims for sowing failure have also been included. The benefit of individual assessment of claims due to localized calamities i.e. hailstorm and landslide has been extended to all the notified areas.

The minimum number of CCEs required to be conducted at village / village Panchayat level, for all crops except groundnut, has been reduced to four.

AIC implemented MNAIS during Rabi 2010-11 in 32 Districts across 12 States. More than 3.45 lac farmers were covered for a sum insured of Rs. 69193 lac. The gross premium was Rs. 45.20 crore, of which premium collected from farmers was Rs. 2293 lac. Claims of Rs. 22.45 lac due to localized calamity i.e. hailstorm have been paid to 3842 farmers in Uttar Pradesh while losses reported in Andhra Pradesh are being assessed and would be paid soon. The final claims due to yield loss, shall be paid after receipt of yield data from the State Governments.

Assam, Gujarat, Jharkhand, Karnataka, Madhya Pradesh, Maharashtra, Uttar Pradesh and Mizoram States have so far issued Notification for implementation of MNAIS during Kharif 2011 for 20 districts.

Other States expected to notify the pilot MNAIS during Kharif 2011 season are Andhra Pradesh (3 districts), Bihar (3 districts), Tamilnadu (3 districts), Uttarakhand (2 districts) and Haryana (1 district).
Orissa (5 districts) & Chhatisgarh (1 district) who piloted during Rabi 2010-11 have decided not to implement the pilot during Kharif 2011, mainly due to increased load of CCEs at Village Panchayat level.
Weather Based Crop Insurance Scheme (WBCIS) aims to mitigate the hardship of the insured farmers against the likelihood of loss on account of anticipated crop loss resulting from incidence of adverse conditions of weather parameters like rainfall, temperature, frost, humidity etc.

While crop insurance specifically indemnifies the cultivator against shortfall in crop yield, WBCIS is built upon the fact that weather conditions affect crop production even when a cultivator has taken all the care to ensure good harvest. Historical correlation studies of crop yield with weather parameters helps in developing weather thresholds (triggers) beyond which crop starts getting affected adversely. Payout structures are developed to compensate cultivators to the extent of losses deemed to have been suffered by them using the weather triggers. In other words, WBCIS uses weather parameters as 'proxy' for crop yield in compensating the cultivators for deemed crop losses. Pursuant to the budget proposals, AICIL introduced a Pilot Weather Based Crop Insurance Scheme (WBCIS) in Karnataka during Kharif 2007 season covering 70 Hoblis in respect of eight rain-fed crops.

AICIL implemented the pilot scheme on Weather Based Crop Insurance Scheme (WBCIS) during 2007-08 in 5 States spread over 190 Tehsils / blocks of 30 districts and covered about 6.71 lakh farmers growing in about 10.35 lakh hectares of crops.

During the 2008-09 year, the scheme was implemented in 14 states, over six lakh farmers' crops grown on over 10 lakh hectares were insured for a sum insured of Rs. 1757 crore.

During the 2009-10 year, the Scheme was implemented in 14 States spread over 672 Tehsils / blocks of 103 districts for the major crops during Kharif and 665 Tehsils / Blocks of 98 districts during Rabi crop season and covered more than 20 lakh farmers, grown crops on approx. 27 lakh hectares for a sum insured of Rs. 3965 crore.

During the year 2010-11, the Scheme was implemented in 17 States namely Andhra Pradesh, Bihar, Chhattisgarh, Gujarat, Haryana, Himachal Pradesh, Jharkhand, Karnataka, Kerala, Orissa, Madhya Pradesh, Maharashtra, Rajasthan, Tamil Nadu, Uttrakhand, Uttar Pradesh and West Bengal spread over 1010 Tehsils / blocks of 118 districts for the major crops during Kharif and 911 Tehsils / Blocks of 115 districts during Rabi crop season and covered more than 67 lakh farmers, grown crops on over 95 lakh hectares for a sum insured of Rs. 9636 crore.

The premium generated by AIC during 2010-11 was Rs. 882 crore and the claim ratio stands at 53%. AIC is implementing WBCIS for over 35 crops, including perennial horticultural crops like Apple, Mango, Grapes, Cashew Nut, Pepper etc.
  1. Atal Pension Yojana

    WHAT IT OFFERS: Pension between Rs 1,000 and Rs 5,000 a month.

    WHAT IT COSTS: For a monthly pension of Rs 1,000, a 40-year-old subscriber will have to invest Rs 291 per month for 20 years, while an 18-year-old will have to contribute Rs 42 per month for 40 years.

    WHO IS ELIGIBLE: All individuals between 18 and 40, who will have to contribute till they turn 60.

    WHO SHOULD OPT FOR IT: This is an investment you need to make on behalf of your domestic staff who may not have anyone to look after them once they stop working.



    2) Pradhan Mantri Suraksha Bima Yojana

    WHAT IT OFFERS: Accidental death and disability cover of Rs 2 lakh.

    WHAT IT COSTS: Premium is Rs 12 per year.

    WHO IS ELIGIBLE: Anybody who has a savings account in the banks that offer this scheme.

    WHO SHOULD OPT FOR IT: Although it is for everybody, this scheme especially suits drivers, security guards, newspaper vendors, vegetable vendors and others who are exposed to the risk of accidental death or disability.



    3) Pradhan Mantri Jeevan Jyoti Bima Yojana

    WHAT IT OFFERS: A pure protection term insurance cover which pays Rs 2 lakh to dependents in the event of the policyholder's death.

    WHAT IT COSTS: Premium is Rs 330 a year.

    WHO IS ELIGIBLE: Anybody in the age band of 18-70 years who has a savings account in a bank that offers this scheme.

    WHO SHOULD OPT FOR IT: This is a must for any member of your staff who is the sole breadwinner in his or her family.



    4) Pradhan Mantri Jan Dhan Yojana

    WHAT IT OFFERS: A savings account with no minimum balance. The Rupay ATM-cum-debit card comes with in-built accident and life covers of Rs 1 lakh and Rs 30,000 respectively.

    WHAT IT COSTS: Nil

    WHO IS ELIGIBLE: Anyone belonging to the economically weaker sections of society. As all future welfare and subsidy schemes are likely to be linked to it, it is a must for your staff.

    WHO SHOULD OPT FOR IT: All those working in the unorganised sector. You can transfer salaries directly into the accounts of your domestic staff to inculcate a banking habit in them.



    5) Post office time deposits and bank FDs

    WHAT IT OFFERS: Time deposits with tenures of one to four years yield 8.4%, while five-year deposits will earn 8.5%. Bank fixed deposits in the name of your employees' senior citizen parents will earn 9-9.25%.

    WHAT IT COSTS: The minimum investment for post office time deposits is Rs 200 and there is no cap.

    WHO IS ELIGIBLE: Anyone with a bank account or Aadhar card.

    WHO SHOULD OPT FOR IT: These investments will help meshorter term requirements of your staff and other unorganised workers like housing loan down payment, coaching class fees and so on.

    6) Kisan Vikas Patra

    WHAT IT OFFERS: A secure interest rate of 8.7% and the promise to double the investment in 100 months.

    WHAT IT COSTS: The minimum investment is Rs 1,000. No maximum limit.

    WHO IS ELIGIBLE: All

    WHO SHOULD OPT FOR IT: All domestic workers, vendors and neighbourhood workers to fund their medium term requirements.



    7) Sukanya Samriddhi Scheme

    WHAT IT OFFERS: Guaranteed annual returns of 9.2%.

    WHAT IT COSTS: Minimum contribution is Rs 1,000 a year and the maximum is Rs 1.5 lakh.

    WHO IS ELIGIBLE: Girl child below the age of 10.

    WHO SHOULD OPT FOR IT: Most domestic workers tend to take their daughters out of school to help with household chores or to make way for their brothers, whose education is considered more important. This serves as an incentive to save for a daughter's education and marriage.



    8) Health insurance

    WHAT IT OFFERS: Cover for expenses incurred during hospitalisation due to illness or surgery.

    WHAT IT COSTS: Rs 700-800 a year for a cover of Rs 50,000 for indivuduals aged between 18 and 40 years.

    WHO IS ELIGIBLE: All

    WHO SHOULD OPT FOR IT: Hospitalisation can wipe out the entire savings of those already at a financial disadvantage. Though not offered by the government, affordable policies are available from state-owned non-life insurers like New India Assurance and Oriental Insurance.

    The ET has further calculated how much these might cost.


    HOW IT STACKS UP

    Pradhan Mantri Jan Dhan Yojan = NIL + Pradhan Mantri Jeevan Jyoti Bima Yojana = Rs 330 + Pradhan Mantri Suraksha Bima Yojana = Rs 12 + Atal Pension Yojana = Rs 3,492* + Health Insurance = Rs 800* + Sukanya Samriddhi Scheme = Rs 1,000# + Kisan Vikas Patra = Rs 1,000# + Post Office Time Deposits = Rs 200#

    All this adds up to = Rs 6,834 (The total amount you need to spend on staff welfare measures in a year)

    *Assuming your employee is 40 years old and monthly pension chosen is Rs 1,000 in case of APY. #If minimum requirement is invested

National Health Insurance Schemes

RSBY ( Rashtriya Swasthiya Bima Yojana)  has been launched by Ministry of Labour and Employment, Government of India to provide health insurance coverage for Below Poverty Line (BPL) families. The objective of RSBY is to provide protection to BPL households from financial liabilities arising out of health shocks that involve hospitalization. Beneficiaries under RSBY are entitled to hospitalization coverage up to Rs. 30,000/- for most of the diseases that require hospitalization. Government has even fixed the package rates for the hospitals for a large number of interventions. Pre-existing conditions are covered from day one and there is no age limit. Coverage extends to five members of the family which includes the head of household, spouse and up to three dependents. Beneficiaries need to pay only Rs. 30/- as registration fee while Central and State Government pays the premium to the insurer selected by the State Government on the basis of a competitive bidding.
Unique Features of RSBY
The RSBY scheme is not the first attempt to provide health insurance to low income workers by the Government in India. The RSBY scheme, however, differs from these schemes in several important ways.
  • Empowering the beneficiary– RSBY provides the participating BPL household with freedom of choice between public and private hospitals and makes him a potential client worth attracting on account of the significant revenues that hospitals stand to earn through the scheme.
  • Business Model for all Stakeholders– The scheme has been designed as a business model for a social sector scheme with incentives built for each stakeholder. This business model design is conducive both in terms of expansion of the scheme as well as for its long run sustainability
  • Insurers– The insurer is paid premium for each household enrolled for RSBY. Therefore, the insurer has the motivation to enroll as many households as possible from the BPL list. This will result in better coverage of targeted beneficiaries.
  • Hospitals– A hospital has the incentive to provide treatment to large number of beneficiaries as it is paid per beneficiary treated. Even public hospitals have the incentive to treat beneficiaries under RSBY as the money from the insurer will flow directly to the concerned public hospital which they can use for their own purposes. Insurers, in contrast, will monitor participating hospitals in order to prevent unnecessary procedures or fraud resulting in excessive claims.
  • Intermediaries– The inclusion of intermediaries such as NGOs and MFIs which have a greater stake in assisting BPL households. The intermediaries will be paid for the services they render in reaching out to the beneficiaries.
  • Government– By paying only a maximum sum up to Rs. 750/- per family per year, the Government is able to provide access to quality health care to the below poverty line population. It will also lead to a healthy competition between public and private providers which in turn will improve the functioning of the public health care provider
  • Information Technology (IT) Intensive – For the first time IT applications are being used for social sector scheme on such a large scale. Every beneficiary family is issued a biometric enabled smart card containing their fingerprints and photographs. All the hospitals empanelled under RSBY are IT enabled and connected to the server at the district level. This will ensure a smooth data flow regarding service utilization periodically.
  • Safe and foolproof– The use of biometric enabled smart card and a key management system makes this scheme safe and foolproof. The key management system of RSBY ensures that the card reaches the correct beneficiary and there remains accountability in terms of issuance of the smart card and its usage. The biometric enabled smart card ensures that only the real beneficiary can use the smart card.
  • Portability– The key feature of RSBY is that a beneficiary who has been enrolled in a particular district will be able to use his/ her smart card in any RSBY empanelled hospital across India. This makes the scheme truly unique and beneficial to the poor families that migrate from one place to the other. Cards can also be split for migrant workers to carry a share of the coverage with them separately.
  • Cash less and Paperless transactions– A beneficiary of RSBY gets cashless benefit in any of the empanelled hospitals. He/ she only needs to carry his/ her smart card and provide verification through his/ her finger print. For participating providers it is a paperless scheme as they do not need to send all the papers related to treatment to the insurer. They send online claims to the insurer and get paid electronically.
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Employees’ State Insurance Scheme of India, is a multidimensional social security system tailored to provide socio-economic protection to worker population and their dependants covered under the scheme. Besides full medical care for self and dependants, that is admissible from day one of insurable employment, the insured persons are also entitled to a variety of cash benefits in times of physical distress due to sickness, temporary or permanent disablement etc. resulting in loss of earning capacity, the confinement in respect of insured women, dependants of insured persons who die in industrial accidents or because of employment injury or occupational hazard are entitled to a monthly pension called the dependants benefit.
Coverage
Applicability
  • The Act is applicable to non-seasonal factories employing 10 or more persons.
  • The Scheme has been extended to shops, hotels, restaurants, cinemas including preview theatres, road-motor transport undertakings and newspaper establishments employing 20* or more persons.
  • The Scheme has been extended to Private Medical and Educational institutions employing 20 or more persons in certain States/UTs.
*Note: 14 State Govts. / UTs have reduced the threshold limit for coverage of shops and ther establishments from 20 to 10 or more persons. Remaining State Governments/UTs are in the process of reducing the same. The existing wage limit for coverage under the Act is Rs. 15,000/- per month ( w.e.f. 01/05/2010)
Areas covered
The ESI Scheme is being implemented area-wise by stages. The Scheme has already been implemented in different areas in the following States/Union Territories of Indian Union.
States :- All the States except Manipur, Sikkim, Arunachal Pradesh and Mizoram.
Union territories :- Delhi and Chandigarh
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The “Central Government Health Scheme” (CGHS) provides comprehensive health care facilities for the Central Govt. employees and pensioners and their dependents residing in CGHS covered cities. Started in New Delhi in 1954, Central Govt. Health Scheme is now  in operation in Allahabad, Ahemdabad ,Bangalore ,Bhubhaneshwar ,Bhopal ,Chandigarh , Chennai ,Delhi , Dehradun ,Guwahati ,Hyderabad, Jaipur , Jabalpur , Kanpur , Kolkatta , Lucknow , Meerut , Mumbai , Nagpur , Patna , Pune , Ranchi , Shillong , Trivandrum and Jammu. The Central Govt. Health Scheme provides  comprehensive healthcare to the CGHS Beneficiaries in India.  The medical facilities are provided through Wellness Centres (previously  referred to as  CGHS Dispensaries) /polyclinics under  Allopathic, AyurvedaYoga,UnaniSidha and Homeopathic systems of medicines.
The main components of the Scheme are:
  • The dispensary services including domiciliary care
  • F. W. & M.C.H. Services
  • Specialists consultation facilities both at dispensary, polyclinic and hospital
  • level including X-Ray, ECG and Laboratory Examinations.
  • Hospitalization
  • Organization for the purchase, storage, distribution and supply of medicines and other requirements
  • Health Education to beneficiaries
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Aam admi bima yojana, a Social Security Scheme for rural landless household was launched on 2nd October, 2007. The head of the family or one earning member in the family of such a household is covered under the scheme. The premium of Rs.200/- per person per annum is shared equally by the Central Government and the State Government. The member to be covered should be aged between 18 and 59 years. On natural death Rs 30,000 On death due to accident / on permanent disability due to accident ( loss of 2 eyes or 2 limbs ) Rs 75,000 On partial permanent disability due to accident( loss of one eye or one limb ) Rs 37,500 Benefits A separate fund called "Aam Admi Bima Yojana Premium Fund" has been set up by Central Govt. to pay the Govt. contribution. Fund is maintained by LIC. A free add-on benefit in the form of scholarship to children is also available under the Scheme. Read more...
Janashree Bima Yojana (JBY) was launched on 10th August 2000. The Scheme replaced Social Security Group Insurance Scheme (SSGIS) and Rural Group Life Insurance Scheme (RGLIS). 45 occupational groups have been covered under this scheme
It provides life insurance protection to people who are below poverty line or marginally above poverty line. Persons between aged 18 years and 59 years and who are the members of the identified 45 occupational groups are eligible to be covered under the Scheme
Note: Aam Admi Bima Yojana and Janashree Bima Yojana have been merged into one scheme. It is renamed as “Aam Admi Bima Yojana” , effective from 01.01.2013.
Reference: www.licindia.in
The four public sector general insurance companies have been implementing Universal Health Insurance Scheme for improving the access of health care to poor families. The scheme provides for reimbursement of medical expenses upto Rs.30,000/- towards hospitalization floated amongst the entire family, death cover due to an accident @ Rs.25,000/- to the earning head of the family and compensation due to loss of earning of the earning member @ Rs.50/- per day upto maximum of 15 days. The Universal Health Insurance Scheme (UHIS) has been redesigned targeting only the BPL families. The premium subsidy has been enhanced from Rs.100 to Rs.200 for an individual, Rs.300 for a family of five and Rs.400 for a family of seven, without any reduction in benefits.
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