Aam Aadmi Bima Yojana by Govt. of India

• Premiums as low as Rs12/day for coverage of Rs.4 Lakhs*
• 10,000+ hospitals for cashless treatment
• Claim up to Rs. 55,000 deduction under section 80D**

Aam Aadmi Bima Yojana is a social security scheme offered by India’s largest life insurance service provider Life Insurance Corporation of India (LIC). This is a death and disability cover that provides lump sum compensation to the insured person following an adverse event. The present scheme is a merger of Aam Aadmi Bima Yojana and Janashree Bima Yojana. The merged scheme came into effect from January 1, 2013 onwards. This health insurance policy cover comes with an affordable price tag and ensures that people are compensated against various eventualities like death and disability.

Eligibility for Aam Aadmi Bima Yojana

People who wish to subscribe to the Aam Aadmi Bima Yojana must meet the following eligibility criteria:

• This cover is available only for members who belong to below poverty line families or marginally above poverty line families.
• This cover is available to people who are aged between 18 years and 59 years.
• Members enrolled in this cover must be the head of the family or an earning member.

Features of Aam Aadmi Bima Yojana

Some of the key features of Aam Aadmi Bima Yojana can be listed as follows:

• The basic sum assured for this policy cover is Rs.30,000.
• The premium charges for this policy is Rs.200 per annum.
• Various subsidies are available for policyholders from poor families. 50% of the premium amount will be subsidised from the Social Security Fund and the remaining 50% will be borne by the state government or union territory.
• During the time of signing up, members must provide a proof for their age. Some of the accepted documents include ration card, birth certificate, voter’s id, Aadhar card, etc.
• The member must name the nominee for this policy cover at the time of sign up.
• This scheme is designed on a Nodal Agency Model. Nodal Agencies include Panchayats, NGOs, self-help groups, and other institutionalised arrangements.
• In addition to death and disability benefit, this policy cover also offers scholarship for the education of the insured’s children.

Benefits of Aam Aadmi Bima Yojana

The benefits offered by Aam Aadmi Bima Yojana policy can be given as follows:

Exclusions of Aam Aadmi Bima Yojana

Some of the exclusions listed out by Aam Aadmi Bima Yojana policy can be given as follows:

• Any medical expenses incurred by the insured following an accident
• Any kinds of self-inflicted injuries, suicide, or attempted suicide
• Injuries occuring due to insanity
• Medical expenses incurred due to childbirth and pregnancy
• Death or disability caused by war or warlike activities
• Death or disability caused by exposure to radioactivity, nuclear weapons, chemical weapons, etc.
• Death or disability caused while breaching the law with criminal intent
• Death or disability arising out of participation in extreme sports

Claim Procedure

In case of the death of the insured member during the policy term, the nominee must apply for the claim along with the death certificate of the insured. The claim application must be submitted in the respective Nodal Agency designated by the insurer. For disability claims, the insured member must file the application with the insurer. The following documents must be submitted at the time of claim application:

• Duly filled claim form
• Original death certificate along with an attested copy
• Post mortem report
• FIR copy
• Policy inquiry report
• Documentary evidence of accident
• Medical certificate from a physician (for disability claims)

Once the documents are submitted to the insurer, the claim process will begin. The insurer will verify the documents and confirm the validity of the claim. If the documents are found to be valid, the claim amount will be paid to the nominee or insured.