What you get
Sr. No.Name of ComponentStandard of assistanceMinimum Time Limit (in Years) for Reclaiming Benefits1. Accidental death or Permanent Total Disability₹5,00,000/-Once to the legal heir after death | Mode of Disbursement: | - The claim amount is deposited directly into the claimant's, nominee's, or legal heir's savings account via Direct Bank Transfer (DBT). | Expected Time of Disbursement: | - The insurance company will settle the claim within 15 working days of receiving the complete claim documentation. If a claim is not settled within this period, the insurance company will pay a simple interest of 10% on the admissible claim amount from the date of document submission until the payment date.
Who can apply
Required Paperwork
- Aadhaar Card
- PAN Card
- Income Certificate
- Residence Proof (Domicile)
Common Questions
What is the scheme is about?
The Group Accident Insurance Scheme (GAIS) is a component of the Pradhan Mantri Matsya Sampada Yojana (PMMSY) that provides insurance coverage to fishers, fish workers, fish farmers, and others involved in fishing-related activities
What does the Accidental Death or Permanent Total Disability (PTD) benefit cover?
The scheme provides a benefit of ₹5,00,000/- for accidental death or permanent total disability.
What is considered a "Permanent Total Disability" under this scheme?
Permanent Total Disability is defined as an injury that, within 12 months of the accident, is the sole and direct cause of the insured person being permanently, totally, and absolutely disabled from engaging in any occupation or employment.
Who is eligible for this benefit?
Eligible individuals are men and women fishers between the ages of 18 and 70, as approved by the State/UT fisheries department. The insured person must not have completed 71 years of age on the date of the accident.
What is the policy's duration?
The insurance cover is valid for a period of 12 months.
How is the premium paid for the insurance?
The entire premium amount is paid by the Central and State Governments, with no contribution from the beneficiary.
How do I report a claim for accidental death or permanent total disability?
The claim must be intimated to M/s Oriental Insurance Company Limited (OICL) within 90 days from the date of the accident.
What documents are required to file a claim?
Common documents include the Intimation Form, Claim Form, a cancelled cheque or bank passbook copy, Certification by an Appropriate Authority, and a government-issued ID. Additional documents, such as the First Information Report (FIR) and Post Mortem Report, are required for specific accidents.
Where do I submit the claim documents?
All hard copies of the insurance claim documents should be sent to the Insurance Cell at the National Fisheries Development Board (NFDB) after being uploaded to the PMMSY-GAIS MIS Portal.
How long does it take for a claim to be settled?
The insurance company will settle a claim within 15 working days of receiving all complete documentation.
What happens if the insurance company delays the claim payment?
If an admissible claim is not settled within 15 days, the insurance company will pay a simple interest of 10% on the claim amount from the date of document submission until the date of payment.
Will the claim be paid to the family or the insured person?
The payment is made directly to the claimant, nominee, or legal heir's savings account via Direct Bank Transfer (DBT).
Are there any exclusions to the accidental death or PTD coverage?
Yes, the policy does not cover death or disability resulting from suicide, self-inflicted injury, pre-existing conditions, drug or alcohol use, criminal acts, or war. Natural death is also not covered.
What is the role of the State/UT Fisheries Department in the claims process?
The State/UT department is responsible for identifying and verifying the fishers to be insured, forwarding claim intimations, and ensuring all claim documents are verified and submitted on time.