Group Accident Insurance Scheme under PMMSY: Accidental death or Permanent Total Disability Gujarat

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

The scheme provides a benefit of ₹5,00,000/- for accidental death or permanent total disability.

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.

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.

The insurance cover is valid for a period of 12 months.

The entire premium amount is paid by the Central and State Governments, with no contribution from the beneficiary.

The claim must be intimated to M/s Oriental Insurance Company Limited (OICL) within 90 days from the date of the accident.

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.

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.

The insurance company will settle a claim within 15 working days of receiving all complete documentation.

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.

The payment is made directly to the claimant, nominee, or legal heir's savings account via Direct Bank Transfer (DBT).

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.

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.