Group Accident Insurance Scheme under PMMSY: Medical Treatment - Gujarat
₹25,000 medical treatment coverage · fishermen Gujarat
Active fishermen in Gujarat aged 18–70 who suffer an accidental injury requiring medical treatment can claim ₹25,000 under this sub-scheme of the Pradhan Mantri Matsya Sampada Yojana (PMMSY). The premium is fully paid by the Central and State governments — fishermen contribute nothing. Claim must be reported within 90 days of the accident via the district office, NFDB helpline (1800-425-1660), or email at support@pmmsygais.com.
About This Scheme
Active fishermen in Gujarat aged 18–70 who suffer an accidental injury requiring medical treatment can claim ₹25,000 under this sub-scheme of the Pradhan Mantri Matsya Sampada Yojana (PMMSY). The premium is fully paid by the Central and State governments — fishermen contribute nothing. Claim must be reported within 90 days of the accident via the district office, NFDB helpline (1800-425-1660), or email at support@pmmsygais.com.
Full official description
The scheme "Group Accident Insurance Scheme under PMMSY" with a component "Permanent Partial Disability" is introduced by the Agriculture, Farmers Welfare and Co-operation Department, Government of Gujarat. Insurance of Fishers is one of the sub-components of the PMMSY, and it provides insurance coverage to fishers, which includes fishermen, fish workers, fish farmers, and other individuals directly involved in fishing and related activities. The sub scheme offers coverage for Medical Treatment. The National Fisheries Development Board (NFDB) and M/s Oriental Insurance Company Limited (OICL) implement the scheme. The premium cost is shared between the Central and State Governments, with no contribution from the beneficiary. The implementing agency of the scheme is the Commissioner of Fisheries.
Objective of scheme:
- To financially assist the fisherman/fisherman's family in case of death/injury.
Benefits
- Medical treatment reimbursement up to ₹25,000
- No premium charged — fully funded by Central and State governments
- Payment via Direct Bank Transfer (DBT) within 15 working days of complete claim submission
- If claim is delayed beyond 15 working days, the insurer pays 10% simple interest on the due amount
💡 Why Startups Should Care
Medical costs from fishing accidents — cuts, drowning-related complications, equipment injuries — can be significant. This coverage ensures fishing families aren't forced into debt to cover treatment costs.
Who Can Apply (Eligibility)
- Must be an active fisher: fisherman, fish worker, fish farmer, or anyone directly involved in fishing/fisheries activities in Gujarat
- Must be between 18 and 70 years of age
- Must be approved/registered with the State Fisheries Department
- Must have registered at the concerned district fisheries office
- Claim must be reported within 90 days of the accident
Exclusions
- Does not cover claims from suicide or attempted suicide
How to Apply
- Fishers or their legal heirs submit required documents to the concerned district office.
- Complete the Intimation Form and Claim Form.
- Attach medical treatment bills and identity proof.
- The district office verifies and processes the claim.
- Claim amount is deposited via DBT to the claimant's bank account.
Frequently Asked Questions
What is the Medical Treatment benefit under the Group Accident Insurance Scheme (GAIS)?
The Medical Treatment benefit provides financial assistance for the medical expenses of a fisher who is injured in an accident.
What does the medical treatment benefit cover?
The benefit covers costs for medical treatment and hospitalisation resulting from an accident, including the cost of medicines, diagnostic tests, doctor's fees, and hospital charges.
Who is eligible to claim the medical treatment benefit?
Any fisher between the ages of 18 and 70, who is registered under the scheme, is eligible for this benefit. The insured person must not have completed 71 years of age on the date of the accident.
How is a claim for medical treatment initiated?
The claim must be intimated to the insurance company within 90 days from the date of the accident.
What documents are required to file a claim for medical treatment?
You will need the Intimation Form, Claim Form, a cancelled cheque or bank passbook copy, Certification by the Appropriate Authority, and a government-issued ID. Additionally, you will need accident-specific documents.
What additional documents are specifically required for a medical treatment claim?
You must provide the original consolidated hospital bill with a breakup of each item, original payment receipts, corresponding prescriptions, the treating doctor's certificate, a copy of the Medico Legal Certificate (MLC), and the original detailed discharge summary.
Do I need to submit the original hospital bills?
Yes, you are required to submit original consolidated hospital bills and payment receipts.
How long do I have to submit all the claim documents?
All claim documents for medical treatment must be submitted within 180 days of the accident.
Is there a timeframe for the insurance company to settle a medical treatment claim?
Yes, the insurance company will settle the claim within 15 working days of receiving all complete documentation.
Are ambulance charges covered under this benefit?
No, ambulance charges are not covered under the accidental hospitalisation claim.
Does the medical treatment benefit cover pre-existing diseases?
No, the policy does not cover expenses for pre-existing physical or mental defects or illnesses.
Ready to apply?
Visit the official government portal to apply for this scheme.
Apply on myScheme.gov.inDocuments Required
- Intimation Form
- Claim Form
- Cancelled cheque of claimant/insured/nominee
- Medical treatment bills