Covid Insurance Claim Settlement To Be Faster

Nirmala Sitharaman, Union Finance Minister, held a video conference with the heads of insurance companies today to review the progress made under the Pradhan Mantri Garib Kalyan Package (PMGKP) Insurance Scheme for Health Workers Fighting COVID-19, as well as to speed up the disbursement of pending claims under the Pradhan Mantri Jeevan Jyoti Bima Yojana (PMJJBY) during the pandemic.

The Finance Minister emphasized the importance of insurance company employees remaining compassionate when providing services to the nominees of deceased policyholders, particularly during pandemics. She also praised insurance firms and banks for their recent efforts to expedite claim processing.

What is Pradhan Mantri Garib Kalyan Package?

Health Workers Fighting COVID-19: Pradhan Mantri Garib Kalyan Package (PMGKP) Insurance Scheme was launched on March 30, 2020, for a 90-day trial period, to provide comprehensive personal accident coverage of Rs. 50 lakh to all healthcare providers, including community health workers and private health workers, drafted by the government for the care of Covid-19 patients, as well as those who may have come into direct contact with COVID-19 patients and were at risk of being impacted by it.

What is Pradhan Mantri Jeevan Jyoti Bima Yojana (PMJJBY)?

People between the ages of 18 and 50 who have a bank account and agree to join/allow auto-debit are eligible for the PMJJBY. The primary KYC for the bank account would be Aadhar. The Rs. 2 lakh life insurance policy will be valid for a year, from June 1 to May 31, and will be renewed. This policy provides risk coverage of Rs. 2 lakh in the event of the insured's death for any reason. The annual premium is Rs. 330, which is auto-debited in one installment from the subscriber's bank account on or before the 31st May of each annual coverage term under the scheme, as per his option.

She also emphasized the significance of reducing the claims procedure and documentation requirements under the schemes in order to expedite payouts.

During the assessment, the Finance Minister noted that a total of 419 claims have been paid under the PMGKP scheme to date, totaling Rs 209.5 crore disbursed in the accounts of their nominees.

To address the issue of delays caused by states delivering documentation, the Finance Minister announced the implementation of a new system in which a simple certificate from the District Magistrate (DM) and endorsement from the nodal state health authority will suffice to process these claims.

The Finance Minister went on to say that under PMJJBY, a total of 4.65 lakh claims worth Rs. 9,307 crore have been paid, with 1.2 lakh claims worth Rs. 2,403 crore being paid since the start of the pandemic on April 1, 2020, at a disposal rate of 99 percent.

During the review, the Finance Minister took stock of the disposition of claims submitted under the PMSBY scheme, stating that as of May 31, 2021, a total of 82,660 claims worth Rs. 1,629 crore had been paid.

• Insurers must complete claim processing in seven days rather than thirty.
• The claim settlement procedure between banks and insurance firms is being digitised from beginning to end.
• Claim paperwork are sent by email/app, avoiding delays caused by paper transmission.
• By June 2021, public sector insurance companies will have implemented an API-based app for claim transmission.
• In lieu of a death certificate, an attending doctor's certificate and a certificate issued by a DM/authorized officer will be acceptable.
• Soon, rationalised paperwork and a simpler claims process will be available.