YSR BHIMA Scheme Latest Guidelines 2021 YSR BHEEMA Rs 1 Lakh / 5 Lakh Insurance

YSR Bima / YSR BHIMA Scheme Latest Guidelines 2021 YSR BHEEMA Rs 1 Lakh / 5 Lakh Insurance. YSR BHIMA Social Security Scheme Guidelines 2021 YSR BHEEMA Rs 1 Lakh / 5 Lakh Insurance Government after careful examination, hereby approves to implement “YSR Bima Scheme” with following modifications for the benefit of approximately 1.32 crore members of poor, below poverty line families focusing on the Primary Bread Earner of the BPL Family with an estimated approximate expenditure of Rs.407.04 crores during the year 2021-22: G.O.Ms.No.7 Dated:27.06.2021
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YSR BHIMA Scheme Latest Guidelines 2021 YSR BHEEMA Rs 1 Lakh / 5 Lakh Insurance

LFB&IMS Department - “YSR BIMA ” (Social Security Scheme) for Providing Rs.1.00 lakh Natural Death relief directly from Government and Rs.5.00 lakh Accidental Death / Permanent Disability relief through Group Insurance Scheme to the Primary Bread Earners of BPL Families – Orders - Issued.
LABOUR, FACTORIES, BOILERS & INSURANCE MEDICAL SERVICES (LAB.I) DEPARTMENT

G.O.Ms.No.7 Dated:27.06.2021 
Read the following:
  • 1. G.O.Ms.No.5, LFB&IMS (Lab.I) Dept, dated 28.08.2020.
  • 2.G.O.Ms.No.6, LFB&IMS (Lab.I) Dept, dated 08.09.2020.
  • 3.Minutes of the meeting of Hon’ble CM convened on 9.06.2021.
  • 4. From the Special Commissioner of Labour, A.P., Lr.No.F/5083/2021, Dt: 14.06.2021.
ORDER:
Government of India implemented the unorganized worker’s social security scheme i.e the converged insurance scheme to provide financial relief to the bereaved families of the deceased unorganized workers in the event of Accidental or Natural death or Permanent disability due to accident and the premium payable towards the converged scheme was shared in 1:1 ratio by both the Central Government and the State Government.
2. Vide office memorandum F.No-U-11017/09/2019–RW of Government of India, Ministry of Labour and Employment dt:08/06/2020 informed that the said convergence scheme issued vide order No. M-21015 /02/2017 – RW dated : 13th November 2017 issued by Labour & Employment stands withdrawn w.e.f. 1st April 2020. Since the Converged scheme is withdrawn, the present YSR-Bima scheme is contemplated by the State Government to ensure insurance relief to the poor, below poverty line families focusing on the primary Bread Earner of the Family. 100% of the premium towards this scheme is borne by State Government of A.P.
3. Accordingly, State Government vide G.O.1st read above read with G.O.2nd read above have issued guidelines for implementation of “YSR Bima Scheme”, a Social Security Scheme to provide relief upto Rs.5,00,000/- in case of Accidental Death or Total Permanent Disability in the age group of 18-50 years; Rs.3,00,000/- relief against Accidental Death & Disability in the age group of 51-70 years and Rs.2,00,000/- in case of Natural Death in the age group of 18-50 year, to the bereaved family members of the deceased Primary Bread Earner. The Premium payable under the schemes totally borne by the State Government on behalf of the Beneficiary and the same was paid to the Insurance Company through the Beneficiaries Bank Account. The enrolment of the beneficiaries was through Banks under PMJJBY & PMSBY Schemes.

4. Despite transfer of full premium and submission of applications, Banks could not enroll all the beneficiaries under PMJJBY & PMSBY Schemes and though enrolled, claims of the beneficiaries who died during the 45 days locking period could not be settled by Banks. Therefore, Government has settled 12039 claims of the beneficiaries who are not enrolled and enrolled but died during the 45 days locking period by paying Rs.254.72 crores for settlement of the claims.

5. During the review, the Hon’ble CM after taking into consideration of all the difficulties in enrolment of beneficiaries through Banks, claims identification, processing, settlement and monitoring of the YSR BIMA scheme, have suggested certain modifications for implementation of YSR Bima during the year 2021-22. Accordingly, the Spl. Commissioner of Labour,AP vide reference 3rd read above has submitted a revised proposal for implementation of the YSR Bima Scheme during the year 2021-22.

6. Government after careful examination of the proposal, hereby approves to implement “YSR Bima Scheme” with following modifications for the benefit of approximately 1.32 crore members of poor, below poverty line families focusing on the Primary Bread Earner of the BPL Family with an estimated approximate expenditure of Rs.407.04 crores during the year 2021-22:

YSR BHIMA Scheme Latest Guidelines 2021 

  • i. Rs.1.00 lakh relief amount will be paid directly by the Government to the nominees of the beneficiaries towards Natural Death in the age group of 18-50 years.
  • ii. Rs.5.00 lakh relief amount will be paid to the beneficiaries under YSR Bima Scheme towards Accidental Death / Permanent Disability in the age group of 18-70 years through insurance company. Insurance coverage will be made under suitable Group Insurance Scheme by payment of premium by Labour Department to the Competitive Insurance Agency identified by the Committee constituted vide GO.Rt.No.310, dated 09.06.2021 of the PR&RD (RD.I) Department, following due procedure calling E-tenders and adoption of reversing Tendering procedure as per the G.O.Ms No.79 of Finance department dt. 25.08.2020.
7. Accordingly, Government have made the following amendments/ modifications to the guidelines issued in the reference 1st read above read with reference 2nd read above for implementation of YSR Bima Scheme w.e.f. 1st July, 2021:

Objective of the scheme
  • The main Objective of the scheme is to provide relief to the bereaved families of BPL in case of death or disability of their Primary Bread Earners to mitigate the financial impact due to the sudden loss of the Primary source of income.
  • The death or disability due to accident of a Primary Bread Earner results in misery to his/her family with hardship and reduced earnings and excessive medical expenditure relating to the accident. Hence, there is every need to provide accidental death and disability insurance to the Primary Bread Earner of BPL families towards social security. Further, even natural death of a Primary Bread Earner of the BPL family results in undue hardship to the surviving family members who are to be provided with some relief. Thus, the State Government has introduced the YSR- Bima scheme.
Salient Features of the Scheme:

1. All Primary Bread earners belonging to BPL families in the State, in the age group of 18 to 70 years are eligible to be enrolled as beneficiaries of new YSR- Bima Scheme.

2. Benefits under the new YSR -Bima Scheme are as follows:

  • i. Rs.1.00 lakh relief amount to the nominees of the beneficiaries towards Natural Death in the age group of 18-50 years under YSR Bima Scheme will be paid directly by the Government through GV/WV & VS/WS Department.
  • ii. Rs.5.00 lakh relief amount will be paid to the beneficiaries towards Accidental Death/Permanent Disability in the age group of 18-70 years through insurance company. Insurance coverage will be made under suitable Group Insurance Scheme by the selected Insurance Company. The total premium for the Scheme shall be paid by the Government.
  • 3. “Labour Department” is the “Nodal Agency” and the “GSWS Department” is the “Implementing Agency”.
  • 4. The GSWS Department will resurvey the Primary Bread Earners of the BPL families and register the beneficiaries under YSR BIMA.
  • 5. All Primary Bread earners belonging to BPL families in the State will be registered through a Door-Door Survey to be undertaken by the Grama / Ward Volunteers and enroll them as beneficiaries under YSR- Bima Scheme.
  • 6. A designated Officer of the Grama Sachivalayam/Ward Sachivalayam i.e., Welfare Assistant shall be the Registering Authority.
  • 7. The role of SERP (PR & RD Dept) as “Implementing agency” as envisaged in G.O.Ms No.5 LFB&IMS Dept. dt. 28.08.2020 will be taken over by the GSWS Department in due course. SERP/PR &RD Dept. shall hand hold the process till handing over the implementation to the GSWS Dept.
8. Guidelines for the implementation of YSR Bima Scheme:

  • (a) All Grama/Ward Sachivalayams are hereby notified as YSR Bima Beneficiary Facilitation Centers, for facilitation of registration of Beneficiaries, their enrollment in social security schemes, processing of claims and for delivery of such other services required for implementation of the YSR Bima Scheme.
  • (b)Implementing agency for this scheme shall be GSWS Department and the Director, GSWS Department using the services of Grama / Ward Volunteers shall identify the eligible beneficiaries.
  • (c)Implementing Agency (GSWS) shall identify the members who are eligible to be covered under the scheme, enroll them as members and prepare database of such members and shall intimate the Government and nodal agency (the Department of Labour) regarding such enrollment along with the data.
  • (d)Data shall be accepted by the Department of Labour after due validation.
  • (e)For the purpose of admission into the scheme, the member shall sign a formal enrolment form and the declaration of good health. If the declaration of health made by the member and other particulars are found to be satisfactory, the implementing agency may enroll the member to the scheme and include in the data base to affect the assurance subject to other conditions.
(f) Eligibility Criteria:  
The members should be aged between 18 completed years and 70 years. He / She should be from Below Poverty line. He / She should be Primary Bread earning member. The decision as to the eligibility of the member for the enrolment into the scheme is fully vested with the Nodal Agency. The Nodal Agency will however, verify the eligibility of the member as per the above criteria. 

(g)Verification of Age: 
The Nodal Agency has to satisfy that the member covered under the Scheme is in the respective age group as desired by the scheme. Age admission will be done based on Aadhar or any other document as specified in the notification under section 7 of the Aadhar Act.

(h)Appointment of Nominee: Every insured member shall appoint one or more from the spouse or children or dependents to be the nominee or nominees in accordance with Section 39 of Insurance Act 1938. In the event of death of the insured member while being covered under the Scheme, the benefits of insurance cover as assured on his life will be paid to the nominee. If the insured member does not have a spouse or child/children or dependents, then he shall appoint his legal representative to be the nominee. The Data regarding nomination will be maintained by the Implementing Agency and they shall submit the details of nomination or legal heirs to Insurance Companies for settlement of claims. In case the nominee is a minor, then the insured member shall appoint an Appointee to receive the benefit of assurance.
(i) Servicing of the Scheme: The Nodal Agency will coordinate with all concerned Implementing Agencies to adopt a strong IT based system to service the Scheme. The implementing agencies will maintain centralized data base of the insured members. The settlement of claims would be subject to implementing Agency submitting Claim form, claim-cum discharge form and copy of the Death Certificate, age proof of member as required by the insurance company in accordance with policy terms, conditions & MoU. Details of nominee like the Aadhar number and bank account to which the claim proceeds are to be credited, and other details as required by insurance company to process the claim.

(j) Master policy & ID Card:
The Nodal agency (Department of Labour) will be the master policy holder. The Implementing agency will submit the details of the individual beneficiary and the nodal agency shall issue a separate unique ID card to each beneficiary along with a standardized introduction letter from Hon’ble Chief Minister addressed to each individual beneficiary family enumerating the benefits, process, procedures, time lines and grievance redressal mechanism of the scheme.

(k) The details of the scheme and modalities of implementation of the scheme shall be as specified in the Annexure appended to this Notification.

(l) At the District level the Scheme shall be monitored closely by the Joint Collector (Welfare) to ensure the claims are settled within 15 days of the death of the Primary Bread earner.

(m)At the State level the APGIC shall provide the necessary technical support for better implementation and monitoring of the scheme from time to time.

8. The Department of Gram Volunteers / Ward Volunteers and Village Secretariats / Ward Secretariats will issue separate “SOP” for implementation of the Scheme.

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