According to data from the Ministry of Labour and Employment, the unorganised sector employs over 93% of all workers in India. Due to their precarious financial situations, employees in these occupational groupings frequently hesitate to purchase health insurance coverage. However, their families might have to bear the disproportionate financial burden in the event of accidental illnesses, injuries, or deaths.
On October 2, 2007, India introduced the “Aam Aadmi Bima Yojana (AABY)” to provide social security to this segment of the population. The phrase “common man’s insurance scheme” is the name’s literal translation. It protects the breadwinners of Below Poverty Line (BPL) families from natural or unintentional death and disability.
What is Aam Aadmi Bima Yojana?
An Indian social security program called Aam Admi Bima Yojana is intended for low-income households. This program helps those who are typically not employed, such as fishermen, car drivers, cobblers, etc. Because of their poor income, individuals might not consider saving money for serious emergencies like death or incapacity. They receive financial assistance from the Aam Aadmi Bima Yojana (AABY) to deal with such unpleasant circumstances.
A second measure to ease the load on the policyholder is the fact that multiple parties are responsible for paying the premium. The government and the policyholder split the AABY Scheme premium, making it even more affordable for those who need it.
Eligibility Criteria
Here are the eligibility criteria for Aam Aadmi Bima Yojana
| Parameters | Details |
| Entry Age | Aam Aadmi Bima Yojana only accepts applicants between the ages of 18 and 59. |
| Income |
|
| Members Covered | Only one family member will be qualified for coverage. He or she should provide all of the family’s income. |
Occupations Covered Under The Aam Aadmi Bima Yojana (AABY)
| Anganwadi Teachers | Hamals |
| Fishermen | Handloom and Khadi weavers/handloom Weavers |
| Agriculturists | Plantation workers |
| Beedi Workers | Handicraft artisans |
| Brick Kiln Workers | Primary milk producers |
| Forest Workers | Leather and tannery workers |
| Carpenters | Manufacturer of leather products |
| Construction Workers | Sheep breeders |
| Tendu Leaf Collectors | Textile |
| Safai Karamacharis | Sericulture |
| Hilly Area Women | Chemical Products like candle manufacture |
| Handloom & Khadi Weavers | Overseas Indian Workers |
| Cobblers | Toddy Tappers |
Features & Benefits of Aam Aadmi Bima Yojana
Here is the list of the features and benefits of the Aam Aadmi Bima Yojana
- Affordable Policy: Aam Aadmi Bima Yojana provides extremely affordable health insurance premiums available for purchase. Thus, managing cash to pay for this plan won’t be a concern for the policyholder. Additionally, the government pays half of the premium.
- Prompt Assistance: If any insured people have questions, they can get them answered quickly by contacting the Life Insurance Corporation (LIC) branch that is closest to them. Additionally, the coverage buyer can call or email the relevant party.
- Scholarship Benefits: It ensures that at least two kids in the family get continuous education. It offers qualifying students in grades 9 through 12 a free scholarship of INR 100 per month on a biannual basis.
- Technologically Advanced Policy: The policy is highly advanced in technology, which enables it to offer the general public greater services. This is because all insured members’ data is digitalized and tracked through a web-based system that enables quick information interchange when necessary. It is advantageous when settling claims.
- Natural Death: People between the ages of 18 and 59 are included in the Aam Aadmi Bima Yojana. LIC pays a Death Claim of INR 30,000 if a plan participant passes away from natural causes.
- Accidental Advantages: Accidents are unpredictable and may have severe repercussions. Accidental Death is covered by the Aam Aadmi Bima Yojana, and the nominee is given a reimbursement of INR 75,000.
- Coverage for Disability: Every member of the family experiences the effects of a family member’s handicap. And things could get worse if the person with the illness is the only provider for the family. According to Aam Aadmi Bima Yojana, an accident-related permanent total disability is covered by a disability claim of Rs. 75,000 and a partial disability claim of Rs. 37,500.
- Additional Benefit: In addition to covering accidental death and disability, the Aam Aadmi Bima Yojana also offers coverage for at least two children’s education in the event of an accident. If a child meets the requirements and is enrolled in ninth through twelfth grade, the policy offers them a free scholarship worth Rs. 100 each month for a half-year.
What Are The Inclusions & Exclusions Under Aam Aadmi Bima Yojana?
Inclusions:
Eligible persons will receive coverage under the Aam Aadmi Bima Yojana in the following circumstances:
- Natural Death: The death certificate for the dead must be presented when filing a claim.
- Accidental Death: A medical certificate stating that the death was caused by accident is required when making a claim.
- A medical certificate from a government doctor outlining the nature of the disability will be required when filing for partial or total disability benefits.
Exclusions:
Here is a list of exclusions (things covered) of the Aam Aadmi Bima Yojana:
- Suicide attempts or self-inflicted injuries.
- Accidents and injuries resulting from risky and adventurous sports.
- Death or impairment brought on by a warlike scenario in the nation.
- Mental Illness
- Death or disability resulting from substance misuse
- Accidents caused by illegal activity
How To Enroll for The AABY Scheme?
The AABY is a social security program supported by the Indian government. India is a multiethnic nation with a secular government. Its population is extremely diverse and speaks many different languages.
On each State Government’s official website, you can find the Aam Aadmi Bima Yojana Form PDF or guidelines for applying for the program. For instance, if you reside in Uttar Pradesh, you must visit the state government’s website to obtain all the necessary information.
Documents Required To Apply For Aam Aadmi Bima Yojana
Here is the list of the following documents required to enrol under AABY:
- Identity proof
- Address proof
- Nominee application form
- Income certificate
- Application form
How To Claim Your Aam Aadmi Bima Yojana?
When compared to other health insurance products, this scheme’s claim process is simple. In the terrible event that the policyholder passes away or becomes disabled, it offers financial assistance. There are four circumstances in which a claim against the policy may be made. The following information relates to the Aam Aadmi Bima Yojana claim procedure:
Claim Procedure For Death:
The nominee will need to submit a claim in the event of death using a Death Certificate. When a beneficiary passes away, the AABY policy should still be in effect. The nodal agency officer assigned should receive the claim. The verification process will be carried out by him or her. Through the procedure, he or she will confirm that the deceased person was a member of a household that was either below the poverty line (BPL) or just over the BPL and earned a living. The person’s line of work will also be considered.
Documents Required To File A Death Claim:
- Aam Admi Bima Yojana Death Claim Form
- Original and copies of the death certificate
Claim Procedure For Accidental Death:
The procedure for filing a claim for accidental death is comparable to that for a claim for a natural death. However, in addition to the claim form and death certificate, the following records will also be needed:
- Copy of FIR
- Police Conclusion Report /Final Report of Police
- Police Inquest Report
- Post Mortem Report
Claim Procedure For Disability:
A person who has a total or partial handicap may file a claim under the Aam Aadmi Bima Yojana. The application procedure is straightforward, and the claimant does not have to cause financial hardship for other family members.
To submit supporting documentation to support a disability claim, the applicant must be disabled. The following records can be used as evidence:
- Accident-related documentation, such as a police accident report, a videotape, or accident photos.
- Medical certificate: It must be signed by a government civil surgeon or trained government orthopedics and include information about the accident, including the member’s loss of limbs and the type of handicap experienced.
Claim Procedure For Scholarships:
Here is the procedure for applying for scholarships:
The beneficiary must complete and submit the Aam Aadmi Bima Yojana Scholarship Online Application Form to the designated Nodal Agency every six months. The Nodal Agency will choose the qualified students. For one child, this additional free scholarship provides Rs. 100 each month. The concerned P&GS section will thereafter receive the list of students. There will be information about the pupils, including:
- Name of the student
- Name of the school
- AABY master policy number
- Name of the policyholder
- Class in which the student is studying
- NEFT details
- Membership number
Every year on the first of July and the first of January, the Aam Admi Bima Yojana Scholarship’s financial benefit will be transferred by NEFT to the student’s account. If any such account doesn’t exist, alternative payment methods will be chosen. It should be noted that the scholarship is only offered to a family’s two eligible children who are in grades nine through twelve.
Frequently Asked Questions
Yes, naming a nominee is required when applying for this insurance plan so that a claim can be filed if the covered person passes away. Before submitting your application, you must properly complete the nomination form that was sent.
No, each family may only submit one application under the Aam Aadmi Bima Yojana. By submitting a death claim, you can take advantage of the current coverage if the policyholder for your family dies. You cannot, however, apply to get the benefit of this scheme more than once.
The entitlement of wards in private hospitals impaneled under the CGHS scheme is based on the pay grade of the individual. Check out the table below for more information on ward entitlement:
The NEFT information of a member is necessary during enrolment since it will be needed in the event of a claim. This makes the claim procedure short and simple for both the insurer and the insured.
The cost of AABY’s premium is fairly reasonable. This is due to the Social Security Fund subsidizing the members of the program with half of the premium amount. As a result, the Social Security Fund is crucial to the success of the Aam Aadmi Bima Yojana.
