STANDARD OPERATING PROCEDURE FOR CLAIM SETTLEMENT UNDER PMSBY

STANDARD OPERATING PROCEDURE FOR CLAIM SETTLEMENT UNDER PMSBY

PMSBY Claim form and SOP for claim settlement

Following benefits are available under PMSBY: 

The process followed will be as under:

Steps to be taken by the Nominee in case of death of depositor in accident:

1. Nominee should approach CBS Post Office where the depositor was having the ‘Savings Bank Account’ through which he / she was covered under PMSBY and collect Claim Form, and Discharge receipt, from the Post Office.
2. Nominee to submit duly completed Claim Form, Discharge Receipt, along with the death certificate in original, FIR/Panchnama in original and Post Mortem Report.
3. Nominee has to provide his/her own Post Office Savings Bank Account details (if opened in any CBS Post Office or Nominee will first open savings account) or bank Account details (if nominee is having savings account in any Nationalized Bank).

Steps to be taken by the Depositor in case of permanent disability in accident:

1. Depositor should approach CBS Post Office where the depositor was having the ‘Savings Bank Account’ through which he / she was covered under PMSBY and collect Claim Form, and Discharge receipt, from the Post Office.
2. Depositor to submit duly completed Claim Form, Discharge Receipt, along with the permanent disability certificate in original by Civil Surgeon and FIR/Panchnama in original. 

Steps to be taken by the Post Office

1. Upon receipt of claim form and discharge certificate alongwith documents mentioned above, the Post Office should check whether the cover for the said member was in-force on the date of his death, i.e., whether the premium for the said cover was deducted from account prior to the Member’s death.

2. Post Office to verify the Claim Form & the nominee details from the relevant Finacle menu through which enrolment was made and to fill in the relevant columns of the Claim form.

3. Post Office should ensure that following documents are attached with claim form:-
(i) Claim Form duly completed
(ii) Death Certificate (in case of death)
(iii) FIR/Panchnama in Original
(iv) Post Mortem report (in case of death)(v) Permanent Disability Certificate issued by Civil Surgeon
(vi) Discharge Certificate duly completed.
(vii) Photocopy of cancelled cheque of the Nominee account (if it is a cheque account).

4. Post Office user will enter relevant details in Finacle menu CCSPMY

The screen shots of menu – CCSPMY
Criteria Page – CCSPMY (Claims and Settlements for PMY Policies)

In the criteria page of CCSPMY menu following functions are provided –

A – Add

M – Modify

V – Verify

I – Inquire

C – Cancel

5. Post Office User has to select the function ADD. Then enter Account ID and select the scheme as PM Suraksha Bima. Click on GO. In case of permanent disability, user will change the option of Existing Disability Status as Yeas and fill details of disability in the relevant field.

Following screen will appear:-

6. User has to enter Nominee Aadhar No. (if given), Nominee Address, Nominee Mail ID(if given), Nominee Mobile Number (if given), Nominee PAN No.(if given), Nominee Bank Account (either POSB or any Bank Account), Nominee IFSC Code (if having account in Bank), Guardian name if Nominee is minor, Nominee Date of Birth (if nominee is minor), select Bank as DOP (if POSB Account) or others if other Bank Account.

7. User will click on validate and ensure that all mandatory fields are filled. It will submit documents to Supervisor.

8. Supervisor will select Function Code Verify and compare all the information filled in claim form and discharge voucher with the data filled by user. After, satisfaction, he will verify the claim. Upon verification, Claim Identification No. will be displayed by the system. This number should be noted on the top of the Claim Form and the claim register.

9. Claim Form duly filled and verified by CBS Post Office alongwith enclosures should be sent to Sr.Post Master Sansad Marg HO, New Delhi 110001 by service registered Letter. One RL should be sent even if more than one claim form is due to be sent on same day.

10. User will also maintain a claim register in which the claim shall be entered. This register has to be prepared manually by entering Date of entry of claim/Account ID/Name of Account Holder/Date of Death/Name of Nominee/Claim Identification No. (generated by system)/ Date on which claim Form sent to Sansad Marg HO/Registered Letter receipt to be pasted against claims sent on a particular date.

11. Snasad Marg HO, on receipt of claim form will enter the claim in the register to be maintained manually and designated PA of this HO will intimate System Manager for extraction of the data from Finacle for the said claim. Data extraction file will be sent to NIC by Sansad Marg HO and all the claim forms received will be sent by service Registered Parcel to the designated branch of NIC. 

12. NIC, after sanctioning of the claim will push credit of the claimed amount into Bank Account of the depositor or nominee as the case may be if account stands at any Bank or Credit the funds toSansad Marg HO Bank Account No._________________ IFSC Code_______________________ if depositor or nominee account is in any CBS Post Office. NIC will provide data file in the format of HTTUM to Sansad Marg HO. Snasad Marg HO will upload the HTTUM file in Finacle provided that funds are already received and account for the money in SB Deposit and Remittance to Bank (against credit entry received from NIC).

13. Sansad Marg HO will make entry of date of credit against the claims in the register and send intimation to the relevant CBS Post Office about the credit.

14. Relevant CBS Post Office will make entry of date of credit in its register and inform the claimant over phone about the credit. No accounting entry is to be made in any other CBS Post Office.