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This Gujarat government scheme provides financial help for medical treatment to fishermen and their families if an Read More... accident occurs, as part of the Pradhan Mantri Matsya Sampada Yojana (PMMSY). Read less

Details

The Agriculture, Farmers Welfare and Co-operation Department of the Gujarat government has introduced the "Group Accident Insurance Scheme under PMMSY" with a focus on medical treatment for its fishing community. This initiative is a part of the larger Pradhan Mantri Matsya Sampada Yojana (PMMSY), specifically covering insurance for fishers. It aims to ensure that individuals involved in fishing, fish farming, and related activities receive crucial financial support for medical care following an accident.

What Is This Scheme?

The scheme acts as a safety net, providing insurance coverage for the medical expenses incurred by fishers. Whether you are a fisherman, a fish worker, a fish farmer, or any other individual directly involved in the fishing sector, this scheme is designed to assist you. The National Fisheries Development Board (NFDB) and M/s Oriental Insurance Company Limited (OICL) are the implementing bodies, with the Commissioner of Fisheries serving as the main agency. The best part is that the entire premium is covered by the Central and State Governments, meaning beneficiaries don't have to pay anything.

Who Can Benefit From This Scheme?

This scheme is specifically for individuals who are actively engaged in fishing and allied activities in Gujarat. This includes fishermen, fish workers, fish farmers, and anyone whose livelihood is directly connected to the fisheries sector. The age criteria and registration requirements are important to meet to be eligible for the benefits.

Why This Scheme Is Important

Accidents can happen unexpectedly, especially in professions like fishing, and they can lead to significant medical expenses. This scheme is vital because it ensures that fishermen and their families are not left to bear these costs alone. By providing financial assistance for medical treatment, it helps protect their financial stability and well-being during difficult times, reinforcing the government's commitment to supporting the fishing community.

Objective

This Gujarat government scheme provides financial help for medical treatment to fishermen and their families if an accident occurs, as part of the Pradhan Mantri Matsya Sampada Yojana (PMMSY).

Benefits

To promote vegetable production, seasonal vegetable seeds are provided to farmers at a 50% subsidy. Farmers are required to apply approximately two months before planting seasonal vegetables.
For example, if a packet of bottle gourd seeds costs ₹200/-, the farmer pays ₹100/- at the concerned Horticulture Mobile team Centre, while the government bears the remaining ₹100/- as a subsidy, allowing the farmer to receive the seeds for ₹100/-.

Sources and references

Guidelines (Page No. 212)

Eligibility Criteria

You must be a fisher, which includes fishermen, fish workers, fish farmers, or anyone directly involved in fishing or related activities.
Your age should be between 18 and 70 years old at the time of applying.
On the date of the accident, you should not have completed 71 years of age.
Your application must be approved by the State/Union Territory fisheries department.
When making a claim, the claimant or the insured fisher needs to be verified and certified by an "Appropriate Authority".
You should have registered yourself with the concerned district fisheries office.

How To Apply

While the input JSON doesn't detail a specific application form or online portal for this scheme, the process generally involves:

Registering yourself with the concerned district fisheries office.
Ensuring your eligibility criteria are met, including age and professional involvement in fishing.
Obtaining approval from the State/Union Territory fisheries department.
In case of an accident, intimating the claim to the insurance company and submitting all required documents as per the scheme guidelines.

Implementing Agency: Commissioner of Fisheries, Government of Gujarat.

Documents Required

For any claim, you'll generally need:

Intimation Form
Claim Form
A cancelled cheque or a copy of the first page of your Bank Pass Book (for claimant/insured/nominee/legal heir), attested by a Gazetted Officer.
Certification by the Appropriate Authority.
A valid ID proof and address proof issued by the Government of India.

The law and customs of the region will apply regarding the specific documents required.

Specific Documents for Different Accidents:

Road/Railway Accident: FIR/RPF report, Spot Panchnama, Inquest Panchnama, Post Mortem Report, Death Certificate, Valid Driving License (if insured was driving).
Drowning: FIR/Police Report, Post Mortem Report, Spot Panchnama, Inquest Panchnama, Death Certificate, statements from two witnesses.
Missing at Sea: Declaration by family and a certificate from an Appropriate Authority.
Fire: FIR/Police Report, Post Mortem Report, Death Certificate. If the body is severely charred, a family declaration and certificate from an Appropriate Authority are needed.
Poisonous Substances: FIR/Police Report, Post Mortem Report, Viscera Report, Forensic Lab Report, Death Certificate.
Lightning/Electric Shock: FIR/Police Report, Post Mortem Report, Inquest Panchnama, Spot Panchnama, Death Certificate.
Machinery: FIR/Police Report, Post Mortem Report, Spot Panchnama, Inquest Panchnama, Death Certificate.
Murder: FIR, Spot Panchnama, Inquest Panchnama, Post Mortem Report, Death Certificate, Final Police Report (if needed).
Falling from Heights/Naxalite Murder/Riots: FIR/Police Report, Spot Panchnama, Inquest Panchnama, Post Mortem Report, Death Certificate.
Animal-related Injury (e.g., snake bite): Certificate from a registered medical practitioner. If available: FIR/Police Report, Inquest Panchnama, Post Mortem Report/Forensic Lab Report, Viscera Report, Death Certificate.

Additional Documents for Hospitalisation Claims:

Original consolidated hospital bill with a breakdown of costs.
Original payment receipts for medical expenses.
Corresponding prescriptions.
Certificate from the treating doctor.
Copy of the Medico Legal Case (MLC).
Original detailed discharge summary from the hospital.

Note: Certified or true copies of the FIR and Post Mortem Report are generally accepted, not the originals.

FAQ’s

What financial aid is available for medical treatment under this Gujarat scheme for fishermen?

The scheme provides up to ₹25,000/- to cover medical treatment expenses for eligible fishermen who suffer an injury due to an accident.

Who is considered an 'eligible fisher' for this insurance scheme?

An eligible fisher is someone aged between 18 and 70 years who is directly involved in fishing, fish working, fish farming, or other fisheries-related activities and is approved by the State fisheries department. Importantly, they must not have turned 71 on the date of the accident.

What steps should a fisherman take if they need to claim medical treatment expenses?

First, the accident must be reported to the insurance company within 90 days of it happening. Then, all required documents, including the claim form, medical bills, and accident-specific reports, need to be submitted within 180 days of the accident.

Can I get money for ambulance services under the medical treatment benefit?

No, the scheme's accidental hospitalisation benefit specifically does not cover ambulance charges.

Is there a time limit for the insurance company to pay out a medical claim?

Yes, the insurance company is supposed to settle a complete claim within 15 working days from the date they receive all the necessary documentation. If they delay, they will pay 10% simple interest on the claim amount.

What happens if a fisherman already had a medical condition before the accident?

The scheme's benefits do not cover expenses related to pre-existing physical or mental health issues or illnesses.

What proof of identity and address is acceptable for the claim?

You can use any valid identity and address proof document issued by the Government of India.

What are the key documents needed for a medical treatment claim besides the basic forms?

For a medical treatment claim, you must submit the original consolidated hospital bill with a detailed breakdown, original payment receipts, prescriptions, a certificate from your doctor, a copy of the MLC (Medico Legal Case report), and the detailed hospital discharge summary.

Does the fisherman need to pay any part of the insurance premium?

No, the entire premium cost is covered by the Central and State Governments. The beneficiaries do not need to contribute anything.

Are original hospital bills mandatory for a claim?

Yes, you are required to submit the original consolidated hospital bills and their corresponding payment receipts.

Where can a fisherman register for this scheme?

Fishermen need to register themselves with their concerned district fisheries office to be eligible for the scheme.