Objectives of Scheme

Objectives of Scheme

This “Mukhyamantri Ayushman Accident Insurance Scheme” (MCDBY) is launched with the objective of providing insurance cover to all the families insured under the health schemes run by the state government - Mukhyamantri Ayushman Swasthya Bima Yojana and Rajasthan Government Health Scheme, in case of accidents mentioned in the scheme. Under this scheme, free accident insurance cover up to Rs 10 lakh will be provided to the insured family. In case of death of the insured family member in an accident or permanent total loss of hands, legs or eyes due to the accident. According to the rules of this scheme, financial support will be provided to the insured family.

Eligibility

• Eligible family members insured under Chief Minister Ayushman Health Insurance Scheme
• Families registered under RGHS
• Electricians who were born before January 1, 2004

When will the benefits be payable under the scheme

1. Death/damage caused by road accident, train accident and air accident
2. Death/damage caused by the insured falling from height or falling of any object from height.
3. Death/damage due to house collapse
4. Death/damage caused by electric shock
5. Death/damage caused by spraying of chemical substances
6. Death/damage due to drowning
7. Death/damage caused by burning

Benefits payable to the family under the scheme

Sl. No.	Type of damage caused by accident	Accident benefit
1.	Death of a family member in an accident	5 lakh rupees
2.	If more than one member of the family dies in an accident	10 lakh rupees
3.	In case of complete loss of both hands or both legs or both eyes or one hand and one leg or one hand and one eye or one leg and one eye in an accident (in case of separation/complete non-functioning of these organs).	3 lakh rupees
4.	In case of complete loss of one hand/leg/eye in an accident (in case of separation/complete disability)	1.5 lakh rupees

Important points regarding the plan

1. The scheme will be operated through the State Insurance and Provident Fund Department.
2. Since this scheme is linked to Jan Aadhar card, only the head of the family mentioned in the Jan Aadhar card will be considered as the head of the insured family.
3. Under this scheme, in case of accidental death/permanent total disability of any member of the insured family, the amount will be paid as per rules into the bank account of the head of the family which is linked to Jan Aadhaar.

Documents required to be uploaded along with online claim form for claim

Category	Type of accident	Death	Damage
1	1. Road accident, train accident and air accident 2. Due to fall of the insured from height and fall of any object from height. 3. Reasons for house collapse	1. Death certificate 2. At least one of the following documents-   (i) Post mortem report   (ii) FIR/Journal/Marg Report   (iii) Panchnama   (iv) Death summary by hospital	1. Hospital report 2. FIR/Journal (if filed) 3. Diagnostic Report 4. Certificate of permanent total disability issued by the Medical Board
2	1. Due to electric shock 2. Due to spraying of chemicals	1. Death certificate 2. At least one of the following documents-    (i) Post mortem report    (ii) Death summary issued by the hospital 3. FIR 4. Details of treatment if admitted to hospital.	1. Hospital report 2. Diagnostic Report 3. Certificate of permanent total disability issued by the Medical Board
3	1. Cause of drowning 2. In case of burning	1. Death certificate 2. FIR 3. Post mortem report 4. FR	1. Hospital report 2. FIR/Journal 3. FR 4. Diagnostic Report 5. Certificate of permanent total disability issued by the Medical Board

Process of claim settlement under the scheme

1. In case of death of any member of the family in an accident or permanent total damage mentioned in the plan due to the accident, the claim form will be filled on the online portal by any adult member of the insured family.
2. It will be mandatory to submit the claim within a period of 60 days from the date of accident (date of death in case of death).
3. The claim form can be completed within a period of 90 days from the date of accident/death by mentioning the appropriate reasons for the delay.
4. A message regarding acceptance/rejection and objection will be sent to the claimant's mobile number.

Arrangement for hearing appeals

Online appeals can be submitted to the Director, State Insurance and Provident Fund Department within a period of 30 days from the date of disposal of the claim.