GPAIS Nomination Form

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GPAIS Nomination Form

Group Personal Accidental Insurance Scheme (GPAIS) is personal accident insurance which will be deducted from the November 2022 salary for of one year with effect from 01.01.2023. An annual one-time premium of Rs. 850+GST for employees of KSEB, Rs. 600+GST for employees of KSRTC and Rs. 500 for State Government employees and employees of Aided Institutions, Universities, Co-operative Institutions, Autonomous Bodies, and all other Public Sector Undertakings.

All DDOs authenticated to draw and disburse the salary of employees should deduct the premium from the salary of all categories of employees included in the scheme for the month of November 2022 payable in December 2022.

GPAIS Nomination Form – Details to be Mentioned

Employees have to fill out the GPAISE Nomination form for that accidental insurance. In this form employees have the following details

  • Name of the Employee
  • Designation
  • Office
  • Name of Nominee
  • Age of Nominee
  • Address of Nominee
  • Relationship with the member
  • Proportion of benefits to be given
  • Contingency under which the nomination becomes ineffective
  • Person whom the amount is to be given if the nominee is a minor

You can download the GPAIS Nomination Form PDF using the link given below.

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