PMJJBY Claim Application Form

PMJJBY Claim Application Form PDF

This is an Application form for the PMJJBY Claim form issued by the Central Government and this form can be downloaded from the official website i.e. http://jansuraksha.gov.in/, or it can be directly downloaded from the link given below.

Steps to be taken by the Nominee

1. Nominee to approach the bank wherein the member was having the ‘savings bank account’ through which he/she was covered under PMJJBY, along with the death certificate of the member.
2. Nominee to collect claim form, and discharge receipt, from the bank or any other designated source like insurance company branches, hospitals, insurance agents etc., including from designated websites.
3. Nominee to submit duly completed claim form, discharge receipt, death certificate along with a photocopy of the canceled cheque of the nominee’s bank account(if available) or the bank account details to the bank wherein the member was having the ‘savings bank account’ through which he/she was covered under PMJJBY.

Steps to be taken by the Bank

• Upon receipt of death intimation, the Bank 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 on Annual Renewal Date, i.e. 1st of June, prior to the Member’s death was deducted and remitted to the Insurance Company concerned.
• Bank to verify the claim form & the nominee details from the records available to them and to fill in the relevant columns of the claim form.
• Bank to submit the following documents to the designated office of the insurance company concerned:
  • Claim Form duly completed
  • Death certificate
  • Discharge Receipt
  • Photocopy of canceled cheque of the Nominee (if available).
• 4. The maximum time limit for the bank to forward the duly completed claim form to the insurance company is thirty days from the submission of the claim to it.

Steps to be taken at the designated office of the Insurance Company

1. Verify that the Claim form is complete in all respects and all the relevant documents have been attached. If not, take up with the Bank concerned.
2. If the claim is admissible, the designated office of the insurer shall check whether the member’s coverage is in force and no death claim settlement has been effected for the member through any other account. In case any claim has been settled, then the nominee shall be intimated accordingly with a copy marked to the bank.
3. In case the coverage was in force and no claim has been settled for the said member, payment shall be released to the nominee’s bank account and communication shall be sent to the nominee with a copy marked to the bank.
4.  The maximum time limit for the insurance company to approve the claim and disburse the money is thirty days from the receipt of the claim from the bank.

In the case where the claim form is directly submitted to any office of the insurer by the claimant, then the insurer’s office would forward the same to the concerned bank of the deceased account holder immediately to get necessary verification, etc. done from the bank concerned. The concerned bank branch will forward the claim form to the designated office of the insurance company for processing the claim.

Download the PMJJBY Claim Application Form in PDF format using the link given below.

Also, Check PMJJBY Claim Form in Different Languages

• PMJJBY Claim Form in Hindi
• PMJJBY Claim Form in Bengali
• PMJJBY Claim Form in Telugu
• PMJJBY Claim Form in Tamil
• PMJJBY Claim Form in Kannada
• PMJJBY Claim Form in Malayalam

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