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Group Accident Insurance Scheme under PMMSY: Medical Treatment - Gujarat

The scheme aims to provide financial assistance to fishermen/fishermen's families in case of death or injury. Through this scheme, insurance coverage for Medical Treatment is provided to eligible fishers.

Authority

State/ UT

Region

Gujarat

Status

Verified 2026

Updated

March 2026

What you get

Sr. No.Name of ComponentStandard of assistance1. Medical Treatment₹25,000/- | Mode of Disbursement: | - The claim amount is deposited directly into the claimant's, nominee's, or legal heir's savings account via Direct Bank Transfer (DBT). | Expected Time of Disbursement: | - The insurance company will settle the claim within 15 working days of receiving the complete claim documentation. If a claim is not settled within this period, the insurance company will pay a simple interest of 10% on the admissible claim amount from the date of document submission until the payment date.

Who can apply

The applicant must be a fisher, which includes fishermen, fish workers, fish farmers, and any other person directly involved in fishing or fisheries-related activities.; The applicant must be between 18 and 70 years old.; The insured person should not have been 71 years of age on the date of the accident.; The applicant must be approved by the State/Union Territory (UT) fisheries department.; At the time of a claim, the claimant or insured fisher must be verified and certified by an "Appropriate Authority".; The applicant should have registered himself in the concerned district office.

Required Paperwork

  • Aadhaar Card
  • PAN Card
  • Income Certificate
  • Residence Proof (Domicile)

Common Questions

What is the Medical Treatment benefit under the Group Accident Insurance Scheme (GAIS)?

The Medical Treatment benefit provides financial assistance for the medical expenses of a fisher who is injured in an accident.

What does the medical treatment benefit cover?

The benefit covers costs for medical treatment and hospitalisation resulting from an accident, including the cost of medicines, diagnostic tests, doctor's fees, and hospital charges.

Who is eligible to claim the medical treatment benefit?

Any fisher between the ages of 18 and 70, who is registered under the scheme, is eligible for this benefit. The insured person must not have completed 71 years of age on the date of the accident.

How is a claim for medical treatment initiated?

The claim must be intimated to the insurance company within 90 days from the date of the accident.

What documents are required to file a claim for medical treatment?

You will need the Intimation Form, Claim Form, a cancelled cheque or bank passbook copy, Certification by the Appropriate Authority, and a government-issued ID. Additionally, you will need accident-specific documents.

What additional documents are specifically required for a medical treatment claim?

You must provide the original consolidated hospital bill with a breakup of each item, original payment receipts, corresponding prescriptions, the treating doctor's certificate, a copy of the Medico Legal Certificate (MLC), and the original detailed discharge summary.

Do I need to submit the original hospital bills?

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

How long do I have to submit all the claim documents?

All claim documents for medical treatment must be submitted within 180 days of the accident.

Is there a timeframe for the insurance company to settle a medical treatment claim?

Yes, the insurance company will settle the claim within 15 working days of receiving all complete documentation.

Are ambulance charges covered under this benefit?

No, ambulance charges are not covered under the accidental hospitalisation claim.

Does the medical treatment benefit cover pre-existing diseases?

No, the policy does not cover expenses for pre-existing physical or mental defects or illnesses.