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Odisha –Aam Admi Bima Yojana (O-AABY)

Scheme and Operational Manual on

Odisha –Aam Admi Bima Yojana (O-AABY)(A joint initiative of GoI, GoO & LIC)

Odisha Livelihoods Mission-OdishaPanchayati Raj Department

Government of Odisha

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Odisha- Aam Admi Bima Yojana (O-AABY)

Aam Admi Bima Yojana’ is a social security scheme of the Central & State Governments launched on 2nd October 2007, administered by LIC of India for the benefit of landless agricultural laborer’ households . It is a group Insurance Scheme for the age group of 18 -59 years. The members should be head of the family (bread earner) or one earning member in the family of rural landless household who are dependent on agricultural labor as their primary source of livelihood. The Premium to be charged under the Scheme is Rs.200/- per annum per member, of which 50% will be contributed by the Central Government and the remaining by State Government. It is ‘Zero’ cost scheme for the beneficiaries.

Odisha Aam Admi Bima Yojana (O-AABY) has been launched in Odisha by signing an MoU between National Rural Livelihoods Mission-Odisha (now Odisha Livelihoods Mission), Panchayati Raj Department, Government of Odisha and LIC of India on 19 th

December 2011. In the first phase 2,49,267 beneficiaries have been covered those who have worked 100 days under MGNREGA during the year 2010-11, 2011-12 and 2012-13.

1. Benefits

Under the Scheme, all insured beneficiaries would be provided life and disability cover. On death and permanent disability due to accident, the family would get Rs.75,000/- In case of partial disability due to accident, the insurance cover would be Rs.37,500/-. On natural death, the family would get Rs.30,000/-. A free add-on scholarship benefit for the children of the members of O-AABY is provided under this scheme. A scholarship at the rate of Rs.100/- per month will be given to maximum two children studying between 9th to 12th Standard and ITI students. This scholarship, however, is payable half yearly.

NOTE: “Death/Total Permanent Disability due to Accident” shall mean Death/Disability occurring within 180 days of the happening of bodily injury, resulting solely and directly from accident caused by violent, external and visible means, independently of any other cause which have occurred after commencement of the Policy.

However, Death/Total permanent disability due to accident shall not include death/disability:

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Caused by intentional self-injury, suicide, or attempted suicide, insanity or immorality or whilst the member is under influence of intoxicating liquor, drug or narcotic; or

Caused by injuries resulting from riots, civil commotion, rebellion, war (whether war be declared or not), invasion, hunting, mountaineering, steeple chasing or racing of any kind; or

Resulting from member committing any breach of law.In respect of Physically Handicapped Persons the Accidental Cover would be restricted to death and disablement, excluding the existing disablement.

Permanent Total disability Benefit:

Documentary evidence of the accident as also the Medical certificate from the Assistant Civil Surgeon of Govt. Hospital certifying permanent total/partial disability due to accident, stating loss of limbs of the member covered under the scheme is to be submitted.

2. Nodal Agency

The Panchayati Raj Department will implement this scheme and Nataional Rural Livelihoods Mission-Odisha (NRLM-O) will function as the Nodal Agency for such scheme. Nodal Agency will Act for and on behalf of Government of Odisha and the Insured Member in all matters relating to the scheme. 3. Coverage/ Eligibility Criteria of beneficiaries:

The following categories of rural Households are covered under the scheme.

Families who have worked under MG NREGS and completed 100 days in the financial year 2010-11 ,2011-12, 2012-13 have coved under this scheme. ( renewed by SMMU)

Head of the Family or an Earning Member of the eligible households aged between 18 and 59 years.

4. Role of Nodal Agencyi. The Nodal Agency shall furnish to the Corporation all the relevant

particulars of the members as are required for the administration of the scheme such as particulars of new members, death of the insured members and other particulars for verification of eligibility conditions, while settling the claims.

ii. The Nodal Agency shall furnish to the Corporation all the relevant particulars in Soft and/or hard copy as may be called for by the Corporation.

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iii. Enroll the members as per the guidelines of the scheme. iv. Make all the arrangements for the purpose of admission into the

scheme that each member shall make an application in the form prescribed in the Scheme by the Corporation and to adhere to all the specific conditions laid down in the scheme AAM ADMI BIMA YOJANA at the commencement of the scheme and at Annual Renewal Date for new entrants.

v. Arrange payment of State Government share of premium to the Corporation in respect of AAM ADMI BIMA YOJANA.

vi. Make all the arrangements to computerize the data in the software specially developed for this purpose by the Nodal Agency.

vii. Nodal agency shall also submit a summary of the claims with due authentication in the format. The Authentication to be done by an authorized official of Nodal Agency.

viii. The payment in respect of claims admitted by the Corporation will be made in favor of beneficiary/ nominee through NEFT/ECS.

ix. The claims in respect of scholarships along with required forms to be collected by Nodal Agency.

x. Nodal Agency shall submit a summary of the scholarship claims with due authentication in the format. The Authentication to be done by an authorized official of Nodal Agency.

xi. Corporation shall process the scholarship claims.xii. The Scholarship payment shall be made available to the Nodal agency

as per rules. xiii. The data on the Nodal Agency site will be accessible to both the Nodal

agency and the Corporation. Physical papers will be with the BPFTL in case of TRIPTI block and ABDO/ APO, MGNREGS in case of non-TRIPTI blocks.

5. Master PolicyThe Corporation has issued a Single Master Policy bearing number:36000 to the Nodal Agency (NRLM-O). The individual member ID has been issued by LIC India which is accessible in www.tripti.org website.. All members will be provided with a certificate of insurance to be issued by LIC of India. The policy is valid for one year effective from 1st March 2014 to 28th February 2015.

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http://www.tripti.org/


6. Modalities for Implementation

The National Rural Livelihoods Mission-Odisha (NRLM-O) has set up different procedures at different levels for smooth implementation of the programme.

i. State Level: a. At state level the Mission Director, NRLM/State Project Director, TRIPTI will the

sole authority for implementation of the scheme in the state.b. Members data to be furnished to LIC in soft copy in the prescribed format.c. State will receive information on death of the insured through block nodal

agency to facilitate required action.d. Will submit the claims within one month of death / accident/ disability with

due authentication in the format by the BPFTL in case of TRIPTI block and APO of MGNREGS or ABDO in case of Non- TRIPTI blocks or any authorized person

e. The summary of scholarships along with required document to be submitted to LIC once in six months i.e. in the month of June and December.

f. Shall furnish to the Corporation all the relevant particulars in Soft and/or hard copy as may be called for by the Corporation.

g. There will be tie up with the Sanjog helpline for a toll free no. for grievance handling, which is already being used for different schemes of Panchayati Raj Department.

ii. District Level a. District Collector shall be sole authority for implementation of the scheme in

their respective district.b. The District Project Managers (DPM) in TRIPTI district and the APD, Credit in

other districts will be nominated as anchor persons for O-AABY in the districtc. The district will earmark as two persons who will work as Master trainers and

have been trained at SMMU, NRLM-O d. Organizing district level sensitization cum training program for field

functionaries e. Ensuring and Monitoring of data collection in hard copy and soft copy from

each block and submission of required information to SMMU NRLM-O5


f. They will also ensure data collection of scholarship forms and monitor receipts of scholarship.

g. Monitoring of the claims and redressed of grievance if any and required follow up will be done by officers

iii. Block Levela. In case of 38 TRIPTI operated blocks the Block Project Facilitation Team Leader

(BPFTL) of TRIPTI project will be the coordinating person for AABY scheme implementation. In other blocks, the ABDO or APO of MGNREGS or any other authorized person posted in blocks will be the nodal person.

b. Nodal person shall be responsible for facilitating collection of relevant data/ information including scholarship applications along with the claim forms from the beneficiaries and data entry into excel form prescribed by SMMU or AABY software (if provided) and submit the soft copy to SMMU through district nodal agency.

c. Distribution of certificate of insurance to the families insured.d. In TRIPTI blocks the BPFTL and in non-TRIPTI blocks the ABDO/ APO, MGNREGS

or any authorized person will be the authorized to authenticate in the claim forms of beneficiaries.

e. Ensuring opening bank accounts those who have no accounts yet in Nationalized bank or RRBs for remitting of scholarship and claims if any in futures.

f. Also monitor the receipt of scholarship amounts by the beneficiaries. iv. At Village/Ground Level

a. CCs in TRIPTI blocks and the MGNREGA Gram Rojgar Sahayak (GRS) in other blocks will be engaged for collection of beneficiary related data, application form, students scholarship forms, claim forms etc.

b. Collection of School/College certificates in respect of the 9th to 12th

class/vocational ITI children belonging to the families insured.c. Documentation for filing claim within 15 days of the incident of death /

accident.7. Claim Settlement

A. Death/ Accidents/ Disabilities

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BPFTL and ABDO will facilitate collection of claim forms along with required documents by CC / GRS within one month of death/ accident/ disability.

Entry of these data at block level and forwarding the claim forms to the state office of Nodal Agency within seven days of receiving claims from field.

State Office will verify whether the documents are proper and forward to LIC, Bhubaneswar within seven days of receiving the claims from block.

LIC will process the claims and inform the requirement if any within seven days and balance cases will be settled within 15 days.

Claim will be credited directly to the bank account of beneficiary/ nominee through NEFT/ECS.

B. Scholarship Claim The CC and GRS will help the member of AAM ADMI BIMA YOJANA whose

child is eligible for scholarship and shall fill up an application form as per PROFORMA (A-I) and submit it to the Nodal Agency.

A list of beneficiary students has to be submitted to the P&GS unit for disbursement of scholarship by the Nodal Agency with full details such as, Name of the Student, School’s Name, class, Member’s Name, members’ LIC id, Master Policy no., Membership no. bank account number, Bank and branch name, IFSC code as per PROFORMA (A-II).

The scholarship will be paid once in six months i.e. in the month of January and July through the Bank account of either the students or to the member.The scholarship will be remitted directly from LIC to the accounts by electronic mode (NEFT/ ECS). Therefore all beneficiaries who is eligible to get scholarship they (either in member’s bank account or students accounts) must have a CBS account preferable in any nationalized bank or RRBs.

8. Procedures for data collection and settlement of claims

(i). Basic Data collection procedures

The following data with LIC ID is already registered in the database of LIC and O-AABY which has been exacted from MGNREGA website to cover upfront under O-AABY.

Sl No

LIC member Id

MGNREGA Members Id

Members Name

Sex

Father/Husband Name

F/H

DOB

DOJ in O-AABY

Village

Block

District

State

Caste

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176881

197489

OR-01-023-001-001/12449

BEDABYASH NAYAK M

NITYANAND NAYAK F

3/1/1977

3/1/2012

BABUNIKTIMAL

BAMRA

SAMBALPUR

ORISSA ST

176882

197490

OR-01-023-001-001/12453

KARTIK NAYAK M

DASHRATHI NAYAK F

3/1/1977

3/1/2012

BABUNIKTIMAL

BAMRA

SAMBALPUR

ORISSA ST

176883

197491

OR-01-023-001-001/12456

MAHESWAR NAYAK M

DASHRATHI NAYAK F

3/1/1975

3/1/2012

BABUNIKTIMAL

BAMRA

SAMBALPUR

ORISSA ST

Further LIC of India and Nodal agency NRLM-O require the collection of data as Nominee’s name, relation with nominee, age of the nominee , (if the nominee is minor )No children studying in 9th-12th std or in ITI and signature of insured member from field itself in the following prescribed formats (example)and the soft copy of the collected data will be prepared in Excel form or O-AABY software (If provided in future) by block nodal team to be submitted to SMMU NRLM-O in E-mail Id: [email protected]. The hard copy will be retained at Block office. For Example from Malkangiri : As format given below, from column no (1) to (7) is already provided and rest from Cl (8) to (12) need to be collected from field.

LIFE INSURANCE CORPORATION OF INDIAP & GS UNIT, BHUBANESWAR. ODISHA AAM ADMI BIMA YOJANA

MASTER POLICY NO.36000 (effective date from 1st March 2012)Data collection sheet

District: Malkangiri Name of the Nodal Block:

Sl No

LIC Membership Id

MGNREGA Members No

Members Name

Village Block Address

Nominees Name

Relation

Nominees age

No of children studing in 9th- 12th /ITI std

Member's Signature

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12)

106016

126624

OR-31-010-001-004/8747

KABASI ULA

JABANPALLI

KALIMELA

TELERAI, Kalimela, MALKANGIRI, ORISSA

106017

126625

OR-31-010-001-004/8803

PODIA KAWASI

JABANPALLI

KALIMELA

TELERAI, Kalimela, MALKANGIRI, ORISSA

(ii) Collection of data for Scholarship a. The following format on PROFORMA A-1 is to be collected from the member

with all particulars signed by insured member, duly countersigned by authorized signatory of the School/institution and nodal agency. The original

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hard copy is to be sent to SMMU, NRLM-O and a photocopy will be retained at Block nodal office.

b. The following PROFORMA A-II , which is the consolidated statement of scholarship application is to submitted in soft copy in Excel form to SMMU for onward transmission to LIC for release of scholarships.

(iii)Claim settlement process (death)

Settlement of Claims

In the event of death of the Insured Member whilst being covered under the scheme, the benefits under the Assurance on his life will be paid to the Nominee (through NEFT/ECS) on receipt of claim papers along with the requirements to the satisfaction of LIC. The Corporation reserves the right to cause an investigation be made into the genuineness of any claim preferred or disbursement effected.

The settlement of Death Claims would be subject to the Nodal Agency submitting to the Corporation claim-cum-discharge form (Annexure V) with LIC id and copy of the Death Registration Certificate and age proof.

In accidental death benefit claim cases the following additional requirements to the satisfaction of the Corporation will have to be submitted in addition to Death Registration Certificate.

a. Copy of FIR

b. Post Mortem Report

c. Police Inquest Report (panchanama)

In case of claims due to snake bite and wild animals, following additional requirements are called for:

Medical Certificate given by Assistant Civil Surgeon Police Inquest Report (panchanama)

CLAIM SETTLEMENT PROCESS CHART

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NODAL AGENCY [OPRM]

LIC, Bhubane

swar

VILLAGE

CRP/GRS

BLOCK [BPFTL/

APO-ABDO

DISTRICT

[DPM/ APD -

Credit]

INSURED

Forwarding physical

claim forms

Soft copies of Claims

Collection of claim forms

Credit claim to the

beneficiary’s / Nominee’s A/c –

15 Days

Sending requirements in

soft files

Forwarding Claims


LIFE INSURANCE CORPORATION OF INDIA

CENTRAL OFFICE,MUMBAI PROFORMA A-I

Odisha -AAM ADMI BIMA YOJANA (O-AABY) POLICY NO. AABY 36000

APPLICATION FOR SCHOLARSHIP UNDER O-AABY (SHIKSHA SAHAYOG YOJANA )

1. TO BE FILLED IN BY THE MEMBERA) NAME OF THE MEMBER UNDER ODISHA AAM ADMI BIMA YOJANA (O-AABY)-

B) MGNREGA MEMBERSHIP NO.-C) LIC membership ID-D) ADDRESS-E) NAME OF THE STUDENT- F) WHETHER SON OR DAUGHTER-G) NAME AND PLACE OF THE SCHOOL/INSTITUTION-H) DATE OF BIRTH OF STUDENT-I) STD/CLASS: ACADEMIC YEAR: 2012-13J) MEMBER/STUDENT’S BANK ACCOUNT NO:

(CBS account is preferable for online transfer. Please attach a Xerox copy of bank passbook where bank account number must be visible clearly)

K) Bank and Branch Name :L) Bank branch code……………………………………….Bank IFSC Name………………………………………………..M) I HEREBY DECLARE THAT I AM FULLY MADE TO UNDERSTAND THAT THE SCHOLARSHIP BENEFIT UNDER SHIKSHA

SAHAYOG YOJANA IS RESTRICTED TO MAXIMUM OF TWO CHILDREN OFA FAMILY AND IS PAYABLE TO STUDENTS STUDYING IN IXTH TO XIITH (INCLUDING ITI COURSES). I HEREBY DECLARE THAT MY CHILD HAS NOT FAILED IN LAST ACADEMIC YEAR.

_________________________________

(SIGNATURE OF THE MEMBER)

2. TO BE FILLED IN BY THE SCHOOL/INSTITUTIONCERTIFIED THAT THE ABOVE PARTICULARS OF THE CHILD ARE TRUE AND CORRECT AS PER SCHOOL/INSTITUTION’S RECORDS.

______________________________________

(COUNTER SIGNED BY THE

AUTHORISED SIGNATORY OF THE

SCHOOL/INSTITUTION UNDER SEAL)

3. TO BE FILLED BY THE NODAL AGENCY

a. NAME OF THE NODAL AGENCY: NRLM-Odisha

b. DATE OF COMMENCEMENT OF THE SCHEME: 1 ST March 2012

WE HEREBY UNDERTAKE TO PASS ON THE BENEFIT OF SCHOLARSHIP AVAILABEL UNDER THE SHIKSHA SAHAYOG YOJANA TO THE ABOVE NAMED BENEFICIARY

__________________________SEAL and SIGNATURE OF THE AUTHORISED NODAL OFFICER OF THE BLOCK)

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P&GS DEPARTMENT, CENTRAL OFFICE, MUMBAI PROFORMA A-II

(To be submitted in Soft copy in Excel form)

MASTER POLICY NO.-(AABY) 36000

LIST OF STUDENTS ELIGIBLE FOR SCHOLARSHIP UNDER O-AABY SHIKSHA SAHAYOG YOJAN (TO BE SUBMITTED BY NODAL AGENCY TO P&GS UNIT)

SR NO.

NAME OF THE STUDENTS INSTITUTION’S/

SCHOOL’S NAME

CLASS IN WHICH STUDYING

DoB of student

MEMBER’S

NAME

LIC-AABY MEMBERSHIP

ID NUMBER

BANK A/C NO

BANK NAME BANK BRANCH NAME

Bank IFSC NO

For the year 2012-13

1 (June 12)

2 (June 12)

3 (June 12)

4 (June 12)

5 (June 12)

6 (June 12)

7 (June 12)

8 (June 12)

9 (June 12)

10 (June 12)

DATE SEAL AND SIGNATURE OF AUTHORISED OFFICIAL OF NODAL AGENCY

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ANNEXURE-V


CENTRAL OFFICE, MUMBAI

GROUP INSURANCE SCHEME UNDER AABY

Master .Policy .NO.36000

CLAIM FORM

PART A: (To be completed by the beneficiary)

1) Name and Address of the deceased Member

2) Name and Address of Nodal Agency :

3) Membership No. :

4) Date of Entry into the Scheme : 1st March 2012

5) Name of Father/Husband :

6) a) Date of death (b) Age at death

7) b) Place of death (b) Cause of death

8) Name of Nominee :

9) Full address of nominee :

10) Relationship with member :

11) Name and Address of Bank and Savings Bank .A/c No.:

I hereby declare that the answers to all the above questions are true in every respect.

(Signature of beneficiary)

Witness : (Signature)

Name : _____________________________ Place :

Address : _____________________________ Date :

PART B : (To be completed by the Nodal Agency)

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Certified that the replies to the above questions are correct in every respect. Nominee named above is registered in the Register of Nominations at serial no.__________________

Signature of Authorised Signatory of

SEAL the Nodal Agency/Master Policy hold

PART C

DISCHARGE RECEIPT

We_________________________________________________________hereby acknowledge receipt from Life Insurance Corporation of India a sum of Rs._______________(Rupees ___________________) in full and final satisfaction and discharge of all our claims under the above master policy on the life of member____________________________.

Dated at ________________this __________________day of _____________________20

Revenue Stamp

SEAL Signature of Authorised Official of the

Nodal Agency/Master Policy holder

PART-D

Please send the claim amount by cheque to the credit of Savings Bank A/c No.____________held by the beneficiary with ________________________________________ (Name and address of the Bank)

SEAL and Signature of Authorized Official of the

Nodal Agency/Master Policy holder

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For any further clarification, the contact persons are 1. Sri Subrata Kumar Biswal, MFS, TRIPTI/NRLM cell no-94392268392. Sri Subrata Kumar Pradhan, PE-FM OLM Cell No: 94382904003. Sri Ashis Vikram , YP-MF: 90407104114. Sri AK Sahoo, Sr Div Manager , Cell No: 94374630405. Sri Sushil Ku Mohanty, Nodal office LIC (O-AABY) cell no: 9437287547Contact address : TRIPTI/ Odisha Livelihoods Mission, SIRD Campus, Unit-VIIIBhubaneswar-751012. Odisha, Tel:91-674-2560166/126,

Email ID: [email protected] / [email protected]

Website : www.tripti.org

***All the Best ***

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tel:91-674-2560166/126


Odisha Livelihoods Mission-OdishaSIRD Campus,Unit-VIII,Bhubaneswar,Odisha

Ph.:0674-2560166/126, Fax: 0674 -2563966Email ID: [email protected]/[email protected]

e-mail: www.tripti.org

LIC of India

(Pension and Group Insurance Scheme Unit),756,1st Floor, Saheed Nagar, Bhubaneswar-751007,

Ph: 0674-2544040/2544240, Email ID: [email protected].

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