A PMJJBY or PMSBY claim that has been rejected or is stuck can still be fixed or appealed. Both schemes are run through your bank or post office, so you file the claim at the subscriber's home branch, then escalate up a ladder if the bank or insurer sits on it. This guide shows a nominee how to file correctly, why claims fail, and how to push a delayed claim through to payment.
PMJJBY (Pradhan Mantri Jeevan Jyoti Bima Yojana) is a life-cover scheme. PMSBY (Pradhan Mantri Suraksha Bima Yojana) is an accident-cover scheme. Many people hold both, since the yearly premium for each is tiny and is auto-debited from the same bank account. Here is how they compare.
| Point | PMJJBY (life) | PMSBY (accident) |
|---|---|---|
| What it covers | Death due to any cause | Death or disability due to accident only |
| Sum assured | ₹2 lakh on death | ₹2 lakh accidental death or full disability; ₹1 lakh partial disability |
| Annual premium | ₹436 per year, auto-debited | ₹20 per year, auto-debited |
| Age to join | 18 to 50 years | 18 to 70 years |
| Cover year | 1 June to 31 May, renews yearly | 1 June to 31 May, renews yearly |
| Who claims | Nominee, or legal heir if no nominee | Nominee or legal heir on death; the subscriber on disability |
The premium amounts above were revised with effect from 1 June 2022. Always check the current figure on jansuraksha.gov.in before you rely on it, because the government reviews it based on claims experience.
Both are government micro-insurance schemes launched in 2015 and run through banks and post offices. Your bank is the “master policy holder”; the actual insurer is LIC or another life company for PMJJBY, and a public-sector or other general insurer for PMSBY. You do not deal with the insurer directly at the start. You enrol, pay, and claim through the bank branch where your savings account sits.
There is no single Act section that governs a PMJJBY or PMSBY claim. These schemes run on their published Rules and FAQs on jansuraksha.gov.in, plus your insurer's group policy and the general insurance grievance framework set by IRDAI. So do not trust any article that quotes a fancy “section number” for these schemes. The real, checkable rules are:
Public-sector banks and India Post are public authorities under the RTI Act, 2005. So if the bank sits on your claim or will not tell you why the auto-debit lapsed, you can file an RTI request to the bank's Public Information Officer and ask for the status, the file notings, and the reason for delay.
For help drafting any covering letter or an RTI to the bank, the AI RTI Drafter can build a clean request in minutes.
Most rejections are avoidable. The common reasons are:
If the bank or insurer rejects the claim or sits on it, climb this ladder in order. Keep every acknowledgement.
For a full walk-through of the IRDAI and Ombudsman route, see How to file an insurance complaint. If your RTI to the bank gets no reply in 30 days, the First Appeal Builder helps you file the next step.
Worked example: a nominee's ₹2 lakh PMJJBY claim, first rejected, then paid
Dr. Shrawan Kumar Pathak of Patna held a PMJJBY policy through his savings account, with ₹436 auto-debited every May. He died of a heart attack. His daughter and nominee, Kashvi Pathak, took his death certificate to his home branch and filed the claim.
The branch first said the claim “could not be processed” because that year's premium had not been debited on time. Kashvi did not stop there. She asked the branch, in writing, for the exact reason, and filed an RTI request with the bank's Public Information Officer for the account statement and the auto-debit record.
The record showed the ₹436 had in fact been debited on the due date; a system error had flagged it as unpaid. With that proof, Kashvi escalated to the bank's nodal officer and the insurer's grievance cell. The ₹2 lakh was paid into her account. The lesson: get the written reason, check the auto-debit record, and climb the ladder.
If the premium was genuinely not paid on the due date and the balance was short, the cover lapses and the claim usually fails. But first check the bank statement. Auto-debit records sometimes show a system error, not a real non-payment. If the money was actually debited, use that proof, and an RTI to the bank, to reopen the claim.
The person named as nominee on the enrolment form files the claim. If the subscriber did not name a nominee, the legal heir can claim. The money is paid into the nominee's or legal heir's bank account.
File as soon as you can. The scheme expects prompt reporting, and long delays are a common reason claims are held up or refused. For the current claim-form timelines, check the PMSBY claim form on jansuraksha.gov.in and confirm with your bank branch.
No. PMSBY pays only for death or disability caused by an accident. Death from illness is not covered, and death by suicide is not covered. Death by murder is covered. For death by any cause, including illness, the life-cover scheme PMJJBY is the one that pays.
Because public-sector banks and India Post are public authorities under the RTI Act, 2005, you can file an RTI request to the bank's Public Information Officer for the claim status and the reason for delay. In parallel, escalate to the bank's nodal officer, then the insurer's grievance cell, then IRDAI Bima Bharosa.
Register the complaint on the IRDAI grievance portal, Bima Bharosa, at bimabharosa.irdai.gov.in. If it is not resolved in about 15 days or the reply is unsatisfactory, approach the Insurance Ombudsman under the Insurance Ombudsman Rules, 2017. Both routes are free.