Bank of Baroda Pradhan Mantri Suraksha Bima Yojana(PMSBY) Form Download

Based on the provided document, here are the key points for the Bank of Baroda Pradhan Mantri Suraksha Bima Yojana (PMSBY) Consent-cum-Declaration Form (pp. 1, 5):

• Accidental Death & Total Disability: A claim of ₹2,00,000 (Two Lakh Rupees) is payable in the event of accidental death or permanent total disability (pp. 1, 5).
• Permanent Partial Disability: A claim of ₹1,00,000 (One Lakh Rupees) is payable for permanent partial disability resulting from an accident (pp. 1, 5).
• Disability Definitions: Total disability includes the loss of both eyes, both hands/feet, or one eye and one hand/foot (pp. 2, 5). Partial disability covers the loss of one eye, hand, or foot (pp. 2, 5).
• Risk Commencement: Your insurance coverage officially begins on the exact date the premium is auto-debited from your bank account (pp. 2, 5).

• Annual Premium: The scheme costs a fixed premium of ₹20 per year (pp. 1, 5).
• Auto-Debit Window: The premium is automatically deducted from your linked bank account every year between 25th May and 1st June for continuous renewal (pp. 1, 5).

• Single Account Rule: You must declare that you have not authorized any other bank or post office to deduct a PMSBY premium for your profile (pp. 1, 5).
• Forfeiture Clause: In case of multiple enrollments across different banks, your total insurance cover remains restricted to ₹2 Lakh, and any extra premiums paid across other accounts will be permanently forfeited (pp. 1, 5).

• Valid KYC Documents: You must attach a copy of one officially recognized identity proof from this list: Aadhaar Card, Voter ID (EPIC), MGNREGA Job Card, Driving License, PAN Card, or Passport (pp. 3, 6).
• Nominee & Guardian Details: The form requires the nominee’s name, relationship, and contact data (pp. 2, 6). If the chosen nominee is a minor, you must designate a legal guardian or appointee (pp. 2, 6).

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