SANJEEVANI SWASTHYA BIMA YOJANA

The Administration of Union Territory of Dadra Nagar Haveli and Daman & Diu have launched a comprehensive health insurance scheme known as “Sanjeevani Swasthya Bima Yojana” for the resident citizen of Dadra Nagar Haveli and Daman & Diu. The insurance coverage is provided by a Public Sector General Insurance Company – The New India Insurance Co. Ltd and claims services will be provided by Health India Insurance TPA Services Pvt. Ltd (Third Party Administrator).

The premium amount for BPL families will be borne by the UT Administration. The premium amount for Domicile families whose family income is between 1 lakh to 2 lakh –per annum 50% of the premium would be borne by the UT Administration and rest 50% of the premiums have to bear by their own. However, other resident families (APL families) have to bear the premium on their own.

The following category of beneficiaries are identified in the scheme:

1. Absolute Poor Family – BPL as per Government Census
2. Domicile Families whose family income below 1 lakh – per annum
3. Domicile Families whose family income is between 1-2 lakh – per annum.
4. Beneficiaries of Saraswati Vidya Yojana.
5. Any other resident families.

New Enrollment
Family Size 1 2 3 4 5
Premium 1070.65 1070.65 1070.65 1070.65 1070.65
PA policy premium 11.50 23.00 34.50 46.00 57.50
Smart Card Fees 23 23 23 23 23
Total 1105.15 1116.65 1128.15 1139.65 1151.15
Documents Required for Enrollment

• BPL Families – BPL Ration Card Only.

• Domicile Families with annual income is below Rs. 1 lakh - Income Certificate issued by respective Mamlatdar (not more than 1 year old), Domicile certificate and Aadhaar Card.

• Domicile Families whose family income is between 1-2 lakh – per annum – Income Certificate issued by respective Mamlatdar (not more than 1 year old), Domicile certificate and Aadhaar Card.

• APL Families- Resident proof only. ( Ration card / Adhar Card / Bank Pass book / Driving License / Employment Letter etc.)
For employees of industries: employee certificate from respective industries.


Coverage

Health Insurance:
Beneficiaries would have a sum assured of 3 lakh on floater basis for unit of enrollment which consists of a family of 5 people. Beneficiary will have to hospitalize at network hospitals only where patients have to produce their smart card and will have to put their thumb impression to validate the identity. Hospital will fill the treatment details and code of package which will be paid directly to the hospital as per package charges.

Personal Accident:
Death Insurance which will include Accidental Death Benefit as under, Insurance amount will be Rs. 1, 00,000/- per individual.

Disability Insurance :
(a) Permanent Total Disability due to accident – Rs. 1, 00,000/- per individual.
(b) Loss of One Eye or One Limb or One Hand in an accident – Rs.50,000/- per individual. This amount is not included in the Rs.3, 00,000/- slab mentioned in the total sum assured for Health insurance and will not be on floater basis.


Renewal
Family Size 1 2 3 4 5
Premium 1070.65 1070.65 1070.65 1070.65 31070.65
PA policy premium 11.50 23.00 34.50 46.00 57.50
Total 1082.15 1093.65 1105.15 1116.65 1128.15