LIC’s Jeevan Arogya is a unique non-participating non-linked plan. This provides complete health care protection for your entire family against certain specified health risks. Provides with timely support in case of medical emergencies. And helps you remain financially independent during difficult times.
What are the highlights of this policy?
It provides valuable financial protection in case of hospitalization or surgery etc.
- Lump sum benefit irrespective of actual medical costs.
- Increasing health cover every year.
- Flexible benefit limit to choose from.
- No claim benefits.
- Flexible premium payment options.
LIC Jeevan Arogya plan is very easy to choose. We can work out and provide the premium payable for taking this policy.
How does this work?
You can choose the amount of Initial daily benefit. As per you need from out of the following choices per day:
- INR 1,000/-
- INR 2,000/-
- INR 3,000/-
- INR 4,000/-
This amount is paid to you on hospitalization in the first year on a daily basis. In case of surgery, the cover would be 100 times the Initial Daily benefit which you choose.
On the basis of the selection for an initial daily benefit. The major surgical benefit sum assured would be INR 1 Lakh, 2 Lakh, 3 Lakh, 4 Lakh respectively. Also, the benefits such as Day Care Procedure Benefit, Other Surgical Benefit and Premium waiver benefit (PWB) shall be payable.
How will the premium be decided? Firstly this depends on your age and gender. Secondly, the health cover option you choose. And whether you are principal insured or other insured life and payment modes.
Who can be insured and covered under the Jeevan Arogya plan?
You being the principal insured. This policy can provide protection to your spouse and children. It also covers for you and your spouse parents.
The below table shows the age limits under this policy:
| Details | Min. Entry Age | Max. Entry Age |
|---|---|---|
| Self/Spouse | 18 Years | 65 Years |
| Parents/ In- Laws | 18 Years | 75 Years |
| Children | 91 Days | 17 Years |
All the adults are covered for health risks to a max. age of 80 years. For children the insurance is up to age of 25 years.
Let us look at the benefits offered in Jeevan Arogya Health Insurance Policy
Hospital Cash Benefit (HCB)
Here the hospitalization should occur within India. The policy holder can choose the initial daily benefit with the minimum INR 1,000 and maximum being INR 4,000.
You are eligible to receive the HCB on hospitalization for 24 hours.
For each and every insured, the maximum life time limit for HCB is 720 days.
Out of this, the limit to be in an Intensive Care Unit (ICU) is 360 days. The HCB stops for the insured individual who attains this limit.
Every year, there is an increase by 5% in the Initial Daily Benefit even if there is a claim. This increases up to maximum of 1.5 times the Initial Daily Benefit.
Example – if the insured individual selects the Initial Daily Benefit in the 1st year as INR 4,000 then every year it increases by 5% till it becomes 1.5 times i.e. INR 6,000 in the 11th year.
Major Surgical Benefit (MSB)
In case of a surgery, the amount equals to 100 times the initial daily benefit. Refer the table below.
| Initial Daily Benefit selected | Major Surgical Benefit (MSB) you will get |
|---|---|
| INR 1,000 | INR 1,00,000 |
| INR 2,000 | INR 2,00,000 |
| INR 3,000 | INR 3,00,000 |
| INR 4,000 | INR 4,00,000 |
Total of 140 Listed covered surgeries clustered into 4 categories shown in the below table:
| Category of Surgery | % of MSB will be paid | No. of Surgeries |
|---|---|---|
| Category 1 | 100% MSB | 15 |
| Category 2 | 60% MSB | 42 |
| Category 3 | 40% MSB | 60 |
| Category 4 | 20% MSB | 23 |
For a complete list of surgeries and their category wise distribution click here.
Day Care Procedure Benefit
There is no requirement of hospitalization here. Also, this benefit covers around 140 surgeries, other than the ones covered under MSB. Here, an amount equal to 5 times the initial daily benefit will be provided in lumpsum. For example
| Initial Daily Benefit selected | Day Care Procedure Benefit you will get |
|---|---|
| INR 1,000 | INR 5,000 |
| INR 2,000 | INR 10,000 |
| INR 3,000 | INR 15,000 |
| INR 4,000 | INR 20,000 |
An insured member can avail to a maximum of 3 times for a given year. Every insured member can take the day care procedure benefit for a maximum of 24 times in a lifetime. In this case, hospital cash benefit (HCB) is not payable.
For a complete list of surgeries click here.
Ambulance Benefit
In case of a major surgical benefit falling under category 1 or category 2, an additional lumpsum of Rs. 1,000 will be payable for ambulance expenses.
Premium Waiver Benefit (PWB)
In the event of any member undergoing surgery under category 1 and 2 of Major Surgical Benefit. Every member will have a premium waived off for a complete year. This surgery can be for any member.