health protection plus

8/4/2019 Health Protection Plus

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LICS HEALTH

PROTECTION PLUS

PLAN 902

A LONG TERM UNIT LINKED PLAN WITHALL TYPES OF HEALTH RISK COVER


2/21

USP Long term unit linked Health Insurance policy

Single Policy for all family members

No restriction on number of members

Addition of newly eligible members during the currency of thepolicy.

3 types of benefits viz., Hospital Cash Benefit, Major SurgicalBenefit and Domiciliary Treatment benefit.

Fixed Benefit schemes: irrespective of expenses forhospitalization and Surgeries

Escalation in Hospital Cash benefits with no increase inpremium.


3/21

USP: ( Continued..)

Extended Hospitalization and major surgical risk coverageafter premium paying term

Health Risk cover for hospitalization and Major Surgeries up to75 years for Adults and 25 years for minor lives

No age limit for Domiciliary Treatment Expenses claim

Automatic recovery of risk charges from fund, in case of nonpayment of premiums

No lapse no foreclosure Policy will continue as long as fundis available.


4/21

USP: ( Continued..) Fund grows with the market

Scheme continues for the family members on the death of thePremium Paying Person as long as the fund is available.

Compulsory savings for age related ailments .

Income Tax Rebate under Section 80(D)of the Income Tax Act1961 for full premium paid up to Rs.15000/=

Any time, Any where premium payment facility

Service through Fully Automated Systems.


5/21

The benefits offered:1. Hospital Cash Benefit: (Double for ICU admissions)

Minimum Rs. 250/- Maximum Rs.2500/- for Principal Insured Rs.1500/- for other Insured. HCB of all Insured children are equal. In multiples of Rs.50/- HCB escalates at the rate of 5% per annum subject to a

maximum of 1.5 times.

2. Major Surgical Benefit:

200 times the Hospital Cash Benefit.

3. Domiciliary Treatment Benefit:

Reimbursement of the Domiciliary Treatment Expensesapplicable from the fund value.


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Benefit structure and the limits

Benefit Annual Limit Maximumlimitfor

theentireterm

HOSPITAL CASH

BENEFIT

(excluding first 48

hours and in excess of

subsequent 4 hours)

18 days in first year

including 9 days of

ICU

60 days in subsequent

years including 30days of ICU

365 days

For minor child up to

age 5: 90 days

MAJOR SURGICAL

BENEFIT

200 times Hospital

Cash Benefit

600 times Hospital

Cash Benefit

DOMICILIARY

BENEFIT

(REIMBURSEMENT)

2 times per year after

payment of at least 3

full years premiums.

Benefit starts from 3rd

policy year if mode is

yearly.

No Limit. During HCB

and MSB coverage

period. Up to the

balance of 50% of the

policy fund and one

annualised premium


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Who can be covered?

Proposer From Age : 18 years last Birthday to 55 years

Nearest Birthday. He/She pays the premium and is

Principal Insured

Spouse From Age: 18 years last Birthday to 55 years

NearestB

irthday

Children Children including adopted children from 3 months

to 17 nearest birthday years are admitted. Risk

cover for MSB starts at 18. No restriction in the

number of children to be covered.

Spouse after marriage/remarriage, new born children/ newly adopted

children can also be included after the commencement of the policy.

Cover commences from next policy anniversary after intimation.


8/21

Risk cover up to

Principal Insured Uptotheageof75 yearsnearerbirthday.

Insuredspouse Uptotheageof75 yearsagenearer

birthday

Insured Children Uptotheageof25 yearsnearerbirthday


9/21

Risk cover ceases, when?. On attaining the maximum age

On death of the any of the insured other than Principal Insured(for that insured only)

On non payment of premiums and fund is in-sufficient to coverthe risk.

On exhaustion of maximum limits for each of the benefits foreach of the insured.

Insured spouses cover terminates on the date of divorce/ legalseparation

Benefits are independent for their cessation.


10/21

If premium paying person (Principal

Insured) dies.. No death benefit is payable. However if the Principal Insured

alone is insured then unit fund value is payable to thenominees.

In other cases, On death of the Principal Insured, the policycontinues on other lives till their maximum age or the fundvalue is available to cover the risk or the limit on the risk coveris exhausted whichever is earlier.


11/21

The waiting Period for availing the

benefits. 0 days for accident claims

180 days for Hospital Cash Benefit and Major Surgical Benefitfrom the Date of Commencement

90 days for Hospital Cash Benefit and Major Surgical Benefitafter revival of the policy

Payment of 3 full years premium for reimbursement ofDomiciliary Treatment Benefit.


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The premiumPrincipal Insured alone

to be covered

Rs.5000/= per annum and six times the

Hospital Cash Benefit whichever is higher.

Principal Insured and

Insured Spouse are to be

covered

Rs.7500/= per annum and Six times the

Hospital cash benefit of Principal Insured

plus three times the Hospital cash benefit of

the spouse whichever is higher.Principal Insured, spouse

and Children are to be

covered

Rs.10000/= per annum and Six times the


plus three times the Hospital cash benefit of

the spouse plus three times the hospital

cash benefit of all the insured children

whichever is higher.

Mode allowed : Yearly, Half Yearly and ECS


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The premium for Sub-standard lives

Principal Insured alone

to be covered

Rs.5000/= per annum and nine times the

Hospital Cash Benefit whichever is higher.

Principal Insured and

Insured Spouse are to be

covered


Hospital cash benefit of Principal Insured if

the Principal Insured is sub-standard plus

five times the Hospital cash benefit of thespouse if the spouse is sub-standard ,


Principal Insured, spouse

and Children are to be

covered



plus three times the Hospital cash benefit ofthe spouse plus five times the hospital cash

benefit of all the insured spouse/children if

the insured spouse/children is Substandard,



14/21

The charges from Premium

Allocation charges 30% in the first year

6% from second year onwards

Policy Administration

Charges

Rs.75/= per month during first year

Rs.25/= per month on subsequent years

Fund Management

charges

1.25% of NAV. (NAV declared is net of these

charges)

Health Insurance

Charges

Separate charges for each insured for each of

the benefits viz., HCB and MSB. Depends onthe age nearer birthday on each policy

anniversary. Recovered on monthly basis

Service Charges 10.3% Charges on Allocation charges, HCB

and MSB Charges, Policy Administration

charges and Fund Management Charges


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The policy lapses

If during the first three years if the premium is not paid within days of

grace, the policy lapses. It can be revived within two years from thedate of first unpaid premium on payment of premiums in full.

Deduction of charges will be made as long as the fund is available.

If lapsation continues after two years and fund is insufficient, policy isforeclosed with a simple Notice to the Principal Insured!

After three years, Principal Insured can pay all the premium or availpremium holidays subject to a balance of one annualised premium in

the fund.


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Addition of members

Situation When to

include

The cover starts

from

Marriage/remarriage ofthe Principal insured aftertaking the policy

Within one yearfrom the dateof marriage

The following policyanniversary

A Child born or Legallyadopted child less than 3months after taking thepolicy

Health Cover starts from the policyanniversary falling immediately afterthe child completes 3 months

Legally adopted child is

more than 3 months old

From the policy anniversary falling

after date of adoption

yThe new members will be eligible for the cover only if they satisfy theconditions of minimum premium and benefits.

yNew members must be included by the Principal Insured only. Nonew members will be allowed after the death of the principal insured.


17/21

The policy does not have..

Surrender value

Policy loan

Assignment

Maturity Value

End for the Term as long as fund is available

Death Benefit

Addition of new member after the death of PI. Extension of cover to already existing members

after commencement


18/21

The attractive features of this

policy Extended risk cover after cessation of premiums at the age of 65 of PI. Once HCB and MSB benefits are exhausted, there is no restriction on

the Min. balance for DTB. DTB can be availed on one lumpsum at anyinterval. One can bring an end to their policy.

Contrarily if one wants to continue their policy endless..willcontinue for DTB alone.

Benefits are independent of their cessation

Premium can be increased/decreased depending on the financial

circumstances subject to the conditions of no alternations in minimumpremium requirements and benefits opted .


19/21

Policy servicing

Premium payment facility through any mode : ECS, NetworkedBranches .

All services viz., Change of address, Inclusion of member, Change ofbank account, Deletion of member, Revivals etc, through automatedsystems. Request Process is initiated at Branch level.

Issuance of Health ID cards by Third Party Administrators

Hospital Cash Benefits and Major Surgical Benefits Claims servicesthrough Third Party Administrators

All payments including Claims through LICs Centralized Systems.

Simplest procedure for domiciliary treatment benefits through yournearest offices.


20/21

A comparison with Medi-claim

Charges for a Male Aged 42 years for

300000 SA under a Medi-claim scheme

Rs.4373/= per annum

Charges for a Male Aged 42 years under

LICs Health Plus I: HCB amount of 1500

X 365 = 547500 upto the end of the term

for MSB of Rs.300000/= is Rs.1631.50


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Additional features

Proposer can take this policy for additional5 lakhs SA if already Plan 901 is taken for5 lakhs.

Major students can be covered based ontheir parents income for a max of 5 lakhSA.

Female lives falling under all threecatergories can be covered under thisplan.

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